If you’ve missed the health insurance Open Enrollment Period (OEP), or if you have had a sudden lapse in your insurance coverage, you might be stressing over how to get covered. But don’t worry, you still have options! One of your best options will be a short-term health insurance plan. These plans tend to be less expensive than traditional health insurance because they provide very limited coverage, and so they are usually meant as a stopgap for generally healthy people. So, what do these plans cover (and what don’t they cover), and what are the specific rules surrounding them?
Compared to traditional health insurance plans, which typically include a comprehensive range of benefits, short-term health insurance plans offer significantly less coverage. In fact, they are not required to provide coverage for the “10 essential health benefits” that traditional ACA-approved plans are required to cover.
That means short term health plans are not required to provide coverage for:
Pre-existing conditions
Medications
Maternity care
Mental health
Substance abuse treatment
But, with that being said, short term health plans are better than nothing, and generally provide coverage for:
What you can expect to pay for a short-term health plan will be determined by the specific plan that you choose, as it would be with any other type of insurance. You will be responsible for paying a monthly premium, in addition to:
Deductibles – As with other types of insurance, with a short-term plan, you pay for services out-of-pocket until your deductible is met. After that, your plan will start to split costs. Short-term health plans can have deductibles that are much higher than those of other, more traditional health plans.
Coinsurance – After you’ve met your deductible, your plan will cover your medical expenses in part, but you will also have to pay a percentage, known as coinsurance. For example, you might have to pay 30% of each covered medical expense, while your plan covers 70%.
Copays – This is a set fee that you may have to pay when you use a medical service. For example, you might have to pay $20 at the point of service when you go to the doctor.
Other expenses – If there are health care services that your short-term plan doesn’t cover, you might have to pay for them completely out-of-pocket. For instance, some short-term plans might not cover or only cover a certain amount of maternity care, mental health or substance use services, vision care, or dental care. If you need these services, you’d have to pay for them yourself.
One good thing about the costs of these plans is that their monthly premiums are typically much more affordable than the premiums for plans offered under the Affordable Care Act (ACA). With that being said, the reason that they are sold at a lower price is because most of the time, these plans don’t cover much, and only a portion of the monthly premium actually winds up being applied toward the cost of actual medical care.
Short Term Plans State-by-State
When it comes to the rules surrounding short term plans, every state is different. In fact, some states don’t even allow residents to buy these plans, but most allow a limited length of time to have one of these plans.
The following states allow you to have coverage with a short-term plan for 364 days, and allow you to renew up to 3 times for a total of 3 years of short-term coverage:
For more in-depth information on your state’s laws surrounding short term insurance, check out our state-by-state guides to health insurance.
Pros and Cons of Short-Term Plans
Short term plans can give you a number of advantages. But you should be aware that there are some drawbacks to this option as well. Knowing both the pros and cons of these plans will help you make an educated decision.
Pros
Affordability – The low price of these plans’ premiums is a highly attractive benefit.
Quick coverage – Plans usually go into effect within 7-14 days of enrolling.
Easy Cancellation – It is possible to terminate short-term insurance plans with little advance notice, particularly if you pay for your plan on a month-to-month basis.
Cons
Renewal Limitations – Short term plans do not automatically renew, and the number of times you are allowed to renew them is usually capped.
Coverage Limitations – In most cases, a temporary health insurance plan will not include coverage for all ten essential health benefits.
Availability Limitations – Not all states or insurance companies offer short-term plans to their customers.
Qualifying for Short Term Health Insurance
As discussed above, the majority of states permit short-term health plans, but there are a few that do not, and others that place restrictions on how long coverage can be maintained.
But even if your state permits short-term plans, you may still be denied coverage by an insurance company for health reasons. For example, you might be denied a short-term plan if you have a serious preexisting medical condition, or if you’re currently expecting a child.
In general, you will qualify for short term plans if you:
Are young and healthy.
Missed the OEP, and don’t qualify for a Special Enrollment Period
Are out of work and can’t afford COBRA or an ACA plan and need coverage in the meantime.
Are almost eligible for Medicare but do not want to enroll in a full year-long plan.
If you have a pre-existing condition, such as asthma or diabetes, you might want to steer clear of short-term plans even if you can get approved, because your premiums will be significantly more expensive, since these plans are not subject to ACA rules on preexisting conditions.
How to Buy Short Term Plans
Although you may be able to enroll in a short-term plan in person in some circumstances, the most common method for purchasing short-term health insurance is doing so online. You can also contact an insurance company that specializes in selling short-term plans directly.
