What is Short Term Medical Insurance?
Short Term Medical Insurance has many different names like temporary health insurance, short term medical insurance, short-term care insurance, short-term health plans, term insurance, or STM health plans. Short-term health plans offer major medical type benefits in the case of unexpected accidents and illnesses.
Both individuals and families can enroll in temporary medical insurance plans.These plans last up to 364 days and are renewable for up to 36 months depending on your state.
4 Important Benefits of Short Term Medical Insurance:
AgileHealthInsurance specializes in these kinds of Short Term Medical Insurance plans.
Why Choose an Agile Short Term Medical Insurance Plan?
1. Starting in 2019, there is no tax penalty.
2. Temporary insurance can bridge the gap until the next ACA Open Enrollment Period.
Unless you qualify for a Special Enrollment Period, you can only purchase an ACA plan between November and mid-December. This is where these short-term plans, also known as interim health insurance, can help.
3. Short Term Medical Insurance is adaptable.
The ACA has strict requirements regarding the benefits it requires, called the 10 essential health benefits. Every plan, for example, must offer maternity services and you cannot be rejected even if you have a pre-existing condition.
Conversely, Temporary Health Insurance is affordable because it offers streamlined benefits to cover you for the unexpected illness or accident: hospital, doctor, x-ray, and other treatment benefits.
4. Agile Short Term Medical Insurance is available 24/7, 365 days a year.
You can apply for Short Term Medical coverage year round.
How Does Temporary Health Insurance Work?
Temporary health insurance is a flexible option for people who do not have an ACA or employer-sponsored health insurance plan. It can bridge the gap for people moving from full time employment to self-employment, from college graduate to employee, or other scenarios where finances are tight and the future unpredictable.
Temporary health insurance is also best for people who are in overall good health and don’t have chronic conditions or complex medical needs.
ACA plans offer benefits for chronic and complex conditions, including mental health needs, and would be more appropriate for people who have had a significant health event or medical condition.
Short Term Medical Insurance might be the best option if you:
- Missed the annual Open Enrollment periods for Obamacare/ACA plans.
- Have a waiting period before you can enroll in another major medical insurance plan.
- Are between jobs, a part-time or temporary worker, or looking for a less expensive alternative to COBRA.
- Are a college student, a recent graduate, or have aged out of your parent’s health plan and you need insurance.
- Recently retired but are still too young for Medicare.
What’s the Difference between Short Term Medical Insurance Obamacare?
Affordable Care Act plans typically have broader benefits than those found in Short Term Medical Insurance plans, but without the premium subsidies available to some qualified purchasers, ACA plans cost much more than Temporary Health Insurance plans.
All ACA individual health plans must have the "10 essential health benefits." Short Term Medical Insurance plans, in comparison, do not have a standardized set of benefits.
Short-term insurance plans usually offer "major medical” type benefits that cover healthcare costs in the event of unexpected accidents and illnesses.
The chart below details some of the major differences between Short Term Medical Insurance and Affordable Care Act plans. It’s important to note that Affordable Care Act plans cannotdeny coverage for pre-existing conditions or reject applicants based on health problems.
|Short Term Medical Insurance Plans||Affordable Care Act Plans|
|Coverage availability||Apply any time and get coverage as early as the next day.||Apply only during Open Enrollment (or Special Enrollment due to a qualifying event) and get coverage on a standardized effective date 2-6 weeks in the future.|
|Coverage duration||1 month to 12 months depending on the state. Many states allow you to reapply for back-to-back coverage.||As long as the plan is available. You can change plans during Open Enrollment (or Special Enrollment with a qualifying event).|
|Prescription drug coverage||Many Short Term Medical Insurance plans provide a drug discount card but do not provide drug coverage. Some newer plans have a prescription drug coverage option for generic drugs not associated with a pre-existing condition. Brand name drugs and specialty drugs are typically uncovered.||Minimum of one drug per class must be covered but the minimum number of drugs per class is often more due to the benchmark formulary chosen for each particular state.|
|Maternity and newborn care||Complications of maternity may be covered but not standard childbirth services.||Full coverage. Applicants cannot be denied based on pregnancy as a precondition.|
|Mental health services||Some plans offer a limited benefit. In some states coverage is included because the state mandates it.||Coverage included, but states vary on their definition of “mental health” services, so while some do include learning disabilities or conditions like Autism, other states do not.|
|Substance use disorder services||Coverage generally is included only when mandated at state level.||Covered. Benefit amounts, services and networks are defined by the State and the plans available..|
|Rehabilitative and habilitative services and devices||Coverage is generally included only when mandated at state level.||Covered. Benefit amounts, services and networks are defined by the State and the plans available.|
|Preventive care||Some plans have selected preventive care benefits with cost-sharing. However, many plans do not cover preventive care services.||Preventative services must be provided without cost-sharing.|
|Pediatric services - oral and dental care||Coverage is included generally when mandated at state level.||Covered. Benefit amounts, services and networks are defined by the State and the plans available.|
|Healthcare provider networks||Short Term Medical Insurance plans typically have broad acceptance among healthcare providers. Some have a preferred network with negotiated pricing for healthcare services and a larger non-preferred network where the plans pay 'usual and customary' fees for covered healthcare.||These plans have networks and some have been noted for a significant use of "narrow networks" to increase the ratio of enrollees to healthcare providers.|
|Coverage of pre-existing conditions||These plans evaluate health status and pre-existing conditions when processing an insurance application and determine whether the applicant is approved or rejected for coverage.||These plans do not consider health status or pre-existing conditions when processing an insurance application.|
What's Important to Know About Short Term Medical Insurance Today?
Short Term Medical Insurance is a great choice for many consumers, but there are certain elements to consider if you’re looking into this type of plan.
1. Temporary Health Insurance plans are not renewable. Instead, they require you to reapply if you wish to add another period of coverage.
Short Term Medical Insurance plans cannot be automatically renewed, and you will need to submit a new application.
2. You can be denied coverage due to pre-existing conditions.
Like medical insurance before the ACA, Temporary Health Insurance plans can deny your application based on your current and past health conditions. Insurers will often review up to five years of your health history.
3. Short Term Medical Care plans are not required to have the same coverage benefits as Affordable Care Act (Obamacare) plans.
The Affordable Care Act established a very clear set of minimum coverage benefits called the “10 essential health benefits.” Short Term Medical Insurance offers major medical type benefis, but does not cover all of the ACA’s “essential health benefits” such as maternity or mental health.
As a result, the premiums for Temporary Medical Insurance are often significantly less expensive but still provide medical coverage for illnesses and injuries and include services such as emergency room, hospitalization, doctors, specialists, labs, and other important benefits.
4. You can cancel your policy anytime you want.
Most short term medical plans allow you to make month to month payments up to the maximum term set by your state.
At the end of your policy, your coverage will automatically terminate. If you need to cancel your coverage earlier, you should contact your licensed AgileHealthInsurance sales agent and inform them.
How Do I Get Short Term Medical Insurance?
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