Pay Your Monthly Premium

Pay your premium

Member Announcement

 

If you have not submitted your monthly premium payment, please read below for important information about your benefits.
 

If you have made your payment, thank you!
 

If you are late, you will be subject to a grace period. A grace period means that you are in “late” status but gives you extra time to get caught up with your premium payments so that your policy is not terminated. There are two different grace periods: For those who are receiving a subsidy, also called an Advanced Premium Tax Credit (APTC), the grace period is 90 days. For those who are not receiving APTC, the grace period is 30 days.

 

 

  I receive APTC (a subsidy) I do not receive APTC (a subsidy)
How long is my grace period? 90 days. This is how long you have to get caught up with your premium payments from the first day of being late. 30 days. This is how long you have to get caught up with your premium payments.
When does my grace period start? The first day after you become late. The first day after you become late.
Does my grace period change if I make a payment? No, unless you completely become current with payments and pay everything you owe. No, unless you completely become current with payments and pay everything you owe.
Will my medical claims get paid if I am in my grace period? First 30 days of grace period. Yes.
 
Day 31–90 of grace period. No.  They will be put in “pended” status.
 

Day 91 and after. No. All pended claims will be denied if you don't pay by Day 90.

No. They will be put in “pended” status.
 

All pended claims will be denied if you don’t pay by day 30.

Can I fill prescriptions during my grace period? First 30 days of grace period.  Yes.

Day 31 and on.  No.
No.
 
 

Payment Options

If you have a monthly premium, MDwise provides the following payment options:
  • Major credit card
  • Debit card
  • Prepaid debit card
  • Money order
  • Check
  • Electronic Funds Transfer (EFT)
  • Over the phone by calling 855-417-5615
 

Set Up Automatic Payments

Learn more about how to set up an automatic payment of your premium.

Make your check or money order payable to MDwise Marketplace. Mail your payment to:
MDwise Marketplace Inc.
33216 Collection Center Drive
Chicago, IL 60693-0331

Note: for Healthy Indiana Plan members click here to make your payment by using WISEpay.
 

I’ve already applied, when do I need to pay my premium?

Payments must be made by the end of the month. If you are not a fully eligible member and are making your first payment you must make the payment by the end of the month in order to be eligible the following month.
 

If you enroll… You must pay your
premium by…
In order for coverage
to begin on…
Between the 1st and 15th day of the month The last day of the month
you sign up
The first day of the
following month
Between the 16th and the last day of the month The last day of the month after the month you sign up The first day of the second following month


What if my payment is late?

Premium payments are due in advance on a calendar month basis. Monthly payments are due by the last day of the month before coverage begins. This means that if any required premium is not paid before the date it is due, the policy will be subject to a grace period.


What is the grace period? What happens during the grace period?

Special Note: There are two different grace periods. One for those who are receiving Advanced Premium Tax Credits (APTC) the grace period is 90 days. For those who are not receiving Advanced Premium Tax credits the grace period is 30 days.

During the grace period the policy will stay in force, however, claims may pend for covered services provided to the member during the grace period. We will notify the Health Insurance Exchange Marketplace, the member, as well as providers of the non-payment of premiums and the possibility of denied claims when the member is in the grace period.
 

I received my invoice and I don’t know what APTC means.

APTC stands for Advanced Premium Tax Credit. Due to your income you were determined to be eligible for a new tax credit to lower the cost of your health coverage purchased through the Marketplace. Advance payments of the tax credit can be used right away to lower your monthly premium costs.


What happens if I don’t make my payment by the end of the grace period?

If you fail to pay your premiums, you will lose your insurance coverage. You will not be able to rejoin a Marketplace Health Plan until there is a new open enrollment or qualifying event and you will be responsible to pay any medical bills you incur. You may also have to pay a penalty when you file your taxes next year if you go without qualifying coverage for more than three months during the year.


If I pay by credit card, check or debit card, how quickly will I be able to see this in my account?

Although most credit card transactions will appear on your account almost immediately, you should wait at least six days to see bank transactions posted.


How often do invoices go out and when?

As HealthCare.gov sends us new conditional members, the initial invoice for each will go out within three to four days; after that, recurring invoices will be mailed on the tenth of each month.


I received an invoice from MDwise Marketplace, but I have obtained other coverage through my employer. What should I do?

You need to go to HealthCare.gov and cancel your MDwise policy. However, you should be sure your employer-sponsored coverage is a qualified plan and that it is less expensive for you. You should check with your employer before cancelling your MDwise Marketplace policy.


I received an invoice for my insurance, but I think the premium is incorrect. What should I do?

This depends on the answers to these questions:
1. What plan did you enroll in?
  • If the invoice is reflecting a different plan than what you thought you enrolled in, you need to cancel the current plan through HealthCare.gov and reenroll in the plan you intended to enroll.
2. Did you enroll any dependents?
  • If the answer is “No” and the invoice has dependent information, you need to contact HealthCare.gov to have the dependent(s) removed.
3. Is there a balance forward amount on the invoice?
  • If the answer is "Yes" and you have questions on this amount please call MDwise Marketplace customer service.


I received my invoice, but my address has changed and it came late. What do I do?

If you are within the grace period, you must make payment before that expires to avoid loss of coverage. You also need to notify HealthCare.gov of the change in your address. Depending on where you moved, you may not have the same service delivery area, which means you will need to reenroll and pick a new PMP.

If the payment due date has passed the grace period date, there is no reinstatement for unpaid premiums past the grace period; you will have to wait until the next open enrollment period. You may also have to pay a penalty when you file your taxes next year if you go without qualifying coverage for more than three months during the year.