Because of the state regulations surrounding short term health plans, and because these plans are offered by both national and regional companies, their availability is highly dependent on the state you live in. National companies sell short term health plans in multiple states, and regional companies have more localized service areas, so you’ll need to shop around. Speak to an EZ agent about what companies in your area offer the best short-term health plans.
FAQs
Will my doctor accept short term health insurance?
It depends on the plan. Some plans require you to stay in their network of doctors, with other plans, you can choose your own doctor and hospital without being subject to any restrictions. With that being said, in this case, there may still be financial incentives for using in-network providers.
Are pre-existing conditions covered?
When you apply for a short-term health plan, you’ll have to answer a short list of questions about your health, including about preexisting conditions. There’s a chance you will be denied coverage if you have certain preexisting conditions, and even if you are considered eligible for coverage, your plan will most likely not provide coverage for treatment of your preexisting condition.
So, when applying for one of these plans, examine the policy’s wording thoroughly. It’s common practice for short-term plans to use post-claims underwriting, which means that they’ll take your word for it about your health when you sign up, but can check your records after you’ve filed a claim to make sure you weren’t lying about any preexisting conditions.
Is losing my short-term coverage considered a qualifying life event?
Since short term health plans are not ACA-approved plans that provide minimum essential coverage, losing such a policy does not warrant a Special Enrollment Period that will allow you to shop for an ACA-compliant plan outside of Open Enrollment.
So, is a Short Term Plan the Best Option?
The purpose of short-term health plans is to provide healthy people with temporary, limited protection. Therefore, those who have ongoing medical needs or who have a history of illness should avoid short term health plans. If you’ve lost your coverage, and are in-between plans and looking to cut costs, short term health coverage is the way to go. But before you make a purchase, you should think carefully about whether or not it will meet your needs.
You can get information on short term health plans by contacting EZ.Insure and speaking with a licensed agent. We’ll go over all the details with you and help you figure out if one of these plans is right for you. And if it turns out a short-term health plan isn’t the best option for you, we’ll find you something that fits your budget and your health status. Get an instant quote by entering your zip code in the box below, or to speak to an agent directly, call 877-670-3557.
If you are unhappy with your current health insurance policy, then it might be time to shop for a different plan. But can you purchase a new plan at any time? Yes, and no. For marketplace plans, once the open enrollment period (November 10 to December 15) is over, you generally cannot get a new plan. The open enrollment period for employer-based insurance might be at a different time of year, but you will still only be able to change your plan during that enrollment period. In most cases, if you want to get health insurance or change your plan outside of the open enrollment period, you will need to qualify for a Special Enrollment Period (SEP). SEPs open up when you experience what is known as a qualifying life event.
Qualifying Life Events
You can get health insurance outside of open enrollment if you qualify for SEP such as getting married or having a baby.
You have 60 days to change your plan if you:
Got married
Had a baby, adopted a child, or took in a foster child
Got divorced or legally separated. However, if you do not lose coverage due to divorce or legal separation, then you do not qualify for a Special Enrollment Period.
Had someone on your marketplace plan die
Changed residence. If you move to a new home in a new ZIP code or county, move to attend school, are a seasonal worker and move between job and home, or move from a shelter or other transitional housing to a permanent residence, you will qualify for an SEP.
Lost your health insurance. This includes losing job-based coverage, losing a plan you bought yourself, losing eligibility for Medicaid or Medicare, and losing coverage through a family member.
Gained membership in a federally recognized tribe or status as an Alaska Native Claims Settlement Act (ANCSA) Corporation shareholder
Became newly eligible for Marketplace coverage because you became a U.S. citizen
Left incarceration
Started or ended service as an AmeriCorps State and National, VISTA, or NCCC member
Short-Term Medical Plans
If you do not qualify for any of the life events listed above, all hope is not lost. You can enroll in a short-term medical plan. Short-term health insurance provides fast, flexible insurance with many benefits. These plans can be extended up to 3 years, and you can pick your deductible amount from many options. You are also able to drop coverage without a penalty if you want to change to a long term insurance option. Premiums are lower than ACA health insurance plans, and you get coverage as soon as a day after applying.
It is important to understand that short-term insurance is temporary and not ideal for those who require more comprehensive coverage or have health conditions. Short term plans are not guaranteed-issue, meaning they do not cover pre-existing conditions. They only cover the basics.
