Common Payment Questions

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.

I forgot to mail my payment and I have lost my coverage. How can I be reinstated?

We are sorry, but there is no reinstatement when you have failed to make your payments within the grace period. You will have to wait until the open enrollment period next fall.

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 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 and cancel your MDwise Marketplace 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 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 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 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.