The answer for you may be: short term health insurance but there are some important things you need to know about this type of coverage before you apply.
Answered in this blog post:
- What is short term health insurance?
- When can short term health insurance help and what are the limitations?
- What is the fastest way to get health insurance benefits?
- Can I get health insurance for one month?
- How can I apply for short term health insurance?
Affordable Care Act (ACA) health insurance is required under law to be “guaranteed issue,” meaning you can’t be denied coverage under an ACA-compliant health insurance plan because of your current health status, including any pre-existing conditions. Plus, many people qualify for subsidies to help offset costs when they enroll in ACA plans.
Sounds like everyone should be able to access an ACA health plan, right? Well, that’s not necessarily the case. It is not always convenient, affordable or even possible to be enrolled in an ACA plan.
Keep reading to learn about options for coverage even when you’re in between major medical insurance plans, and how to get health insurance now!
Can’t I Just Go Without Health Insurance?
It may be tempting to go without health insurance to avoid monthly premium costs. Especially if it’s just for a month or two. You may be questioning if it’s worth it to get health insurance.
But consider the cost of a typical emergency room visit:
- $50 to $150 with ACA-compliant health insurance, which typically includes your copay and coinsurance.
- $150 to $3,000 or more without insurance, depending on the severity of your condition and what diagnostic tests and treatment are required.
If you get hurt or sick and require emergency room care, hospitalization or other treatment, are you prepared to pay for related medical care entirely out of pocket?
If not, short term health insurance may be able to provide some benefits to help pay for covered medical expenses.
Let’s look more at this health insurance option and compare some of the features and limitations to help you understand if it’s a good fit for you.
Alternatively, if you qualify for a special enrollment period, you may be able to enroll in an ACA plan outside of open enrollment as long as you do so within 60 days of the qualifying life change.
When Can Short Term Health Insurance Help?
Short term health insurance plans are designed to bridge the gap while you are waiting to access other coverage such as major medical insurance or Medicare. Here are some examples of situations where it might be useful to purchase short term health insurance for one month or longer:
Missed open enrollment – If you missed the annual deadline to enroll in a major medical plan and your specific situation does not qualify you for a special enrollment period, short term health insurance may be a solution until you can enroll in an ACA plan.
Newly employed and waiting for insurance – Many Americans have health insurance administered through their employer, and those between jobs usually go through a transitional period where they are no longer covered by their previous employer’s benefits and not yet covered by insurance under their new employer.
In fact, according to federal law your new employer can wait up to 90 days to extend health insurance benefits to you. Short term health insurance can help to limit your financial exposure for covered medical services during this transition period.
Part-time seasonal workers – Some people work office jobs that see them employed year-round, while others perform vital seasonal work that results in the person being unemployed and without health insurance through their employer for part of the year.
Seasonal employees can apply for short term medical insurance to bridge the gap between seasons and ensure that they always have some form of health insurance coverage.
Close to Medicare eligibility – There are several ways to qualify for Medicare in the United States. Turning 65 is one way, but you can also qualify for Medicare while under 65 if you receive Social Security Disability Insurance (SSDI) and have been for more than 24 months.
If you are just a few months away from qualifying for Medicare, temporary health benefits in the form of short term health insurance may be able to help provide some level of benefits for covered healthcare services. Because short term policies are individually underwritten and you must be approved by the carrier in order to enroll, if you have a pre existing condition you may not be able to access this type of insurance.
What is Short Term Health Insurance?
Short term health insurance is a type of limited-benefit insurance that does not meet the minimum coverage requirements of ACA plans. It is designed to provide temporary health insurance in cases where an unforeseen or unexpected lapse in coverage takes place, bridging the gap while you wait to enroll in a comprehensive health insurance plan that provides full benefits.
Find short term health plans available to you and compare costs.
What a Short Term Health Plan Typically Covers
Life is unpredictable, even if you are in good health. Should unexpected situations become reality, a short term health insurance plan can offer peace of mind that you have some level of benefits to help pay for covered medical expenses until your ACA-compliant qualified health insurance plan takes effect.
Temporary health plans:
Provide one-month health insurance if that’s all you need. You can have short term health insurance for as few as 30 days, in some states, if that is all you need until you begin an employer’s plan or can buy an ACA-compliant individual major medical plan through open or special enrollment.
Provide limited duration insurance coverage for 30 to 364 days depending on your state. Not all states allow for durations of 30 or 364 days and some states don’t allow short term medical insurance at all.
Include benefits for unexpected medical care. Covered expenses may include inpatient hospital care, intensive care, outpatient hospital care, outpatient emergency room visits, surgical services and more—benefits will vary by plan.
May be customized. Choose your deductible and coinsurance percentage, as well as your plan network type, to design the temporary health insurance coverage that works best for you.
Premiums may be more affordable. Premiums for temporary health insurance plans are typically lower than ACA-compliant major medical insurance premiums; however, short term medical policies are not as comprehensive. While it’s a completely individual decision, a lower monthly health insurance bill may be helpful if you are in a life transition.