Do you qualify for a special enrollment period? If not, are you considering a short-term health insurance plan to hold you over until open enrollment begins? EZ.Insure can help. We offer accurate health insurance quotes based on your specific region, free of charge. That’s right. We will provide you with an agent who will compare all available plans for you, and help you choose a health insurance plan that is based on your health needs and budget, for free. To get your free quotes, simply enter your zip code in the bar above, or to speak to an agent, call 888-350-1890.
Losing a job is not easy. You lose the money that paid your bills, and you lose the health insurance that protected you and your family’s health. But you do not have to go without insurance just because you lost your employer’s group plan. EZ will find you an affordable short-term health insurance plan that keeps you insured until you get another job. All of our services are free, so no need to worry about paying for anything other than the plan you sign up for. There are various different plan options but when looking for something between jobs, you may find that the perfect plan is a short-term plan.
You can find affordable health insurance, such as short-term plans. They offer coverage and cheaper than long-term plans.
Short-Term Health Plans
Short-term insurance is insurance anyone can get if they missed the open enrollment period, or need insurance while in between coverage (for example, if they have lost their job and no longer have insurance). It is best for those who are healthy and only need a policy temporarily in case of an unexpected sickness or injury. These plans are cheaper than ACA plans, but provide limited coverage: they are not required to cover the 10 essential benefits that ACA plans are required to cover.
What Short-Term Plans Provide
Short-term health insurance provides fast, flexible insurance with many benefits. It provides coverage with low premiums to help weather the storm.
Short-term health insurance provides fast, flexible insurance with many benefits. You are able to pick your deductible amount from many options. You are also able to drop coverage without a penalty for a long term insurance option. Premiums are lower than ACA health insurance plans, and you get coverage as soon as a day after applying.
The catch is that these plans are less expensive because they cover less. They are ideal for those who are relatively healthy and do not need a lot of coverage. They are considered more of an in-between (gap) plan, or a plan for healthy people who need the basics covered.
If you do need to keep short-term for longer than expected, then you can. Insurance companies now have the ability to sell short-term health insurance plans that cover you for up to 3 years (36 months). These plans may offer less coverage, but will be there for those who can not afford, or do not feel that they need, extensive coverage.
If you are interested in obtaining more information on short-term insurance, contact EZ.Insure and connect with a highly trained agent. EZ.Insure will weigh the benefits and downsides of a short-term plan. We will go over everything with you and help you decide if one of these plans best suits your needs. If it does not, then we will direct you to other plans. Enter your zip code in the bar above to get instant quotes. Or to speak with your own personal advisor call 888-350-1890.
We take pride in servicing our customers, and strive to get you the best plan for the best deal. Do not go another day stressed due to lack of insurance, call EZ.Insure and get started with the right insurance plan for you.
The time has come. You made it to 26 with health insurance coverage through your parents. But now your birthday is approaching and are getting kicked off your parent’s health insurance plan. You may be wondering if you can stay on your parents’ health insurance longer. The answer to this is, unfortunately, no. You will get kicked off the plan at
When you turn 26 years old, tjere is a deadline for your hralth insurance. You will have to get your own plan.
either the end of the month that you turn 26, or at the end of the year. Its inevitable, but where do you start?
The Options
If you are employed, then you can join your company’s health insurance plan if they have one. Another option is to hop on your spouse’s health plan if you are married. If none of these options apply to you, then your only choice is to get your own health insurance plan. Those options are:
Long-term Plans
When you turn 26, you qualify for a special enrollment period for Obamacare, also known as the Affordable Care Act (ACA). You also have the option of getting private insurance in which licensed health insurance agents are able to create a policy that is unique to your specific needs using a full spectrum of different insurance companies. It is important to shop around because these plans are sometimes cheaper than the marketplace insurance plans. Long-term plans offer more comprehensive coverage. These plans help manage day to day expenses and are convenient for those that require routine medical work, such as medication, lab work, and inpatient/outpatient services. Major medical health insurance complies with the ACA requirements which means it provides the ten essential health benefits.
Essentially, when you are over 26 years old and are no longer on your parent’s plan, then a major medical plan is best if you are looking for coverage of pre-existing conditions, and need routine medical work , such as medication,
The two options for health insurance are short-term and long-term. Short term plans do not cover pre-existing conditions, only the basics. If you need comprehensive coverage, long-term is best.
lab work, and inpatient and outpatient services. Major medical health insurance complies with the ACA requirements which means it provides the ten essential health benefits. These ten essential benefits are: ambulatory patient services, prescription drugs, emergency care, mental health services, hospitalization, rehabilitative services, preventative and wellness services, laboratory services, pediatric care, and maternity and newborn care.
