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If I enroll in the exchange, will that coverage take effect immediately?

  • By
  • healthinsurance.org contributor
  • April 18, 2016

Q: If I enroll in the exchanges, will that coverage take effect immediately? What’s the earliest my coverage will take effect after I complete the enrollment process?

A: No, it will not take effect immediately. Your coverage effective date mostly depends on the date that you enroll, although there are some qualifying events that allow for effective dates that differ from the regular schedule.

But the regular schedule in all but three states works like this:

  • If you enroll by the 15th of the month, your coverage will take effect the first of the following month.
  • If you enroll between the 16th and the end of the month, your coverage will take effect the first of the second following month.

So an enrollment completed on May 9 would have a June 1 effective date, but an enrollment completed on May 17 would have a July 1 effective date.

Three states with different rules

There are three states – Massachusetts, Rhode Island, and Washington – where the exchanges allow people to enroll as late as the 23rd of the month and still have a first of the following month effective date. So May 17 enrollment in one of those three states would result in a June 1 effective date (but a May 24 enrollment would result in a July 1 effective date).

Qualifying events

If you’re enrolling during a special enrollment period triggered by a qualifying event, effective dates mostly still follow the same schedule outlined above. But if you get married, you’re eligible to get coverage effective the first of the following month, regardless of how late in the month you enroll. And if you have a baby, adopt a child, or receive a court order for medical child support, the coverage can be backdated to the date of the birth, adoption, or court order.

2017 open enrollment

Open enrollment for 2017 coverage will start on November 1, 2016. The first available effective date will be January 1. And in all but three states, you’ll need to complete your enrollment by December 15 in order to have coverage effective January 1, 2017. Open enrollment for 2017 will continue until January 31. But enrollments completed after December 15 will have coverage effective in February or March, depending on when the enrollment is completed.

Outside the exchanges, effective dates generally follow the same rules as inside the exchanges. When exchanges offer extensions (which is becoming less common now that the glitches are mostly worked out and consumers know what to expect), carriers can opt to allow the same extension outside the exchange, but they’re not required to do so.

 

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