These policies also typically have medical underwriting, meaning that your coverage can be rejected if you have a pre-existing condition. The pre-existing condition is also generally excluded from coverage.
Remember, your premium rate will ultimately depend on a number of factors, including the benefits you select. The only way to know how much a plan may cost you is to request a quote and – if short term plans are available in your area – to compare plan options.
Can be purchased online, anytime (if you qualify). Shop and enroll in short term medical insurance 24/7. Remember, you have to be approved by the carrier in order to enroll and obtain coverage. The application takes only a few minutes. Get started now by requesting a quote.
Begin coverage (almost) right away. Temporary health insurance coverage takes effect as early as the day after application and enrollment. You may not need to wait until the first of the following month for your policy to take effect. If you need health insurance now, your best option may be to apply for a short term plan that will take effect as early as the day after you are approved and make your first premium payment.
May be paired with additional benefits. Short term insurance generally can be used with other supplemental insurance and discount programs that can help you reduce out-of-pocket expenses. And you can keep and continue to use these products once you enroll in major medical insurance if you like them.
You may want to take a look at supplementing your short term policy with:
- Medical gap insurance to provide a lump sum benefit for covered healthcare services or critical illnesses.
- Dental insurance to help make preventive oral healthcare like regular teeth cleanings more accessible.
- Telemedicine services, prescription drug and other discounts may help make access to healthcare service providers more convenient, affordable or both, and may be a nice complement to a short term medical policy. Health and medical discounts are not insurance.
Common Options and Exclusions in Short Term Health Insurance
As previously mentioned, short term health insurance does not cover all the required health benefits of ACA plans. This (along with screening out those with pre-existing medical conditions) helps keep premiums lower than those of ACA plans by as much as 54%.
However, it also makes it all the more important that you be on the lookout for limitations and exclusions, and fully understand what you’re getting in any short term policy you’re considering purchasing because you cannot be certain that it covers the essential health benefits, for example, or that you won’t reach your annual limit if you do need to use your policy’s benefits.
Possible coverage options for short term health insurance include (but are not limited to):
- Hospital room and board
- Emergency care, including anesthesiology and surgical procedures
- Diagnostic services, including X-rays, medical imaging, laboratory testing and analysis
- Ambulatory care and surgical services
- Doctor visits, including routine check-ups and physical examinations
As you may have noticed, short term health insurance generally provides coverage for high-dollar, unexpected care and treatment as opposed to preventive care or the kind of routine healthcare services you may require if you’re managing a chronic health condition.
Despite its flexible nature, there are many conditions that won’t be covered by a short term health insurance plan or that may actually make you ineligible to enroll. Examples include (but are not limited to):
- Treatment of pre-existing conditions
- Sport-related injuries (team sports and martial arts included)
- Injuries or illness related to participating in extreme sports or other dangerous activities
- Medical costs resulting from injury from riding an ATV, dirt bike, snowmobile, or Go-cart, or from racing a motorcycle, boat or any type of aircraft.
- Tobacco, drug, and alcohol-related treatment expenses
- Any medical expenses incurred prior to the effective date or after the expiration date of the policy
It’s a good idea to be on your best behavior while you’re covered by a short term health insurance policy since any injury or illness stemming from your participation in an inherently risky activity is unlikely to be covered under your policy.
Find short term health plans available to you and compare costs.
Can I Have a Short Term Plan Instead of an ACA Plan?
The two are not interchangeable. There are both tax and financial implications to consider when deciding whether or not you can have a short term plan instead of an ACA plan.
First, the tax implications: The federal tax penalty for going without ACA-qualifying major medical insurance was eliminated beginning January 1, 2019, meaning you will no longer owe a federal tax penalty if you go uninsured. However, you may still be subject to a state penalty depending on where you live.
Please note: the materials available at this web site are for informational purposes only and not for the purpose of providing legal or tax advice. You should contact your attorney or tax professional to obtain advice with respect to any particular issue or problem.
Second, the financial and coverage implications:
- Short term plans have limited benefits especially when compared to ACA plans, so they may not provide enough coverage or benefits for you. For example, they include few, if any, of the essential health benefits and don’t include preventive care.
- Short term health plans are not guaranteed issue and pre existing conditions exclusions apply, which means your health history can impact whether or not you qualify for coverage.
- There are also annual benefit limits, unlike ACA plans which do not have annual or lifetime limits on essential health benefits.
It’s important to consider several factors, including both coverage and cost, when trying to figure out how to choose the right health insurance for you.
Summary + Next Steps
Short term health insurance should not be considered a replacement or substitute for an ACA-compliant major medical plan, as you won’t be covered for pre-existing conditions and there are many cases where you may require medical care but won’t receive your short term policy’s benefits at all.
Still, short term insurance plays a vital role in our health insurance system, ensuring that people that are between major medical plans and qualify can quickly and simply secure insurance that covers many types of unforeseen expenses.
Call (888) 855-6837 to connect with a licensed health insurance agent to talk about your options and get help finding the right product for you.
Learn more about short term medical health insurance or get a quote now – it just takes a minute and you can compare coverage and costs for multiple policies.