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What’s the deadline to enroll during open enrollment if I want a January 1 effective date?

  • By
  • contributor
  • September 30, 2015

Q. What’s the deadline to enroll during open enrollment if I want a January 1 effective date for my new coverage?

ACA open enrollment guide

The Insider’s Guide to Obamacare’s Open Enrollment offers time-saving strategies for selecting coverage during open enrollment. (Click the image for a free download.)

A.  In almost every state, you’ll need to enroll by December 15 in order to have coverage effective January 1.

However, there are three states that have regular monthly deadlines after the 15th of the month to get a first of the following month effective date: MassachusettsRhode Island, and Washington all allow consumers to enroll or make a plan change up until the 23rd of the month and still have a first of the following month effective date, so in those states, your enrollment needs to be completed by the 23rd of December.

But in the remaining 47 states and the District of Columbia,

  • Enrollments submitted between November 1 and December 15 will have a January 1 effective date.
  • Enrollments submitted between December 16 and January 15 will have a February 1 effective date.
  • Enrollments submitted between January 16 and January 31 will have a March 1 effective date.
  • Open enrollment for 2016 ends on January 31.

Special rule for loss of coverage

If you have a grandmothered plan that is being terminated on December 31 (all grandmothered plans in Oregon and Colorado will terminate at the end of 2015), you’ll be able to enroll in a new plan as late as December 31 and still get a January 1 effective date, as long as you indicate that your enrollment is being triggered by a qualifying event (loss of coverage is a special qualifying event that allows an effective date the first of the following month regardless of how late in the month you enroll).  However, waiting until the last minute isn’t recommended, as it will still take time for the enrollment to be processed and the new insurance policy and ID cards to be mailed to you.

Don’t count on extensions

In 2013 and 2014, there were nearly universal extensions granted in December, allowing people to enroll after the scheduled deadline and still obtain a January 1 effective date. The extensions were generally granted due to technical problems with the exchange and high volume that prevented call center staff from helping everyone prior to the deadline.  It’s possible that some extensions could be issued again this year, but don’t count on it.  Err on the side of caution, and plan to get your enrollment completed by December 15.

The sooner the better

The enrollment process gets more efficient and user friendly with each passing year, but it’s wise to assume that there will still be some web glitches, billing errors, and delays during open enrollment. Even if you’re enrolling off-exchange, the sheer volume of applications that are likely to come in during December could result in longer processing times.

So although you can enroll on December 15 and still get a January 1 effective date, you might not actually receive your policy until later in the month. It can be tedious if you need to use your coverage before everything has been finalized by your carrier. Sometimes this involves paying for your care up front and getting reimbursed later on. It’s certainly better than not having coverage at all, but life will be easier if don’t wait until the last minute.