Jeffrey Wade
Short-term health insurance plans are sold through private insurance companies and are not available through the Health Insurance Marketplace. They are not ACA-compliant, meaning they do not meet the minimum essential coverage required by the Affordable Care Act, and they do not qualify for premium subsidies. Short-term health insurance plans are meant to bridge the gap in health insurance coverage for those who temporarily lack major medical insurance. They are not meant to be a replacement for comprehensive health insurance plans, especially for those with chronic medical conditions. The average cost of short-term health insurance is $208 a month, but this depends on factors such as age, health status, and the types of services offered. Some companies that offer short-term health insurance include Progressive Health by eHealth, Allstate Health, and UnitedHealthcare.
| Characteristics | Values |
|---|---|
| Coverage | Preventive care, doctor visits, urgent care, emergency care, prescriptions (in some cases) |
| Cost | Relatively inexpensive premiums, high out-of-pocket costs |
| Availability | Available in 35 states, not available in Washington D.C., Delaware, Maryland, and Oregon |
| Duration | One to three months, with the option to extend for another month in a 12-month period |
| Application | Can be applied for at any time of the year, requires a health questionnaire |
| Coverage Limitations | Does not cover pre-existing conditions, mental health, substance abuse, pregnancy and childbirth |
| Plan Limitations | May have caps on how much the insurer will pay for certain services, may not be ACA-compliant |
| Examples of Insurance Companies | UnitedHealthcare, Pivot Health, Allstate Health, Progressive Health by eHealth |
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What You'll Learn
Companies offering short-term health insurance
Short-term health insurance plans are not governed by Affordable Care Act (ACA) requirements, so companies can decide what they will and won't cover. These plans are meant to bridge the gap in health insurance coverage for those who temporarily lack major medical insurance. They are not meant as a replacement for a comprehensive health insurance plan, especially for those with chronic medical conditions.
Temporary health insurance plans typically don't cover all ten categories of essential benefits, so they generally do not cover pre-existing conditions, mental health and substance abuse, pregnancy and childbirth, and many other items covered by ACA major medical plans. To qualify for short-term health insurance, you will likely have to fill out a health questionnaire, and you may need to disclose any pre-existing conditions, which can disqualify you from obtaining coverage.
Despite this, some companies do offer short-term health insurance plans. Here are some companies that offer short-term health insurance:
- Everest: This company has the advantage of being widely available in most states, but its plans may have higher premiums when compared to other companies.
- UnitedHealthcare: This company offers the Copay Select Max plan, which covers prescription drugs.
- Pivot Health: The Epic Base plan offered by this company covers prescription drugs.
- Allstate Health: Allstate offers guaranteed-issue plans, which are unique because they are available even if you have health problems. However, these plans tend to be expensive, and you have to use certain doctors and hospitals to get the most out of your plan.
- EHealth: This company offers low-cost short-term health insurance plans with a wide selection of personalized coverage solutions.
- Progressive Health by eHealth: Progressive Health offers low-cost temporary health insurance plans.
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What does short-term health insurance cover?
Short-term health insurance, also known as temporary health insurance, is designed to cover unexpected medical events and typically lasts between one and four months. It is important to note that short-term health insurance is not a substitute for comprehensive health insurance or an ACA health plan. These plans are not required to comply with the Affordable Care Act (ACA) guidelines and may not cover all Essential Health Benefits.
Short-term health insurance typically provides coverage for preventive care, doctor visits, urgent care, and emergency care. Some plans also offer coverage for prescriptions, hospital stays, and surgical procedures. However, it is important to carefully review the exclusions and limitations of each plan before purchasing, as coverage for pre-existing conditions, mental health services, maternity care, and chronic conditions may be excluded.
Short-term health insurance plans offer flexibility and can be purchased at any time during the year, with coverage starting as soon as the next day. These plans are ideal for filling temporary gaps in coverage, such as between jobs or during transitional periods. They provide a more affordable option compared to traditional plans, with premiums starting at under $100 per month.
