Open Enrollment November 1 - December 15, 2019

How Soon Does Major Medical Insurance Start?

Open enrollment gives people a chance to shop for health insurance once a year. In 2018, the open enrollment period for coverage starting next year begins on November 1 and runs through December 15. You have other chances to enroll, though. If you have a baby, get married, lose your job or move, you might be able to enroll in a major medical plan thanks to a special enrollment period. No matter when you sign up, though, coverage doesn’t start right away in the major medical world. (Short term health insurance is a different story.) Not sure when your coverage will start based on when you sign up? Here’s what you need to know.

Signing Up During Open Enrollment

As we mentioned above, the federal open enrollment period for ACA 2019 health insurance runs from November 1 through December 15, a period of about six weeks. Whether you sign up at the very beginning of open enrollment, at the very end or right in the middle, your coverage will go into effect at the same time. All plans bought during this timeframe take effect on January 1, 2019.

If you have a 2018 health plan, that coverage will continue until December 31, 2018, as long as you keep up with your premium payments. Your new plan will take effect as soon as the previous one ends. In fact, if you choose to keep your current policy or you’re automatically re-enrolled, you may not even notice any transition period as you move from one calendar year to the next.

Some states that have their own health insurance exchange sites apart from HealthCare.gov can (and do) set their own deadlines for open enrollment. Residents of those states may be able to wait until the end of December or January to choose their plan for health insurance in 2019. An extended signup period gives people more time to decide on the health insurance that’s right for them, but it does impact when coverage starts. If you want your coverage to begin on January 1, 2019, you’ll still probably have to buy your plan by December 15, 2018. Waiting later than that will likely push your effective date back to February or even March.

Special Enrollment Period Signups

Experiencing a major life event can give you an additional opportunity to sign up for an Obamacare health plan or switch to a different major medical plan. Only certain life events qualify you for a special enrollment period, however, and your new healthcare coverage won’t begin right away. You typically have 60 days after a qualifying event to apply for a change in health insurance. The sooner you apply, the sooner coverage takes effect.

When does coverage take effect if you buy it during a special enrollment period? It depends. The general rule for special enrollment periods is that your coverage will start either the month after you submit your application or the month after that.

  • If you apply for major medical coverage by the 15th day of the month, your new plan will go into effect on the first day of the following month.
  • If you wait until the 16th or later to apply, your new healthcare coverage won’t begin until the first day of the month after next.

For example, if you submit your request for coverage on April 13, your plan will have an effective date of May 1. However, if you pick a plan on April 17 – just four days later – your health insurance won’t begin until June 1.

This rule applies to many of the circumstances that can qualify for you a special enrollment period. These include getting divorced, experiencing a shift in income that changes your eligibility for premium tax credits, and being released from prison. Keep in mind that for some of these qualifications, you’re eligible for special enrollment only if you already have a health insurance plan that qualifies as minimum essential coverage.

Exceptions to Special Enrollment Effective Dates

Not all special enrollment periods hold to the general rule about effective dates. There are exceptions to the rule, including adding children to your plan and knowing ahead of time about coverage changes.

Adding Children to the Family

Birth, adoption and foster placements allow you to apply for major medical coverage when these events happen even if you don’t already have a major medical plan in place. You have two options to choose from when applying for insurance after adding a child to your home: retroactive coverage or future coverage.

Retroactive coverage can be retroactive to the date that the child became part of your family. If your baby was born on September 2, for example, then you can opt for your coverage to have an effective date of September 2, even if you don’t fill out the application until October 23. Alternatively, the coverage can go into effect on the first day of the month after you submit your application. If you want to keep your current insurance plan for one more month before switching, this could be a better option for you.

Anticipated Changes

Sometimes, you have advanced notice that you’re going to be experiencing a major life event. Moving to a new state or losing job-based healthcare might be something you can anticipate. In these cases, you might also be able to plan ahead for your new insurance coverage. Your special enrollment period will begin 60 days before your change is to take place, and it will close 60 days after the change.

If you sign up for a new plan in the 60 days preceding the event, you might be able to start your new coverage sooner. Your new plan’s effective date will be the first day of the month after which the change takes place.

Waiting until after the change occurs could lead to delays in coverage. Your new plan won’t start until the first day of the month after you buy it.

As an example, let’s say that you move to a new state on August 10. Picking out a new plan before you move means that your coverage will begin on September 1. Selecting your new coverage on August 11, right after your move, would also qualify you for a start date of September 1. However, because you have a 60-day window after the event to sign up for a plan, you could also wait until early October to make your health insurance change. If you don’t sign up until October 3, your plan won’t go into effect until November 1.

When buying a health insurance plan, consider the start date for coverage. Open enrollment runs for about six weeks. If you don’t have coverage when you sign up for a new plan during enrollment, then you’ll have to wait until the new year to use your health plan. In the interim, you might consider short term health insurance to fill the gap while you’re waiting for your health plan to take effect. Signing up during a special enrollment period can be an issue of timing as well, so consider your options carefully as you look for the perfect plan.

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