Short-Term Health Insurance Plans
Short-term health insurance may provide you with temporary medical coverage in certain situations. That said, many of the features offered by these temporary health insurance plans differ greatly by provider. What is short term health insurance and is it right for you?
Simply put, a short-term health insurance plan, also known as temporary health insurance, is a medical plan with a limited duration. If you’re ever between jobs or in a situation where there’s a temporary gap in your health insurance, one of our short-term plans could be the answer. They are designed to bridge gaps in your health care coverage during a period of transition, like graduating from college, or starting a new job where you may have to wait for new coverage to begin.
What is a Short-Term Health Insurance Plan?
Short-term health insurance is a flexible medical coverage solution. During transitional periods in your life, it offers in-the-moment support, bridging the gap until you’re ready to move onto something more lasting in nature.
Generally, people need this kind of coverage when they’re outside enrollment periods for more long-term plans.
Short-term coverage is most states, and can serve as fallback coverage if your only alternative is to remain uninsured. In most states, it’s the closest thing you can get to “real” health insurance if you find yourself needing to purchase a policy outside of open enrolment
If you experience certain types of life changes — like losing health coverage, getting married, or having a baby — you may qualify for a special enrollment period to enroll in a marketplace plan. However, for those without a qualifying event — short-term coverage is the best option.
How Much Does Short-Term Health Insurance Cost?
Before considering cost, it’s worth noting that price is dependent on an individual’s personal situation. This information is based on average pricing statistics. Zip code, age, gender, and an array of other factors depict more specific pricing. Hence, you’ll be in a better position to consider cost once you receive a personalized quote.
More generally—and to help you estimate—is that short-term plans can be purchased for ~$55 per month. Compared with the $225 per month that you’d pay for major medical coverage on average, short-term health plans are a highly affordable alternative.
Here are some other considerations for when you’re seeking out a short-term plan:
- The premium is your monthly fee.
- The cost hinges upon your chosen coverage level.
- This includes a deductible, c-oinsurance, and services.
- Short-term health plan deductibles are often much higher than a traditional coverage.
- Out-of-pocket costs for services are required until you meet your deductible.
- After meeting your deductible, your plan starts sharing costs.
- After you meet your deductible, coinsurance is the percentage of costs you share with your plan.
- You usually pay this fee at the time of your doctor visit—this is a requirement of some short-term plans.
Out of Pocket Costs:
- Not everything will be covered by these plans, meaning you’ll end up paying out of pocket in those instances,
- For example, many short-term plans don’t cover mental health and substance use services. The same can be said for maternity care, vision care, and dental care.
There might be other costs involved in your plan. Make sure to read all the fine print in your contract to ensure you aren’t caught off-guard by anything.
How Long Is Short-Term Medical Insurance?
There’s no answer set in stone. It comes down to your state’s rules and various other factors (ie the existence of pre-existing conditions). So, term lengths vary by state, but in some states you can apply for up to nearly 12 months of coverage.
What Does Short-Term Medical Insurance Cover?
The answer here varies depending on the company/plan, where you live and your current circumstances, among othe factors.
Short term insurance plans do not have coverage requirements, so plans vary in what they cover. That’s because the Affordable Care Act (ACA) guidelines don’t apply to short-term plans; hence, providers aren’t forced to comply. Therefore, you aren’t guaranteed to receive the minimum essential coverage associated with the ACA.
Typically, these bridge plans provide coverage for the following medical services:
- Preventive care
- Doctor visits
- Urgent care
- Emergency care
Sometimes you might receive some coverage for prescriptions, but it’s not commonplace. More comprehensive short-term plans provide cost savings when you see in-network providers. Before signing on the dotted line for any plan, read the “exclusions and limitations” section. When you do this, you’ll be well aware of all coverage limitations.
Are Short-Term health Plans ACA Compliant?
As was highlighted in the previous section, ACA compliance standards don’t apply to short-term health plans. Thus, the insurer can be very selective with what’s being offered since there’s no mandated minimum essential coverage. It pays to look at several alternatives.
Who Can Get Short-Term Health Insurance?
Really, anybody healthy and under the age of 65 can obtain short-term health insurance. Of course, if you present a greater health risk, you’d likely be paying unaffordable premiums—or not qualify at all.
However, here’s a list of criteria for people that likely to benefit most from this coverage type:
- Those who don’t qualify for ACA (ie Obamacare) coverage due to missing Open Enrollment should use this as a temporary solution.
- You should first try to apply for special enrollment—and if that doesn’t work, then look at short-term plans.
- Anybody waiting for ACA coverage to kick in would benefit from temporary plans.
- People seeking coverage to provide a bridge into Medicare.
- Those who’ve recently turned 26 and are coming off theirs parent’s insurance.
- People who are unemployed or someone waiting for benefits to kick in at a new job might find temporary health insurance advantageous.
Does short-term health insurance provide ideal coverage? Provided you’re seeking out a long-term solution, the answer is no. But there’s a reason it’s referred to as temporary coverage. While it’s true that you may save money by choosing short term health insurance, you need to be sure you know what you are buying—and that it’s a good choice for you. For the right situation, short term insurance plans can definitely provide fast, flexible, temporary health insurance coverage that fits your needs.