When considering a short-term health insurance plan, it is important to keep in mind that they are not mandated or standardised, and the coverage and costs can vary greatly depending on the plan and the insurance company. It is essential to carefully review the details of the plan, including any exclusions or limitations, to ensure that it meets your specific needs.
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What doesn't short-term health insurance cover?
Short-term health insurance provides temporary medical coverage when you are between permanent health plans. It is important to note that short-term health insurance is not a good substitute for comprehensive health insurance. It is designed to cover unexpected medical events and typically lasts for three to four months.
Short-term health insurance plans are not governed by Affordable Care Act (ACA) requirements, so each company decides what it does and does not cover. This means that pre-existing conditions are typically not covered by short-term health insurance plans. You can be denied coverage for a medical issue you've previously been treated for. In addition, short-term health insurance plans generally have caps on how much the insurer will pay for certain services or in total.
Short-term health insurance plans typically do not cover all ten categories of essential benefits. They often exclude essential health benefits such as preventive care, mental health services, substance abuse treatment, maternity care, and pregnancy and childbirth. It is important to note that short-term health insurance plans do not have to cover prescriptions, and you may have trouble finding one that does.
Short-term health insurance is not a one-size-fits-all solution and may not be ideal for everyone. It is important to carefully review the "exclusions and limitations" information before purchasing any plan to understand what is and is not covered.
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Who should get short-term health insurance?
Short-term health insurance is designed for those who need temporary coverage. It is not a long-term solution and does not offer the same amount of coverage as long-term health insurance. It is also not governed by Affordable Care Act (ACA) requirements, so each company can decide what it does and does not cover.
Short-term health insurance is a good option for those who are young, healthy, and do not generally require health services or have regular prescription needs. It can be a low-cost alternative to COBRA health insurance, for example, if you lose your job and don't need many healthcare services. It can also be a good option for those who need immediate coverage in an emergency.
Short-term health insurance can also be useful for those who are between jobs or waiting for other insurance coverage to take effect. For example, if you have a waiting period before being eligible for your employer's health benefits plan. It can also be useful for those who are starting college and need insurance.
Short-term health insurance may also be a good option if you missed open enrollment for a traditional health plan. However, it is important to note that short-term health insurance does not cover pre-existing conditions and may not cover prescriptions. It is also important to understand how long a short-term plan will last and whether it is renewable.
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How much does short-term health insurance cost?
Short-term health insurance plans are typically much more affordable than major medical plans. For example, eHealth offers plans for as little as $55 per month, compared to at least $225 per month for major medical coverage. However, the actual price of short-term health insurance depends on your zip code, age, gender, and other factors.
Short-term health insurance is usually a much cheaper option than COBRA health insurance, but you get fewer benefits with short-term coverage. Short-term health insurance rates were compared for a 30-year-old woman who is a nonsmoker in three cities: Orlando, Florida, Phoenix, and El Paso, Texas. The three lowest quotes for each plan in each city were averaged.
Short-term health insurance plans aren’t governed by Affordable Care Act (ACA) requirements, so each company decides what it does not cover. For example, short-term plans generally do not cover pre-existing conditions, mental health, substance abuse, pregnancy and childbirth, and prescription drugs. As such, short-term health insurance plans generally have caps on how much the insurer will pay for certain services or in total.
If you are young and healthy, a short-term health insurance plan could be a low-cost alternative. However, it is important to note that short-term health insurance shouldn't be viewed as comprehensive coverage or a long-term solution.
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Frequently asked questions
Short-term health insurance provides temporary medical coverage when you are in between plans. It is not a replacement for a comprehensive health insurance plan, especially for those with chronic medical conditions.
Short-term health plans are sold through private insurance companies. Some companies that offer short-term health insurance include UnitedHealthcare, Allstate, Progressive Health by eHealth, and Everest.
Short-term health insurance plans vary in cost and coverage. They typically provide coverage for preventive care, doctor visits, urgent care, and emergency care. Some plans offer cost savings for seeing in-network providers. Short-term health insurance usually does not cover prescription medications, vision or dental care, mental health care, or maternity care.
