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When Health Insurance Starts

In most cases, your health insurance effective date is not immediate.

You have pressed Send on your health insurance enrollment application and paid your premium. Now you are covered.

Maybe, maybe not.

Your health insurance coverage start date—also known as your plan’s “effective date” is when your insurance company will start helping to pay for your medical expenses. Before that date, they will not. In most instances, your effective date is not immediate. In fact, depending on when you sign up for health insurance, your health plan effective date could be more than a month away. The day your health insurance goes into effect depends on which half of the month you purchase your plan.

Professional Advice About Coverage Start Dates

Here’s a simple explanation of how coverage start dates work in many states.

During an Open Enrollment Period

1. If you enroll in a plan between the 1st and 15th of the month and pay your premium by the due date, your coverage will be effective on the first day of the next month.
2. If you purchase a plan between the 16th and the end of the month, you have to skip a month, and your coverage won’t begin until the 1st day of the month after next month—meaning the second following month.

For instance, if you bought a plan on January 3, 2020, you’d be covered starting February 1, 2020. If you purchased a health insurance plan on January 16, your effective date would be March 1, 2020.

If you are eligible for a special enrollment period outside of open enrollment, the health insurance effective dates generally work the same way. After open registration ends, you can still shop for health insurance if you have a qualifying event, a change of life circumstances such as a divorce, or a move to another state. Thus, if you purchase a plan on May 1, expect your coverage to start on June 1. If you purchase your plan on May 16 (or any time after the 15th of the month), your coverage start date most likely won’t be until July 1.

Yup. You guessed it. There are a couple of exceptions here, also.

1. If you have a new baby, whether, by birth, adoption, or placement, any plan you shop on the marketplace will have an effective date starting the day the baby is born or become the child’s legal guardian.
2. If you have to switch insurance plans since you get married or lose your job, your new insurance company must cover you on the first day of the next month, irrespective of when you sign up for coverage.

What Else You Require to Know

You must complete the enrollment form for the start date to be effective.

Remember, for your coverage start date to take effect; you will need to do two things: Complete your enrollment form and pay your first month’s premium. Only after you have done both—enrolled and made your first payment—will your insurance kick in. It is never a bad idea to call your insurance company just to be sure everything is in order, and to confirm the day your coverage will go into effect.

References and Resources

• Buying Health Insurance
• Health Insurance Enrolment Form