It depends on your situation, and generally if you have no coverage during January you can still sign up for coverage thru the end of the month, with either a February or March effective date. There are some exceptions such as if you lost coverage in the past sixty days you can get new coverage faster, in some cases even retroactively to the first of the current month in some limited scenarios.
All hope is not lost if you didn’t sign up and haven’t had coverage. Even without a life change which would yield a special election period, those who historically have had no coverage are still eligible to sign up. For those without coverage, you can sign up via a well versed broker, or via the government healthcare marketplace. Either way it’s critical that the application is complete and submitted by midnight Pacific Time on January 31st to ensure coverage. This is the end of the annual open enrollment period for individual health plans in the United States.
Those who have a qualifying life event can enroll in new coverage at any time of the year, subject to time limits set based on the type of life event. Qualifying life events (not an exclusive list) include things such as getting married or divorced, having a baby (good for whole family to change plans), death of a family member, moving outside the current plan’s service area. Gaining a job with coverage or losing a job under which coverage was provided. There are some other very unusual special circumstances I won’t discuss because they are so extremely rare.
When a qualifying life event occurs coverage will typically be issued, assuming timely application on the part of the insured, where no gap in coverage exists. More often than not, application would need to be completed within thirty days of the qualifying event to ensure no gap in coverage. Some events will even allow completion of the application ahead of the event to allow a no gap in coverage situation. (Loss of coverage thru an employer for instance, if you are no longer employed mid moth but coverage remains in place thru the end of the month an application can be completed before the first of the new month ensuring timely no-gap coverage.)
For things such as marriage and birth, an application should be completed as quickly as possible following the event. Failure to meet timeliness requirements will leave those without coverage uncovered until the following January, unless another life event occurs. This is especially critical at the time of a birth.
Although Medicaid is an option for some, typically under 100% or 138% of the Federal Poverty Level, don’t assume it is a given in any situation, especially in states that did not expand the Medicaid program where historic enrollment requirements prevail. In these situations it is far more difficult to apply for and be granted Medicaid than in states where expansion occurred. Regardless if you believe you qualify for Medicaid don’t wait until there is a need to use the coverage to apply, do so when other coverage is lost so you will know with certainty if it will work or not. If not, then secure other coverage in a timely manner.
Regardless of circumstances nobody can just wait until they are sick or injured and then apply for coverage and have it retroactively pay for the care needed. (Only when a life event occurs at the same time would this ever be allowed, and even then it’s allowed solely based on the life event qualifications.) Those who don’t use the healthcare system often find these provisions difficult, but when one looks at how costs would be if everyone could skip coverage while healthy and only pay for and use it when the insurer has to pay claims, it would make premiums we see today look very inexpensive.
Ultimately if you don’t have coverage in place today get with a broker or go on the exchange and sign up. Failure to do so will yield hefty penalties at tax time next April. If you lose coverage and have a qualifying life event fill out the extra page or two on the application and get new coverage so you remain covered.