Understanding Health Insurance Coverage Effective Dates

Once you have picked a health insurance policy and paid your first month’s premium, you probably expect your coverage to begin immediately. However, depending on when you enrolled and under what circumstances, you may have several weeks before your health insurance coverage takes effect.

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When Does Health Insurance Coverage Begin?

Your health insurance plan’s effective date is the day your coverage begins. Usually, your health insurance policy coverage will begin the 1st of the month following your enrollment. It may be different depending on many factors. Ask your human resources representative at your job, or your health insurance agent (if you had an agent help you buy a plan), when your policy begins. “Qualified Health Plans” for the most part begin on the 1st of the month. This is true for Medicare, and any Qualified Health Plans. If you enroll during “Open Enrollment” for individuals and families between November 1st and December 31st, your plan will begin January 1st.

Health Insurance Coverage Effective Dates

Depending on your policy, this is the date when your medical costs that you pay, such as, co-pays, coinsurance, prescription drugs co-pays, or any money you spend on qualifying health care services, counts towards your deductible and annual out-of-pocket limit.

Types of Enrollment Periods

There are two types of enrollment periods. The period in which you sign up for coverage affects when coverage begins.

Open Enrollment Period

The Open Enrollment Period normally runs from November 1 through January 15th each year but can change. When you enroll in November or December, your health insurance takes effect on January 1st. If you apply on or after January 1st through January 15th (which is the last day to enroll during open enrollment) your coverage will begin February 1st.  After January 15th each year, you’ll need an “SEP” to enroll.

Special Enrollment Period (SEP)

If you sign up for a new policy outside of the yearly open enrollment period, you must have a qualifying life event. A “Qualifying Life Event” can be getting married, having a baby, moving into Nevada and losing your coverage, etc. You’ll have a Special Enrollment Period of 60 days to start a new plan. The coverage will be effective on the first day of the following month, regardless of when you signed up. For example, if you do not sign up until July 17, your coverage will take effect August 1. The exception to the rule is the birth/adoption of a baby. The baby’s coverage will be back dated to the birth/adoption.

If you apply within those 60 days and you purchase a health insurance policy prior to the end of the month, then you can expect your health insurance to take effect on the first day of the following month.

Waiting to Purchase Coverage Is a Gamble

The benefits of robust health insurance are easy to overlook, especially if you are young or enjoy generally good health. However, anyone can experience a sudden and serious injury or illness. Without health insurance coverage, you may be on the line for tens or even hundreds of thousands of dollars in medical debt. Because of the way health insurance enrollment periods and effective dates work, it is not a good idea to wait until you need coverage to purchase it. You will find yourself uninsured with large medical bills.

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Finding Affordable Health Insurance with Nevada Insurance Enrollment

Understanding when your health insurance coverage goes into effect can help you make informed decisions about when to schedule primary care services or what your options are if you experience an injury or illness. At Nevada Insurance Enrollment, our experienced health insurance agents assist you in comparing policies and find the right one for your needs and budget. We can also help you review your health insurance policy and determine when your coverage begins.

Related Articles:

Major Medical vs Other Types Of Health Insurance Coverage

Individual Health Insurance vs Group Health Insurance: What’s the Difference?

Health Insurance, Vision Insurance or Both?

What Is a Qualified Health Insurance Plan?


Read More: Health Insurance in Las Vegas, Nevada


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