Paul Sanchez
Short-term health insurance provides temporary medical coverage for a limited period, typically less than a year. It is designed for individuals and families who need coverage during a lapse in permanent insurance, such as between jobs, waiting for coverage, or attending college. Short-term plans are not subject to Affordable Care Act (ACA) guidelines, so they do not cover pre-existing conditions and may deny coverage for specific conditions. They generally offer lower premiums than ACA plans but provide limited coverage for emergencies, doctor visits, prescriptions, and hospital stays. Short-term health insurance can help bridge gaps in coverage and protect against unexpected medical expenses.
| Characteristics | Values |
|---|---|
| Purpose | Temporary, limited coverage during a lapse in permanent coverage |
| Coverage Length | 1-12 months, with a maximum of 3 years in some states |
| Coverage | Emergency hospital visits, doctor's appointments, prescriptions, preventive care, urgent care |
| Exclusions | Pre-existing conditions, maternity care, mental health, substance abuse, pregnancy and childbirth |
| Cost | Affordable premiums, low monthly costs |
| Availability | Sold through private insurance companies, not available through the Health Insurance Marketplace |
| Waiting Periods | May have waiting periods for covered treatment, even for serious conditions |
| Ideal For | Healthy individuals who do not generally require health services or have regular prescription needs |
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What You'll Learn
Who is short-term health insurance for?
Short-term health insurance is designed to cater to individuals and families who need temporary, limited healthcare coverage. It is a good option for those who are generally healthy and do not require regular health services or prescriptions.
Short-term health insurance can be a good option for those who are:
- Between jobs: If you have lost your job and are in between employee benefits, short-term health insurance can provide temporary coverage.
- Unable to get major medical coverage: If you are unable to obtain major medical coverage, a short-term insurance plan may be able to offer you temporary coverage.
- Students: If you are attending college and need insurance, short-term plans can provide coverage to fit your needs.
- Waiting for coverage: If you are waiting for coverage to begin, a short-term insurance plan can provide temporary protection.
- Missed open enrollment: If you missed the open enrollment period for a traditional health plan, a short-term plan can provide temporary coverage until the next enrollment period.
It is important to note that short-term health insurance plans are not a substitute for comprehensive coverage and do not provide the same level of benefits as traditional health plans or ACA plans. Short-term plans typically do not cover pre-existing conditions, maternity care, mental health services, prescription drugs, and other essential health benefits.
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What does short-term health insurance cover?
Short-term health insurance is designed to provide temporary, limited healthcare coverage for individuals and families who need it. It is often used to bridge the gap during a lapse in permanent coverage, protecting individuals from expensive medical bills that arise from unexpected health changes or emergencies.
Short-term health insurance plans are not a part of the Affordable Care Act (ACA) and are not required to comply with its guidelines. This means that pre-existing conditions are typically not covered, and insurers can deny coverage or charge more based on an individual's health history. Short-term health plans also have a lifetime maximum that the insurer will pay out, ranging from $250,000 to $2 million.
The specific coverage provided by short-term health insurance varies based on the plan and the insurance company. Most plans cover emergency hospital visits, certain prescription medications, and some doctor's appointments not related to pre-existing conditions. Some plans also offer cost savings for seeing in-network providers and coverage for preventive care, urgent care, and emergency care.
It is important to carefully review the policy or certificate to understand any exclusions or limitations regarding coverage. Short-term health insurance is not a comprehensive long-term solution but can be a budget-friendly option for individuals who need temporary coverage.
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$14.39 $19.99
What doesn't it cover?
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 need coverage in case of an emergency. However, it's important to note that short-term health plans are not a part of the Affordable Care Act (ACA) and, therefore, do not need to comply with its standards. As a result, there are several limitations to the coverage provided by short-term health insurance.
Firstly, short-term health insurance typically does not cover pre-existing conditions. This means that you can be denied coverage or charged higher premiums for medical issues that you have previously been treated for. Additionally, short-term plans may have waiting periods for covered treatments, even for serious conditions or emergencies. During these waiting periods, the plan will not cover certain conditions at the beginning of the policy.