Short-Term Plans
Unlike long-term plans, their short-term counterparts do not need a qualifying life event to enroll. Short term health insurance provides fast, flexible insurance with many benefits. These plans can be extended up to 3 years, and you can pick your deductible amount from many options. You are also able to drop coverage without a penalty if you want to change to a long term insurance option. Premiums are lower than ACA health insurance plans, and you get coverage as soon as a day after applying.
It is important to understand that short-term insurance is temporary and not ideal for those who require more comprehensive coverage or have health conditions. Short term plans are not guaranteed issue, meaning they do not cover pre-existing conditions. They only cover the basics.
When you consider purchasing health insurance, you have to think about how much you want to pay, the coverage provided, and which term length is best for you. It can be quite overwhelming when you embark on this new journey. EZ.Insure can help. We will provide you with a highly trained agent within your area that can provide you quotes and plans from all the different health insurance companies in your region. To get started, enter your zip code in the bar above. Or to speak to an agent call 888-350-1890, or email [email protected]. We will go over everything with you and help you decide if this plan best suits your needs. If it does not, then we will direct you to other plans.
The Trump Administration has finally finalized expanding insurance companies ability to sell short-term health insurance plans for up to 3 years (36 months). This will allow consumers to buy less expensive and less comprehensive insurance policies for a longer time. The old rule for short-term health insurance was that it cannot last for more than three months. This new rule will open these policies to consumers for up to 36 months, in hopes that more healthy people will utilize them. These plans may offer less coverage, but will be there for those who can not afford or do not feel that they need extensive coverage.
“We want to open up affordable alternatives to unaffordable Affordable Care Act policies,” said Health and Human Services Secretary Alex Azar. “Americans need more choices in health insurance so they can find coverage that meets their needs. The status quo is failing too many Americans who face skyrocketing costs and fewer and fewer choices. This is one step in the direction of providing Americans health insurance options that are more affordable and more suitable for individual and family circumstances.”
In 2016, Obama restricted these plans by limiting them to just three months of coverage from 12 months. Back in October, Trump issued an executive order to cut back the restrictions on these plans that limited them to three months. By removing these restrictions, Trump gave the public the ability to decide for themselves whether they need a more committal plan, or a short term plan for the next year. This is one of Trump’s first steps to achieving his promise of dismantling the ACA once and for all.
Some skeptics worry that the more healthy people leave the marketplace, the more expensive premiums will be for those still in the market. The premiums would increase and cause subsidies for policyholders to rise which in turn would cost the government more money.
When asked about the concerns that the proposed rules would destabilize insurance markers Seema Verma, the administrator of the federal Centers for Medicare and Medicaid services said, “we don’t think there’s any validity”. She continued to state that federal officials believe that between 100,000 and 200,000 healthy people now buying insurance through those federal exchanges would switch to the short-term plans, as well as others who are now uninsured.
Once someone signs up for a short term plan for a year, they can now continue to renew it for up to three years. Insurers can ask medical questions and possibly reject consumers due to pre-existing conditions for a short-term policy. Once approved for the plan, if a consumer develops a ‘pre-existing condition’, then they can be rejected when it is time to renew.
Short term plans do not cover maternity care, so if you are considering getting pregnant you should take into consideration how much out of pocket costs you can handle.
Short term plans are less expensive, because they cover less, for example, maternity care and preventative care are not covered. It is ideally for those who are relatively healthy and do not need a lot of coverage. The hope is that the new rule will be more appealing for younger and healthier people.
The Trump Administration believes this will bring in an increase in premium revenues and profits because more people would sign up for a short-term insurance plan. This will allow the insurers to set prices to reflect a customer’s health risk of high medical costs. Trump believes that this 36 month extension is important because premiums more than doubled from 2013-2017 for health plans in the federal Marketplace Insurance exchange.
If you are looking for a short term plan or have questions regarding it’s coverage, EZ.Insure can help. Our agents specialize in short term plans in your area and can answer any questions you have to find out if it is right for you. You will be given your own advisor who will go over different plans, and help sign you up free of charge. To start saving, enter your zip code in the bar above to get instant quotes, email us at[email protected], or call 855-220-1144. We guarantee we will be able to find you a plan that is affordable and meets your needs.
