Coverage Start Date Explained

Coverage Start Date Explained

2019-01-09T10:14:43+00:00Friday, November 14, 2014|

Basic Explanation

You’ve pressed Send on your health insurance enrollment application and paid your premium. Now you’re covered, right?

Maybe, maybe not.

Your health insurance coverage start date—also called your plan’s “effective date”—is the day your insurance company will begin helping to pay for your medical expenses. Before that date, they won’t. In most cases, your effective date isn’t immediate. In fact, depending on when you sign up for health insurance, your 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 buy your plan.

Expert Advice About Coverage Start Dates

Here’s a simple explanation of how coverage start dates work in most 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 start the first day of the next month.
  2. If you buy a plan between the 16th and the end of the month, you have to skip a month, and your coverage won’t start until the 1st day of the month after next month—meaning the second following month.

For example, if you bought a plan on January 3, 2015, you’d be covered starting February 1, 2015. If you bought a plan on January 16, your effective date would be March 1, 2015.

If you qualify for a special enrollment period outside of open enrollment, the effective dates generally work the same way. After open enrollment ends, you can still buy health insurance if you have a qualifying event, a change of life circumstances such as a divorce or a move to another state. So if you buy a plan on May 1, expect your coverage to start on June 1. If you buy 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, too.

  1. If you have a new baby, whether by birth, adoption, or placement, any plan you buy on the marketplace will have an effective date starting the day the baby is born or you become the child’s legal guardian.
  2. If you have to switch insurance plans because you get married or you lose your job, your new insurance company must cover you on the first day of the next month, no matter when you sign up for coverage.

What else you need to know

Remember, for your coverage start date to take effect, you’ll need to do two things: Complete your enrollment form and pay your first month’s premium. Only after you’ve done both—enrolled and made your first payment—will your insurance kick in. It’s 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.