64.06 Late payment/grace period
Grace Period An individual enrolled in Dr. Dynasaur is entitled to a premium grace period as described in this paragraph (1) if the individual has not paid their monthly premium by its due date. The grace period starts the day after the due date, extends 60 days and ends on the last day of the month in which the 60-day Eligibility-and-Enrollment Procedures Part 7 – Page 45 (Sec.64.00, Sub.64.07) period ends.102 During the grace period described in paragraph (1) of this subsection, Medicaid will pay all appropriate claims for services rendered to the individual. (b) Notice of premium nonpayment and reinstatement If a full premium payment is not received by AHS on or before the premium due date, before the fifth business day of the grace period, AHS will send a notice advising that the individual is in a grace period status. The notice will also advise the individual: (i) Of the Dr. Dynasaur disenrollment protection as provided under § 64.07; (ii) Of the consequences of being in a grace status; (iii) The actions the individual must take to resume good standing; and (iv) The consequences of exhausting the grace period without paying all outstanding premiums. At least 11 days before the end of the grace period, AHS will send the individual a closure notice advising that enrollment will terminate at the end of the grace period. Subject to the payment allocation described in (4) below, if AHS receives at least a full premium payment for the grace period on or before the end of the grace period: (i) The payment will first be applied to cover the premium due for the grace period; (ii) The individual will be reinstated; and (iii) The individual will be reenrolled for coverage in the month following the grace period. Payment allocation. If an individual is in grace period status for more than one unpaid premium when AHS receives payment and the payment covers the premium due for at least one, but fewer than all, of the grace periods, the payment will be applied as payment of one or more premiums in full and allocated in chronological order beginning with the oldest grace period. If AHS receives a full premium payment for the grace period after the end of the grace period, the individual will not be reinstated or reenrolled, and will need to re-apply.