There’s generally a short waiting period between when you enroll in health insurance coverage and when your plan actually begins to cover you. But not always. The coverage delay can range from a few days to up to a year. It all depends on the type of insurance you enroll in — from the Affordable Care Act (ACA, also known as Obamacare) health plans to workplace coverage — as well as the time of year you purchase it.
If you’re not comfortable going without insurance for, say, even a month, it’s possible to get at least some insurance protection for emergencies with a short-term insurance plan.
Waiting Period Rules for ACA Insurance Purchased During Open Enrollment or Special Enrollment: If you’re buying health insurance on your own on a Marketplace Exchange, your health insurance waiting period generally starts on the following:
- First day of the next month. This applies when you enroll earlier than 15 days from the start of the next month. For example, if you buy health insurance up to November 15, your coverage will start on December 1.
- First day of the month following the month you enroll. If you enroll on the 16th or later, coverage begins in one-and-a-half months. For example, if you sign up for health insurance on November I6 or later, your coverage starts January 1.
- Immediately, if you have a genuine life-changing event such as moving to a new zip code, marrying, adopting a child, or giving birth. Check the federal government’s full list of acceptable life-changing events at https://www.healthcare.gov/glossary/qualifying-life-event/.
Waiting Rules for Workplace Insurance
With workplace plans, some companies impose a 30-day to a 365-day waiting period before coverage begins. Be sure to inquire about your new health benefits, including the waiting period, before starting a new job. A phone call or email to HR or your future manager should protect you against going to work, signing up for insurance, and then finding out your coverage doesn’t start for months. If you do face a gap in coverage, you may want to consider purchasing COBRA coverage from your old employer or a short-term health insurance plan from a private insurer in the states where those policies are available.
Look into the benefits and pitfalls of short-term policies before you enroll. Overall, this coverage offers low premiums and coverage for emergencies and urgent care, but little more. Assuming you are in good health, a short-term plan may protect you from an unforeseen serious illness or injury. What’s more, the coverage may start as soon as the day after you enroll. But short-term plans typically do not provide any of the 10 essential health benefits or many other benefits that are provided in ACA compliant plans. Most importantly, short-term plans almost always do not cover preexisting conditions, including in some cases, conditions not diagnosed at the time you enroll. Also, without ACA essential benefits, four states — California, Massachusetts, New Jersey, Rhode Island — and Washington, D.C., may impose a penalty on your income tax return for not maintaining what’s called credible health insurance. In essence, short-term plans provide catastrophic coverage for a few months at a time for sudden emergencies, like serious illness or injury from a car accident or fall.
Employer-Based Health Insurance: If your company offers health insurance, it can postpone your coverage for anywhere up to a year after you begin work. On the other hand, coverage can start as soon as your first day on the job, depending on your employer’s insurer.
You can get employer-based insurance even if you apply outside of the annual health insurance open enrollment period because a new job is a “qualifying life event” that allows you to purchase major medical health insurance immediately.
Medicare: As long as you plan ahead, you can get Medicare and supplemental Medicare coverage that begins on the first day of the month that you turn 65 years old. There are a number of Medicare rules that determine whether you’re automatically enrolled and when your coverage will begin. Go to the federal government’s website for the details to get Medicare at 65, https://www.medicare.gov/sign-up-change-plans/get-started-with-medicare.
Medicaid: If your application for Medicaid is approved, then coverage will begin on either the day that you applied or the first day of the month that you applied. The specific rules will depend on your state and should be explained in your application. If you are uncertain, go to your state’s Medicaid website.COBRA: COBRA allows you to continue your health benefits provided by your employer with no break in coverage for a year or more, typically when you lose your job. Most likely, you will be required to pay your premiums and all medical bills on your own, since your old employer will stop contributing — typically burdening you with hefty costs. But you still have continuous insurance coverage.