What is Short Term Health Insurance?
Short Term Health Insurance has many different names like temporary health insurance, short term medical, short term 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. They are used for individual and family healthcare coverage and last for a defined term of up to 364 days and renewable for up to 36 months depending on your state.
There are 5 advantages of short term health insurance:
At Agile Health Insurance, we specialize in exactly these kinds of Short Term Health Insurance plans, and we have many affordable policies in most states! Get a quote now!
Why Choose A Short Term Health 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.
3. Short Term Health Insurance is adaptable.
The ACA has strict requirements regarding the benefits it requires, called 0 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, Short Term 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. Short Term Health is available 24/7, 365 days a year.
You can apply for a Short Term Health Insurance year round. There are no blackout dates.
FYI: The ACA Open Enrollment Period is the six weeks between November 1, 2019 and December 15, 2019.
How Does Short Term Health Insurance Work?
Short Term Health Insurance is an affordable transition option for people who do not have an ACA or employer-sponsored 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. It is best for people who are in overall good health, don’t have certain 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 folks with larger concerns or requirements Additionally, people who have had a significant health event or medical condition in the past five years may have a hard time finding a Short Term Health Insurance plan that will accept them or provide coverage for their pre-existing condition.
Short Term Health 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 is the Difference? Short Term Health Insurance vs Obamacare
Affordable Care Act plans typically have broader benefits than those found in Short Term Health Insurance plans, but without the premium subsidies available to some qualified purchasers, cost much more than Short Term Health Insurance plans.
All ACA individual health plans must have the "10 essential health benefits." Short Term Health Insurance plans, in comparison, do not have a standardized set of benefits.
Short term plans usually offer what would be described as streamlined "major medical type benefits that covers healthcare costs in the event of unexpected accidents and illnesses.
The chart below details some of the major benefit differences between Short Term Health Insurance and Affordable Care Act plans. It is important to note that Affordable Care Act plans do not deny care for pre-existing conditions nor do they reject applicants based on health problems.
|Short Term Health 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 Health 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 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 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 only 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 Health 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 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 Health Insurance Today?
Short Term Health Insurance is a great choice for many consumers, but there are certain elements that you should take into consideration when looking at Short Term Health Insurance as a health insurance option.
1. Short Term Health Insurance plans are not renewable, but instead require you to reapply if you wish to add another period of coverage.
Short Term Health 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, Short Term 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 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 Health 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 Short Term Health 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 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 Health Insurance?
AgileHealthInsurance.com is the online leader in affordable Short Term Health Insurance policies. Click the link below to see how easy and simple it is to get a quote and compare all of our plans!