Short-Term Benefits for Necessary Coverage
Short-term health insurance is a necessary and very helpful option for anyone experiencing a lapse in or lack of regular health insurance. These plans are not required to follow ACA regulations, but they will almost always cover:
- Unexpected illness and injury
- Inpatient and outpatient hospital services (doctor’s visits, urgent care)
- Emergency care
They often, however, do not cover:
- Preventive care
- Pre-existing conditions (typically illnesses that have been treated/diagnosed within the last 2-5 years)
- Maternity (pregnancy)
- Dental, vision, and hearing
Some plans still include even some of this coverage. If you’re not sure if your illnesses are covered, or you simply want to make sure certain benefits are included, you can view the potential plan’s “exclusions and limitations.”
Costs of short-term health insurance will vary depending on the plan you purchase. The most important thing you need to know is that they function on a low-premium model—each plan has a very low monthly premium payment, but high out-of-pocket costs (including both copayment and coinsurance fees). Also, while some plans include it, not every plan has caps on annual costs while you’re covered by it.
Who Needs Short-Term Health Insurance?
Short-term health insurance benefits those who are experiencing a gap in health insurance coverage. Under ACA, everyone must be covered by insurance or else face a penalty. A short-term plan, then, not only provides a “safety net” in case of a medical emergency but also allows you to avoid the fee.
- Missed general enrollment period (GEP) for the year (and don’t qualify for a special enrollment period—if you did, you could enroll in Medicare at any point regardless of the GEP).
- You are experiencing changes or issues with your employment.
- You are between jobs.
- You lost your job or got laid off.
- You are a temporary or seasonal employee.
- You are on strike, laid-off, or a terminating employee.
- You are waiting for employer group coverage to start.
- Are waiting for your Medicare coverage to begin (depending on your time of enrollment, your coverage may not start for 3-6 months. The same can be applied to Marketplace coverage).
- Waiting for Marketplace coverage to start.
- Traveling outside of the network area.
- For younger individuals, if you are:
- A recent college graduate
- A dependent no longer covered under parents plan
Why Short-Term Health Helps
The greatest benefit of short-term health plans are, of course, their flexibility. Plans can last anywhere from as little as 30 days up to 36 months with a one-time optional renewal. And, more often than not, you can get approved for coverage as soon as the day of or after you apply.