Alyssa Lane
If you need immediate medical insurance, you can consider short-term health insurance, which can provide coverage for unforeseen medical expenses. Short-term health insurance is available for up to four months and can be purchased at any time during the year. It is important to note that short-term plans are not required to comply with certain federal market requirements, such as the Affordable Care Act (ACA), and may not cover pre-existing conditions. To purchase a short-term plan, you can contact a licensed insurance agent or find a private insurance company that offers them. Additionally, you may qualify for a Special Enrollment Period if you have experienced specific life events, such as getting married, having a baby, or losing health coverage. During the Open Enrollment Period, which typically runs from November 1 to January 15, you can also apply for health insurance through the Health Insurance Marketplace.
| Characteristics | Values |
|---|---|
| Time of application | Outside of the annual Open Enrollment Period (1 November - 15 January) |
| Qualifying criteria | Specific life events, including but not limited to: getting married, having a baby, losing health coverage, turning 65, or having end-stage renal disease or certain disabilities |
| Type of insurance | Short-term health insurance, also known as temporary health insurance or term health insurance |
| Coverage | Medical services for a limited period of time, typically less than 365 days and no more than four months |
| Cost | As little as $55 per month, compared to at least $225 per month for major medical coverage |
| Application process | Short application questions to determine eligibility; pick your deductible amount from several options |
| Provider | Private insurance companies; not available through the Health Insurance Marketplace |
| Compliance with ACA guidelines | Not ACA-compliant; does not cover pre-existing conditions |
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What You'll Learn
Short-term health insurance plans
Short-term health plans are medically underwritten, meaning that the insurer evaluates your health status, medical history, and sometimes lifestyle factors before approving coverage or setting premium rates. They are not required to cover the same essential benefits as ACA plans, so it is important to carefully review your policy to understand any exclusions or limitations regarding coverage of pre-existing conditions or health benefits such as hospitalization, emergency services, maternity care, prescription drugs, and mental health services.
While short-term plans can provide fast and flexible coverage, they are not a good fit for everyone and are not intended to be a long-term solution. They typically have fewer benefits and federal protections than other types of health insurance options. If you are seeking comprehensive coverage, a traditional health plan offered through your employer or purchased through an individual insurance company or the Health Insurance Marketplace may be a better option.
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Special Enrollment Periods
- Losing health coverage
- Moving
- Getting married
- Having a baby
- Adopting a child
- Placing a child for foster care
- Gaining a dependent or becoming someone else's dependent due to a court order
- Experiencing a serious medical condition, natural disaster, or other emergencies that kept you from enrolling on time
- Becoming a citizen, national, or lawful permanent resident
- Losing coverage after leaving active duty, reserve duty, or the California National Guard
- Death of someone on your Marketplace plan
If you qualify for an SEP, you must pick a plan within 60 days of the qualifying event (90 days if you lost Medicaid or CHIP coverage). You will then need to submit documents within 30 days of picking a plan, and your coverage will start on the first day of the month after you pick a plan.
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ACA-compliant coverage
If you're looking for immediate medical insurance, you may be considering short-term health insurance. Short-term health insurance is not ACA-compliant, and it does not provide coverage for pre-existing conditions. It also does not include the mandated coverage necessary to avoid a penalty under the Affordable Care Act (ACA). Short-term health plans are not required to comply with certain federal market requirements, such as covering the 10 essential benefits.
The Open Enrollment Period is an annual window of time when most Americans can apply for a health plan through the Health Insurance Marketplace. It takes place from November 1 through January 15. This is the only time when you can apply for a health plan through the Health Insurance Marketplace without qualifying for a Special Enrollment Period. Some states with their own health insurance marketplace exchanges have different date ranges for their Open Enrollment Period. During these extended Special Enrollment Periods, you can also apply for an ACA health insurance plan outside of the Open Enrollment Period.
If you are not experiencing a situation that qualifies you for a Special Enrollment Period, short-term health insurance might be right for you. It can fill the gap in coverage until you can choose a longer-term solution. Short-term health insurance is available for up to 4 months of total coverage during a 12-month period.
