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What Are the Limitations and Exclusions of Short Term Health Insurance Plans?

info icon signaling important information about short term health insurance plans

So, you’ve been looking into short term health insurance plans. 

Whether you’re between plans, having difficulty securing a traditional ACA plan, or you’re just looking to get covered as quickly as possible, no doubt having a short-term plan comes with several benefits.

However, short-term health insurance plans, while beneficial in certain circumstances, are not a full-fledged replacement for comprehensive health insurance. It’s important to understand their limitations and exclusions to make an informed decision.

That’s what we’re looking at today as we deep dive into the typical issues you may find with a short-term healthcare insurance plan, including limitations and exclusions you need to know.

Let’s go.


A Comprehensive List of the Limitations and Exclusions of Short Term Health Insurance Plans

Lacking Duration and Renewability

As the name suggests, short-term health insurance plans are only available for the short term, meaning they typically last for a few months. This means you can never rely on them for long-term coverage. 

Though you can renew these plans, there’s usually a cap on how many times you can do this before your application is simply rejected. Also, renewals are not automatic and require you to reapply each time.

Short Term Health Insurance Plans Don’t Cover Pre-existing Conditions

One of the primary limitations is the lack of coverage for pre-existing conditions. 

Most Short-term insurance plans often exclude any health condition you had before the policy’s start date. This exclusion can range from chronic diseases like diabetes to recent injuries. 

Thus, short-term health insurance might not be the right choice if you have a pre-existing condition.

A Lack of Comprehensive Benefits

Short-term plans do not cover all of the ten essential health benefits mandated by the Affordable Care Act (ACA). 

These benefits include preventive care, maternity care, mental health services, and more. Short-term plans focus mainly on emergency care, which could leave you exposed to high out-of-pocket costs for non-emergency medical services.

No Preventive and Routine Care

Routine checkups, preventive screenings, and immunizations are usually not covered by short-term plans. They also typically don’t cover prescription drugs unless it’s associated with an accident or sudden illness. 

If you require regular medical attention or prescriptions, you might find a short-term plan lacking.

Increased Coverage Caps

Short-term health insurance plans often have coverage caps. This means that the plan will stop paying for your care after it has spent a certain amount. Unlike ACA-compliant plans, which have no lifetime or annual coverage limits, short-term plans can leave you with considerable medical bills if you have a severe illness or accident.

Many State Restrictions

Not all states allow short-term health insurance. States like California, New York, New Jersey, Rhode Island, and Massachusetts do not permit the sale of these plans

Moreover, other states might have more stringent restrictions on the duration and renewal of these plans.

A Lack of Subsidies

Because short-term health insurance plans are not ACA-compliant, they are not eligible for federal subsidies. This means that while the plans might appear cheaper initially, they could actually be more expensive for individuals who qualify for premium tax credits on ACA-compliant plans.


Short term health insurance plans have numerous limitations and exclusions that can leave you underinsured or with high out-of-pocket costs. They serve specific, temporary needs and should not be considered as a long-term solution. 

If you’re considering such a plan, ensure you fully understand its limitations and weigh it against your healthcare needs and financial circumstances.

Struggling to make the right decision?

Here at My Healthcare Direct, our experienced experts and agents are always on hand to help guide you to the plan that perfectly suits your needs. Contact us today, and let’s get your healthcare plan sorted once and for all.

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