What exactly is Short-Term Health Insurance?

Short-term health insurance is a type of health plan that can provide you with temporary medical coverage when you are between health plans, outside enrollment periods, and need some coverage in case of an emergency. However, to get the most out of a short term health plan, you need to understand how they work, what they cost, and what they cover.

*It’s important to note this is temporary health insurance and pre-existing conditions are not covered.

What does Short-Term Health Insurance cover?

Short-term health insurance coverage varies greatly depending on the plan and the insurance company you buy from. Select insurance providers such as Golden Rule Insurance Company may offer a short-term plan that offers coverage for up to a year.

Short-Term Health Insurance plans are not required to comply with Affordable Care Act (ACA) guidelines. ACA plans are required to provide certain levels of coverage—called minimum essential coverage. Short-term health plans are not required to meet the same standards.

Short-term health insurance typically provides some level of coverage for preventive care, doctor visits, urgent care, and emergency care. There may also be coverage for prescriptions. Some plans also offer cost savings for seeing in-network providers. The process of choosing your health insurance is daunting and complicated, but that’s why we’re here1 We’re able to explain the “exclusions and limitations” information before buying any plan to help educate you as to what is covered and not covered by each plan.  

How much does Short-Term Health Insurance cost?

If you’re considering temporary health insurance, typical upfront costs include:

• Premium: This is the monthly fee you pay for having coverage. The premium will vary depending on the level of coverage you choose, including deductible and coinsurance, as well as the types of services covered.
• Deductible: The deductibles on short-term health plans can be significantly higher than other more traditional health plans. You pay out of pocket for services until you meet your deductible. Then your plan starts sharing costs.
• Coinsurance: This is the percentage of costs you share with your plan after you meet your deductible. It’s often shown as a percentage. Most short-term plans have a deductible and coinsurance.
• Copay: This is a fee you may have to pay when you visit a doctor; usually payable at the time of the visit. Some short-term plans require you to pay a copay for certain doctor visits.
• Other out-of-pocket costs: If there are health care services not covered by your short-term plan, there is a chance you may be responsible for the costs. For example, some short-term plans may not cover or may limit your coverage for maternity care, mental health or substance use services, vision care, or dental care—these are costs you’d have to pay yourself for any services you receive.

Other costs may apply depending on what type of coverage you buy. The great news is our expert agents at Florida Healthcare Insurance are able to help determine your costs and see if you qualify for any subsidies to lower your costs down.

What are the pros and cons to Short-Term Health Insurance?

If you’re considering whether a short-term health insurance plan is right for you, here are some pros and cons:

Pros:

• Designed to fill short-term gaps in coverage should you need it
• You can cancel coverage whenever you’d like without penalties
• You can typically choose a plan that covers you up to a year, if needed
• Many different plan designs are available, depending on insurance carrier

Cons:

• Significantly higher deductibles than traditional health plans with other possible unforeseen costs
• No coverage for pre-existing conditions and limited coverage for most services
• A medical questionnaire may be required to be approved for coverage
• Coverage is not mandated or standard, so plans vary greatly in covered services and costs with very little government oversight

Short-term health plans vs. ACA health plans

Short-term plans were created to help fill temporary gaps in coverage that can occur in certain situations. These types of plans are typically not good substitutes for traditional health plans. They do not have to adhere to ACA standards. They provide limited benefits with generally much higher costs.

ACA health plans, on the other hand, must provide certain types of coverage as mandated by the government. They must offer coverage for essential health benefits like maternity and preventive care at 100%, mental health and substance use benefits, and more. Before you decide to purchase a short-term health plan, give us a call!

We will ensure you fully understand what types of care and services are covered and not covered and make your insurance buying process easy and stress free.

Do short-term health insurance plans cover pre-existing conditions?

Short-term health plans are not a part of the Affordable Care Act (ACA), so they do not need to comply with those standards. That means pre-existing conditions are not covered in a short-term or temporary health plan. You can be denied coverage for a medical issue you’ve previously been treated for.

How do I know if Short-Term Health Insurance is a good idea for me?

Short-term health insurance may not be ideal for the long term. But there are some situations in which you may need temporary coverage and a short-term health plan may provide it:

• You missed open enrollment for a traditional health plan
• You lost or left your job
• You turned 26 and just transitioned off your parents’ health plan

Is a short-term health plan a good idea for you? As a first step, we recommend you call and speak to one of our expert agents. We will go over and anticipate your upcoming health needs. Would costs for care be lower with a short-term plan than without? Explore plans available to you. Duration, types of benefits, and even costs can vary widely between insurance companies that offer these plans. Plans may also vary depending on the state you live in due to state regulations.

How do you buy a short-term health insurance plan?

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 Affordable Care Act (ACA) guidelines. To buy a short term medical plan, you can search for a private insurance company that offers them. Make sure to read all details before you buy or enroll. These plans can vary greatly in cost and coverage.