It’s a requirement of the Affordable Care Act for you to have health insurance or face paying a penalty. The question is, once you have purchased health insurance how soon are you actually covered?
If you have to have health insurance then you’re going to want to be covered by it as soon as possible; you’ll need to make sure that you’re provided for should you encounter any health problems. This is especially the case given the high costs of health care today.
I’m buying a policy so when will it start?
The health insurance market place was created as place for people to be able to purchase affordable health insurance during a certain period each year (the enrollment period). If you buy your health insurance at the marketplace then the date it starts is dictated by the date on which you make the purchase.
Normally if you buy your health insurance policy between the first day of the annual enrollment period and the third week in December then the policy will come into effect on the first day of the new-year. If you purchase after this time then certain rules apply.
A policy bought between the 1st and the 15th of the month comes into effect on the first day of the month following the purchase. A policy bought at any other time of the month comes into effect on the first day of the month after the month following purchase.
What if you need life insurance outside of the enrollment period?
There are provisions in place that allow you to apply for health insurance in a special enrollment period in certain circumstances. These circumstances include the loss of your current health care provision. The special enrollment period lasts for 60 days and the same rules of entitlement apply as for the normal enrollment period.
You do have the option to apply for health insurance outside of the market place altogether; you should note that from 2015 your policy will need to cover the same basic requirements as those applicable within the marketplace.
If you apply outside of the marketplace then you will need to check with your insurance provider when the policy becomes effective. In most cases your coverage will commence in the month after you purchase the policy and you will need proof of coverage for when you have health care.
So you’re covered but what happens if the insurer refuses your claim?
If the insurer believes that your treatment isn’t a medical necessity, or if you’re claim is deemed to be out of time, then you may find your claim is refused. There are many reasons why a refusal can happen. You shouldn’t feel that this is the end of the matter as you do have the right to appeal the decision. The first part of the process is an internal appeal looked at by your insurer and the second part is an external review which is considered by a third party.