Outside of the individual market’s annual open enrollment period a short-term health insurance policy might be your best option, especially without a qualifying event. Short-term plans generally provide the most comprehensive coverage available outside of open enrollment.
Short-term policies have been around for some time. They are a good option for people who are between jobs or waiting for a new employer’s coverage to become effective. Unlike regular individual major medical plans, short-term health insurance policies are not regulated by the Affordable Care Act and their sale is not limited to open enrollment windows.
If you experience a qualifying event that triggers a special enrollment period, you’ll need to apply for an ACA-compliant policy (on or off-exchange) during your special open enrollment period, which lasts for 60 days in most cases. If you opt for a short-term policy instead, you won’t have the option to switch to an ACA-compliant plan after your open enrollment period ends. But, if you miss open enrollment and haven't experiences a qualifying event, a short-term policy will provide you with up to six months of coverage in most states.
Short-term plans are typically offered with a selection of premiums, deductibles and benefit maximums. The policies are considerably less expensive than ACA-compliant major medical plans, so you may find that you can afford to purchase a plan with a low deductible and a high-benefit maximum. Plus, healthy applicants can secure immediate individual and family coverage, with plans that can start almost immediately.
The policies also cover a range of physician services, surgery, outpatient and inpatient care. In addition, policy holders can often choose their own doctor and hospital without restrictions, though there may be financial incentives for using in-network providers.
Short-term major medical plans may be a great fit for healthy folks who just need temporary coverage, but the plans weren’t designed to cover everything, and they do not provide coverage for all of the ACA’s essential benefits.
They typically won’t cover your routine office visits, maternity, mental health or preventative care – and they won’t cover pre-existing conditions. They also still use medical underwriting, which means that applicants with serious pre-existing conditions may not be able to get short-term coverage. Be sure to check the list of exclusions on any policy.
Give us a call to find out if short-term health insurance is an option for you.