Premium Payments and Income.
You will receive a paper bill in the mail and you can sign up for auto-pay. Ignore emails from the marketplace about making a payment – you cannot pay through their site – even though they are inviting you to
If your policy payment is 30 days late, your policy will cancel for non-payment and you can’t reinstate it outside Open Enrollment (11/1 to 12/15).
If your premium should increase unexpectedly during the plan year, contact us right away. This is a symptom of an issue with your application which must corrected immediately.
Contact us to discuss the situation. Please do not contact the Health Insurance Marketplace directly unless we advise you to do so, as there may be unintended consequences for you.
If your premium is unaffordable or your income drops dramatically or there is a large adjustment on your tax return, let us know as soon as possible.
Your plan choice and access to doctors
Before you make any medical appointment, call your insurer to confirm that the provider is in your plan's network.
- All Anthem plans are HMOs with no coverage in the CMMC family of providers. This does not guarantee that a non-CMMC doc is in network, however.
- All Harvard Pilgrim Maine’s Choice HMO plans have a two-tiered provider network with CMMC providers in the standard, not preferred, network. Your PCP must be in the preferred network and your claims in the standard network will be applied to a separate, and larger, deductible and out of pocket maximum.
- Only PPO plans have coverage outside their network, but the deductible is 2x the in-network deductible.
You cannot change the plan you are enrolled in or add people to your plan after December 15th unless one of the following events occurs: Significant drop in income, Marriage, Divorce, Birth, Adoption, or you move to another state. Contact us if one of these events occurs.
Your plan choice and access to doctors
Eligibility for other coverage
If you get offered coverage through a job, please contact us. To determine if you can keep your current plan (and the Premium Tax Credit you receive with it), we need to know how much it will cost you to enroll in the plan, and how much it will cost you to add a spouse and/or children and what the coverage is (deductible, out of pocket maximum.)
In a word, no. If you are approaching your 65th birthday, or your 25th month of eligibility for Social Security Disability Income, call us to discuss your options under Medicare. You are REQUIRED to switch to Medicare from Obamacare as soon as you are eligible to do so.
We cannot look up your claims information and we cannot take your payments nor tell you the amount that you owe or the payment due date. So we recommend you contact the insurer FIRST with your questions about pending claims or bills and then call us afterwards. We will do our best to advise you.
The marketplace sends out a lot of email, but the official letters always come in the mail. As a result, you are free to unsubscribe from any phone calls or emails from the Health Insurance Marketplace. If you get a notice from the Marketplace in the mail and action is required, please contact us before contacting the Marketplace.
If you have a login for www.healthcare.gov and can’t sign in, you’ll need to contact the Marketplace. We recommend you have them email you a temporary password (rather than sending a link to reset the password.) However, we can perform any task on your behalf – like getting a 1095A form, or updating your application, or updating your income estimate, and so on. So do please contact us first before you call the Marketplace. It might save you 30 minutes or more on hold.
Just have them mention your name when we ask them how they heard about W.J.Wheeler. Send new customers our way and you will receive a small gesture of our thanks and a chance to win up to $1,000 in our annual Referral Rewards drawing.