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Qualifying life events
A qualifying life event is a life-changing situation that can impact your health insurance. It can be planned or unexpected, and it may qualify you for a Special Enrollment Period (SEP), allowing you to change your health plan outside of the annual Open Enrollment Period.
The Open Enrollment Period is an annual window when most Americans can apply for a health plan through the Health Insurance Marketplace. It typically runs from November 1 through January 15, although some states with their own health insurance marketplaces have different date ranges. During this period, individual/family health insurance can be purchased by nearly anyone.
- Loss of health coverage: Losing your insurance is considered a qualifying life event. This includes losing your health insurance or expecting to lose your coverage within the next 60 days.
- Change in residence: A move to a new location can be a qualifying life event, and you may be asked for documents to confirm the change of address.
- Change in household: Household changes can include circumstances where members of your immediate household become eligible or lose eligibility for coverage under an existing plan.
- Turning 65: Aging into Medicare eligibility is a qualifying life event, as you can now explore Medicare plans, which serve as the primary source of health insurance for those 65 and older.
- Gaining U.S. citizenship: Becoming a U.S. citizen can be a qualifying life event and may impact your health insurance options.
- Natural disaster or public health emergency: SEPs may be offered due to unforeseen circumstances, such as natural disasters or public health emergencies, to provide relief and ensure access to healthcare.
It is important to note that the availability and specifics of short-term health insurance plans can vary by state, and certain exclusions or limitations may apply. It is always advisable to consult official sources and speak with a licensed insurance agent or your insurer to understand your specific options and requirements.
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Health Insurance Marketplace
The Health Insurance Marketplace, also known as the ACA Health Insurance Marketplace, is a platform that offers a wide range of health insurance plans. These plans are designed to provide individuals and families with access to affordable and comprehensive health coverage. The Marketplace is facilitated by the federal government, with some states also operating their own Marketplaces with unique enrolment deadlines.
To be eligible to enrol in health coverage through the Marketplace, you must be a U.S. citizen or national, or be lawfully present in the country. There is no income limit for using the Marketplace, and it offers special patient protection under the Affordable Care Act (ACA). The ACA requires all health plans to cover 10 essential benefits, such as hospitalization, emergency services, maternity care, prescription drugs, and mental health services.
The Open Enrollment Period for the Health Insurance Marketplace typically runs from November 1 through January 15. During this period, most Americans can apply for a health plan. However, some states with their own Marketplaces may have different date ranges. Additionally, certain life events, such as losing your job or having a child, may qualify you for a Special Enrollment Period outside of the Open Enrollment Period.
Short-term health insurance is also an option for those who need immediate coverage. These plans can be purchased at any time during the year and can provide coverage for up to four months. However, they are not ACA-compliant and may not cover pre-existing conditions or all the essential benefits. Short-term plans are medically underwritten, meaning your health status and history will be evaluated before approving coverage.
If you purchased health insurance through the Marketplace, you will receive a Form 1095-A, which helps with your federal individual income tax return. This form reports information such as monthly premiums paid and can be accessed through your HealthCare.gov account or by contacting your Marketplace.
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Frequently asked questions
Short-term health insurance is a type of health plan that can provide temporary medical coverage when you are between health plans, outside enrollment periods, or in case of an emergency. These plans are typically much more affordable than major medical plans, with monthly costs as low as $55.
Short-term health insurance plans are not required to comply with Affordable Care Act (ACA) guidelines, so they do not cover pre-existing conditions. These plans typically cover emergency hospital visits, certain prescription medications, and some doctor's appointments.
Short-term health insurance provides coverage for a limited period, typically less than 365 days, with a maximum coverage period of four months.
Short-term health insurance is available to anyone who does not qualify for a Special Enrollment Period (SEP) to apply for an ACA plan. To qualify for a Special Enrollment Period, you must have experienced specific life events, such as getting married, having a baby, or losing health coverage.
Short-term health insurance plans are sold through private insurance companies. You can search for a company that offers these plans and apply directly through them.
