How to buy health insurance today

The fact that you’re reading this article suggests that you need to buy health insurance coverage soon. So what are your options for buying a health plan today, tomorrow, or at any other point during the year?

It depends on the type of insurance and when you enroll

The first thing you need to know before buying health insurance is that signing up for health insurance coverage isn’t the same thing as having coverage in effect. You may be able to enroll in a health plan today, but that coverage may not take effect for several weeks.

In the ACA-compliant market, individual/family health plans can only have first-of-the-month effective dates (with an exception for new babies or newly adopted children). So in most cases, if you’re applying during a special enrollment period, your coverage will take effect the first of the following month.¹

But plans that aren't regulated by the ACA can offer effective dates as soon as the day after you apply. And Medicaid can backdate your effective date to the start of the month you apply, or even earlier in many states. Your effective date depends not just on when you apply, but also on the type of coverage you're getting.

So what are your options for getting coverage that’s effective ASAP?

ACA-compliant coverage with a qualifying life event

Although open enrollment has ended for 2026 coverage, you may still be able to enroll in an ACA-compliant health plan if you're eligible for a special enrollment period. In most cases, special enrollment periods are triggered by a qualifying life event. If you enroll in a plan through the Marketplace/exchange during a special enrollment period, you may be eligible for income-based premium subsidies and possibly cost-sharing subsidies.

Our in-depth guide to special enrollment periods explains how the rules work for each qualifying life event, and what you can expect if you're using a special enrollment period to sign up for health coverage.

It’s important to understand that in many cases, you’re only eligible for a special enrollment period if you already had minimum essential coverage in place before the qualifying life event.

American Indians and Alaska Natives have year-round access to Marketplace enrollment. As discussed in more detail below, some states offer year-round access to certain health plans for enrollees with relatively low income.

But in most cases, if you don't qualify for a special enrollment period, you’ll have to wait until open enrollment (November 1 through December 15 in most states) to buy health insurance coverage. And plans purchased during open enrollment take effect January 1. So  some people look to short-term health insurance to bridge the gap between signing up and having coverage in effect.

• Related: Qualifying life events that trigger ACA special enrollment
• Related: Special Enrollment Period 2026 Guide
• Related: Frequently asked questions about enrollment

Short-term health insurance

Short-term health insurance plans are not ACA-compliant, but can still provide some level of coverage for unforeseen medical expenses – and you can purchase the plans at any time during the year, if they're available in your area.

That means you could apply for a short-term plan today and you could have coverage in force as soon as tomorrow. The option for an immediate effective date for short-term plans can appeal to consumers who are enrolling in ACA-compliant coverage but who face a wait of days or weeks before that coverage takes effect.

(It's important to understand that most short-term insurers have a very basic underwriting process at the time of application, and tend to rely instead on post-claims underwriting; this is why such a fast approval process is possible.)

As the name implies, the coverage is temporary, and short-term plans are not available in all states. In states where they are available, maximum plan durations vary from as little as three months to as much as 36 months (including renewals), depending on state rules and the plan options that insurers choose to offer.

If you're losing other coverage (like a job-based plan, or aging off a parent's plan), you almost certainly have access to a special enrollment period that will allow you to buy an ACA-compliant plan – which you can cancel at any time in the future, if you obtain coverage elsewhere.

It's also important to understand that if you need coverage because of a medical condition that has arisen, a short-term plan isn't going to cover anything that was pre-existing before the plan took effect. All of this means that there is little reason for most people to enroll in short-term coverage, and it's essential to check your options for ACA-compliant coverage before settling for a short-term plan.

• Related: Short-term health insurance

Enroll in Medicaid if you’re eligible

If you live in Washington DC or one of the 40 states that have implemented the ACA’s Medicaid expansion and you earn up to 138% of the federal poverty limit, you may be eligible to enroll in Medicaid. Even better, Medicaid enrollment is year-round.

Federal poverty level calculator
for 2026 coverage

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of Federal Poverty Level

Begin enrollment in an ACA qualified plan Read more

In addition, CHIP (Children's Health Insurance Program) enrollment is also available year-round, and eligibility extends to higher income levels than Medicaid.²

The good news is that if your application is successful, your Medicaid coverage will be effective either on the date of the application or the first day of the month that you apply.³ And in even better news for some applicants: Most states still have a three-month retroactive coverage period for Medicaid enrollees who would have otherwise been eligible in the months prior to their application. (States can seek federal approval to eliminate this retroactive coverage availability, and some have done so.)⁴

So if you've been eligible for Medicaid but have neglected to enroll for whatever reason, your state might provide you with retroactive coverage when you do enroll. This could be very beneficial if you received medical care in the days or weeks before you submitted your application.

Our federal poverty level calculator (see above) will help you determine whether you meet the Medicaid eligibility level for your state. If you're not eligible for Medicaid or CHIP, you may be eligible for ACA Marketplace subsidies. This also depends on your income and percentage of the federal poverty level (FPL).

• Related: Frequently asked questions about eligibility for health insurance

In some states, people with fairly low income can enroll year-round

Depending on where you live and your household income, you might find you can enroll in health coverage anytime during the year. And  you may not have to pay any premiums for your coverage. People eligible for year-round enrollment include:

• Applicants who are eligible for Basic Health Programs in Washington DC, Oregon, and Minnesota, as well as a similar program in New York.
• Applicants who are eligible for the ConnectorCare program in Massachusetts (for people who are newly eligible or who haven't enrolled before).
• Applicants who are eligible for the Covered Connecticut program in Connecticut.

Put the next open enrollment period on your calendar

Open enrollment for 2026 coverage has ended. The next open enrollment period will begin November 1, 2026. In most states, it will end December 15, 2026, but some state-run exchanges might choose to have open enrollment continue until the end of December. All plans selected during open enrollment will take effect on January 1, 2027.

During open enrollment, individual/family health insurance can be purchased by nearly anyone. The enrollment window applies both on-exchange and off-exchange, although subsidies are only available to eligible applicants who enroll through the exchange.

There is no requirement that you have a qualifying life event or have maintained prior coverage if you're signing up during open enrollment. And as is always the case with ACA-compliant coverage, your medical history will not be taken into consideration when you’re enrolling in a new plan or switching from one plan to another.

Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written hundreds of opinions and educational pieces about the Affordable Care Act for healthinsurance.org.