Health insurers nationally said they would give consumers until Jan. 10 to pay for health coverage starting Jan. 1 as part of government-run exchanges under the federal healthcare law.
But some state exchanges, including those of California and Connecticut, indicated they would stick with slightly different deadlines that were already extended. The extensions come amid a sharp rise in applicants and continued difficulties for many people trying to navigate the sign-up process.
Consumers who want coverage that starts Jan. 1 must enroll by Monday.
Then they must pay their insurance company the first month's premium for a policy to take effect. Federal and state officials had already pushed back enrollment and payment deadlines to allow consumers more time, particularly during the busy holiday season.
In California, however, the executive director of the Covered California marketplace said it would keep its Jan. 6 payment deadline, and it will be reminding applicants to follow through on time.
"This bill is not one to sit on," the executive director, Peter Lee, said on a conference call Wednesday with exchange officials from other states. "The coverage has to be made effective by payment. I doubt any health plans will provide unlimited care for someone who might pay."
Connecticut has set a payment deadline of Jan. 7. New York's state exchange said it would allow people a 10-day grace period until Jan. 10, similar to what insurers announced.
For people who miss the January cutoff, open enrollment continues through March 31.
The Jan. 10 extension was announced by America's Health Insurance Plans, a trade group. It cited the holidays and technical problems at the federal exchange serving 36 states as reasons for granting more time.
"Our community is taking an important step to give consumers greater peace of mind about their healthcare coverage," said Karen Ignagni, the group's chief executive.
Federal officials applauded the insurance industry's move. But officials and patient advocates also urged consumers to check with their health insurer because some companies may have different requirements for payment.
"Consumers should still check with their issuer to confirm the date their first month's premium is due," the U.S. Centers for Medicare and Medicaid Services said in a statement.
The differing deadlines and shifting dates during the initial enrollment period have made a complex healthcare law even more confusing to some consumers. Many people have grown frustrated at a lack of clarity on the status of their application, from either the exchange or their insurance company.
Anthony Wright, executive director of Health Access, a consumer advocacy group, urged people to check with their insurance company as soon as possible to ensure they aren't saddled with unexpected medical bills.
"You don't want to be stuck without coverage," he said. "You never schedule going to the ER."