APTC Grace Period and Premium Payment Details Now Easier to Find

Flu vaccinations

Delays in a HumanaOne® member’s premium payments may result in a pended or denied claim or a request for a claims refund. Humana offers several ways for health care providers to check a patient’s eligibility.

Using the Availity Web Portal, Humana.com secure portal, interactive voice response (IVR) or X12 transaction, health care providers will get a message or messages that will indicate if the following situations apply:

  • The member’s initial premium payment has not been received.
  • The member’s most recent premium payment has not been received.
  • The member is within the first, second or third month of the advance premium tax credit (APTC) grace period. (The grace period month will be specified and a paid-through date provided.)

This information is provided whether the member is on-exchange or off-exchange. The grace period information applies only to on-exchange members receiving the APTC.

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