Q. If I turn down my employers’ offer of insurance and then am in an accident, don’t I have a right to sign up for coverage?
A: No. You can only purchase coverage in the individual market during open enrollment periods, or during special enrollment periods triggered by qualifying events (getting sick or hurt is not a qualifying event). The open enrollment period for 2017 coverage will run from November 1, 2016 to January 31, 2017.
For 2018 coverage, the same November-January window will be used. But starting with 2019 coverage and going forward, the open enrollment window will be November 1 – December 15, with all coverage effective January 1.
It’s important to note that coverage in the individual market is not available at all – on or off-exchange – unless it’s open enrollment or you’ve got a special enrollment period (Nevada is an exception; off-exchange coverage is available year-round in Nevada, but with a 90-day waiting period).
So going without coverage is a risky choice. The only plans that are available year-round are those that are not regulated by the ACA, such as short-term policies. But those do not have to cover pre-existing conditions, so you might find yourself out of options if you go uninsured and then get sick or hurt.
However, Medicaid and CHIP are available year-round for people who are eligible. Medicaid has been expanded in 31 states and DC, and anyone with household income up to 138 percent of the poverty level is eligible for Medicaid in those states. If you’re eligible for Medicaid, it’s best to enroll as soon as possible however, so that you can begin to have access to primary care immediately, rather than waiting until you’re sick.