Short Term Plans
Short term insurance plans offer a temporary solution for individuals or families in need of health coverage for a limited period. However, the characteristics of these temporary health insurance plans can be significantly different from those of conventional health plans.
What is short-term health insurance?
Short-term medical plans provide temporary catastrophic coverage when you are in between health plans or outside enrollment periods and require temporary medical coverage. These plans are less expensive than marketplace plans, but they have restrictions on their coverage and only offer temporary coverage for a limited time.
Average individual ST Premium
Average Individual ST Deductible
Who should get short-term health insurance?
College Students
Attending college and need insurance? Short-term plans give you coverage when and where you need
No Obamacare
Can't get major medical coverage? A short-term insurance plan may help.
Pre Medicare
Waiting for Medicare to kick in? A short-term insurance plan can help protect you in the meantime.
Employment Change
Laid off? Job loss? Get covered while in between jobs and employee benefits..
What does short-term health insurance cover?
The coverage provided by short-term health insurance plans may differ depending on the plan you select. Generally,
- emergency hospital visits,
- some prescription medications,
- and certain doctor’s appointments that are unrelated to pre-existing conditions are covered by most short-term plans.
However, pre-existing conditions, maternity care, mental health, and other items are typically not covered by temporary health insurance plans. Additionally, short-term plans do not guarantee the essential health benefits and protections provided by Affordable Care Act plans. Moreover, they may have waiting periods, during which the plan will not cover specific conditions at the beginning of the plan. If you switch from one short-term plan to another, you may lose coverage for certain conditions that become pre-existing conditions, and you may have to restart any deductible or waiting period requirement in your plan. It is also essential to note that short-term plans usually have an overall maximum amount they will pay out in coverage.
It is crucial to review the details of your plan carefully to understand its limitations and coverage. The above summary provides general guidance, and you must review your plan’s official documentation to ascertain its coverage, limitations, and restrictions.
How much does short-term health insurance cost?
If you’re considering temporary health insurance, you should expect to incur the following typical upfront costs:
Premium: This refers to the monthly fee for coverage, which varies depending on the level of coverage you choose, such as the deductible and coinsurance, as well as the types of services covered.
Deductible: The deductibles for short-term health plans are often higher than those for more traditional health plans. Until you meet your deductible, you must pay for services out of pocket. After that, your plan starts sharing costs.
Coinsurance: This represents the percentage of expenses you split with your plan once you meet your deductible. It is frequently expressed as a percentage. Most short-term plans have both a deductible and coinsurance.
Copay: This is a fee you might have to pay when you visit a doctor, usually payable at the time of the visit. Some short-term plans require you to pay a copay for certain doctor visits.
Other out-of-pocket expenses: If there are health care services not covered by your short-term plan, you may have to pay for all costs. For instance, some short-term plans may not cover or may restrict your coverage for maternity care, mental health or substance use services, vision care, or dental care. These expenses are yours to bear for any services you receive.
Depending on the type of coverage you select, additional expenses may apply. Before making your decision, carefully read all plan information to be fully informed of your plan’s actual cost.
Short-term health plans vs. ACA health plans
Short Term Plans
Short-term plans were designed to provide temporary coverage in specific circumstances when there are gaps in coverage. However, they are typically not adequate replacements for traditional health plans. They are not required to adhere to Affordable Care Act (ACA) standards and have limited benefits with substantially higher costs.
ACA Plans
ACA health plans are mandated by the government to provide certain types of coverage. They must cover essential health benefits such as maternity and preventive care at no cost-sharing, as well as mental health and substance use benefits. Prior to deciding to purchase a short-term health plan, ensure that you have a comprehensive understanding of what care and services are covered and excluded. Thoroughly read the exclusions and limitations information.
Who qualifies for short-term health insurance?
Short-term health insurance requires you to complete a health questionnaire, which may include disclosing any pre-existing conditions that could prevent you from obtaining coverage with a temporary health insurance plan.
In addition, some insurance companies may disqualify you from coverage if you are
- pregnant,
- currently insured under another policy,
- weigh over 300 pounds (if you’re a man) or 250 pounds (if you’re a woman),
- have been diagnosed with or treated for HIV or AIDS,
- qualify for Medicaid, or
- are not a U.S citizen.
However, this list is not exhaustive, and plan qualifications may differ depending on the insurance carrier.
FAQS
What is short term insurance, and how does it differ from regular health insurance? Short-term insurance is a type of health insurance that provides temporary medical coverage for a specific period, usually between one to twelve months. Short-term insurance is meant to provide coverage for individuals who are between health plans or need coverage outside of the enrollment period. Unlike regular health insurance, short-term insurance plans do not have to adhere to the Affordable Care Act’s (ACA) essential health benefits.
What are the benefits of short-term insurance? Short-term insurance plans can provide temporary medical coverage at a lower cost than regular health insurance. They can be a good option for individuals who only need coverage for a short period, such as during a job transition or while waiting for open enrollment. Additionally, short-term insurance plans may offer more flexibility in terms of provider choice and cost-sharing.
What are the limitations of short-term insurance? Short-term insurance plans do not have to cover essential health benefits mandated by the ACA, such as maternity care, mental health and substance abuse treatment, and prescription drugs. They also do not cover pre-existing conditions. Furthermore, short-term insurance plans may have waiting periods, limits on coverage, and restrictions on provider choice.
The Bottom Line:
Short-term insurance plans can provide temporary medical coverage for individuals who need coverage for a limited period. They can be a good option for individuals who are between health plans, outside the enrollment period, or cannot afford regular health insurance. However, short-term insurance plans have limitations, including limited benefits and coverage exclusions. It’s essential to carefully review the plan’s coverage, limitations, and restrictions before purchasing a short-term insurance plan. If you have pre-existing conditions or need coverage for essential health benefits, you may want to consider other health insurance options, such as the ACA marketplace or Medicaid.
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