Secondly, short-term health insurance plans generally do not cover all ten categories of essential benefits offered by ACA major medical plans. This includes coverage for mental health and substance abuse, pregnancy and childbirth, and maternity care. Short-term plans may also have limitations on the number of doctor visits, daily hospital stays, emergency room visits, and surgical procedures that are covered. Furthermore, there may be caps on treatment reimbursements, which could result in unexpected out-of-pocket expenses.
Lastly, short-term health insurance plans usually have a lifetime maximum on the amount the insurer will pay for covered costs. This means that once your medical bills reach this maximum, the plan will no longer contribute to your care. Therefore, it is crucial to carefully review the "exclusions and limitations" information before purchasing any short-term health insurance plan to fully understand what is and isn't covered.
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How much does it cost?
The cost of short-term health insurance varies depending on the plan and the insurance company. It is important to note that short-term health insurance is not subject to Affordable Care Act (ACA) guidelines, which means that it may not cover essential health benefits and protections. Therefore, when considering the cost of short-term health insurance, it is crucial to review the plan details carefully to understand what is covered and what is not.
Some common cost-related terms associated with short-term health insurance include:
- Premium: The monthly fee paid for having coverage. The premium varies depending on the level of coverage, deductible, coinsurance, and the types of services covered.
- Deductible: The amount paid out of pocket before the insurance benefits kick in. Short-term health plans often have higher deductibles compared to traditional health plans.
- Coinsurance: The percentage of costs shared with the plan after meeting the deductible.
- Copay: A fixed-dollar amount paid for certain services, such as a doctor's visit or prescription drugs.
Generally, short-term health insurance is more affordable than major medical plans, with monthly premiums starting at around $55 compared to at least $225 for major medical coverage. However, it is important to note that the actual prices depend on factors such as location, age, gender, and individual needs.
To find the best rates for short-term health insurance, individuals can consider the following:
- Choosing a higher deductible can lower the monthly premium.
- Staying in-network for care can help save money, as in-network providers often agree to lower fees.
- Selecting a plan with fewer benefits can result in a lower-priced plan.
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Where can I buy it?
Short-term health insurance plans are sold through private insurance companies. Not all companies offer this type of plan, and they are not available through the Health Insurance Marketplace.
You can purchase short-term health insurance from providers such as UnitedHealthcare, Pivot Health, and Everest. These companies offer some of the best short-term health insurance plans, according to Forbes.
You can also get short-term health insurance from eHealth, which offers a wide selection of plans and free quotes for low-cost short-term insurance. Progressive Health by eHealth allows you to compare over 3,600 plans from 16+ carriers.
Before purchasing a short-term health insurance plan, it is important to note that these plans are not ACA-compliant and do not cover pre-existing conditions. They are meant to bridge the gap in health insurance coverage for those who temporarily lack major medical insurance.
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Frequently asked questions
Short-term health insurance is meant to cover your medical bills for a short time, often during a gap in other insurance coverage.
Short-term medical insurance typically provides some level of coverage for preventive care, doctor visits, urgent care, and emergency care. There may also be coverage for prescriptions. However, short-term plans do not guarantee the essential health benefits and protections of Affordable Care Act (ACA) plans. Most temporary health insurance plans do not cover treatment for pre-existing conditions, maternity care, and mental health, among other items.
Short-term health insurance plans offer quick and temporary coverage that can last anywhere from 1 to 12 months. In most states, coverage is limited to three months, with the chance to extend the plan for another month for a total of four months in a 12-month period.
Short-term plans offer limited coverage, so their monthly premium costs may be much lower than an ACA plan, particularly if you’re young and healthy.
Short-term health plans are sold through private insurance companies. Not all companies offer this type of plan. These plans are not available through the Health Insurance Marketplace and do not conform to ACA guidelines.
