Ambetter (GA): Large Bill stating Premium Delinquency

This isn't my personal issue, but rather my cousin. He received a large bill the other day requesting I believe over $5,000 in premium delinquency. He ended up calling Ambetter and this letter was sent explaining the bill.

Letter: https://imgur.com/UdUgGUt

3 people were on Ambetter plan. My uncle died and now there are only 2 people left on it.

01/01/2022 – 06/07/2022 : Ambetter Balanced Care 31 with a base rate of $1851.61 and tax credit of $1851.61 leaving the monthly premium to $0.00.

My uncle died on 06/07/2022. The policy was requested to be terminated on that date, but as far as my knowledge goes, they did not request the policy termination themselves. I would assume it was terminated to be re-adjusted to a 2-person policy plan.

To prevent a lapse in coverage, the policy was retroactively amended from 07/01/2022 to 06/08/2022 by Ambetter with the Ambetter Balanced Care 31 policy again except the base rate is now $1027.94 with no tax credit. Effectively making the premium $1027.94 a month.

Then back to the next year, the plan swaps to the Clear Silver plan but gets withdrawn from immediately on New Years and they're enrolled on the CMS Standard Silver plan with a base rate of $1043.92 and tax credit of $968 so now their monthly premium is $75.92.

Ambetter is requesting a binder payment of $6424.29 to effectuate the coverage from last year. Is there a way where he can amend this and get the tax credit back onto the bill or get the bill lowered in general? I personally told him to call Ambetter and see about it but he really knows nothing about insurance and is afraid he'll mess up the bill if he calls again. My other uncle told them to just pay the bill when they had extra money. I told him that I'll try to research more about it, so if anyone has any information about this kind of situation and what he should do. I really don't want them to be stuck with this bill that they don't deserve.

See also  Trouble getting provider to bill insurance

submitted by /u/lxz9
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