Temporary Health Insurance: Everything You Need to Know
Temporary health insurance is designed to fill short-term gaps in coverage and usually lasts for a year. Many different plans are available, depending on the insurance carrier. These types of plans are not required to comply with Affordable Care Act guidelines, they do not need to meet the same standards. If you are enrolling in a temporary health insurance plan, be prepared for premiums, deductibles, coinsurance, copay, and other out-of-pocket costs.
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UPDATED: Jan 16, 2022
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- Temporary health insurance is typically used to bridge a short-term gap
- This type of coverage can help you if you experience an accident or major illness during a period when you don’t have comprehensive health insurance
- Temporary health insurance plans are available year-round
A person can enroll in health insurance as an individual, within a group, and through their job. For people who are in between jobs or dealing with a few different obstacles in life, temporary health insurance is available.
Individual, or personal health insurance plans are those you enroll in by yourself, usually through the government’s Marketplace program. Most people who enroll in these plans do so because their employer does not offer health insurance benefits.
Some may confuse temporary insurance with term life insurance, but they are different.
Private insurance plans can be expensive, so it’s important to explore all of your options.
Find out if your insurance company offers temporary health insurance. Enter your ZIP code, and get a free quote today.
What is temporary health insurance?
Temporary health care plans typically bridge a short-term gap; it is not designed as a long-term solution. This type of coverage can help you if you experience an accident or major illness during a period when you don’t have comprehensive health insurance.
These types of plans are available year-round, focusing on protecting against inexpensive unforeseen accidents or illnesses.
Temporary health insurance typically has lower ACA premiums because coverage is limited and can provide people with an affordable premium.
These types of medical plans require medical underwriting. This will expose your medical history and information will be considered before you are provided with coverage. If you have preexisting health conditions or a health problem prior to the date your new coverage is expected to start, you may be denied coverage.
Typically, short-term coverage plans last for one year, but in some cases — if you reapply — you can have temporary coverage for up to three years. Any condition you have or develop during your short-term plan period could be considered a pre-existing condition when you reapply for a new plan.
Some states have created their own limits. These include bans, term limits of six months or less, and restrictions on opportunities to reapply for coverage.
What does temporary health insurance cover?
Although temporary health insurance does not cover preexisting conditions, it can provide coverage for certain services such as routine office visits, preventive care, maternity care, mental health services, and prescription drugs.
Temporary health insurance is not required to cover the Affordable Care Act’s 10 essential benefits:
- Prescription drugs
- Pediatric services
- Preventive and wellness services and chronic disease management
- Emergency services
- Mental health and addiction services
- Pregnancy, maternity, and newborn care
- Ambulatory patient services
- Laboratory services
- Rehabilitative and habilitative services and devices
Although some of these services may be covered, it is not a requirement for them to be covered. Check with the plan’s benefits before you enroll.
Exclusions that demonstrate the limitations found in many short-term health plans include these statistics:
- 43% do not cover mental health services
- 62% do not cover substance abuse
- 71% do not cover outpatient prescription drugs
- Short-term health insurance does not cover maternity care
- Short-term health insurance does not cover wellness visits
Who is temporary health insurance for?
According to Cigna, temporary health insurance is not only for people who are between jobs. This type of insurance is also suitable for the following types of people:
- Those waiting to be enrolled in a group plan by a new employer
- Recent college graduates
- Those transitioning from a spouse or parent’s health plan
- Those making a career change
- Those who are seasonally employed
- Those needing coverage outside of the open enrollment period
- Those waiting for enrollment in Medicare after retirement
You should not consider short-term health insurance if you have a lot of medical expenses or expect to need maternity care because you could end up paying much more out of pocket. If you qualify for subsidies to purchase a plan in the ACA Marketplace, that could be a more affordable option with better benefits for you than a temporary insurance plan.
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Who offers short-term health insurance?
|Company Name||Plans||Coverage Limit||Waiting Period||Deductible|
|Everest||1||$250,000 to $1.5 million||1 day - 6 months||$1,000, $2,5$5,000, $7,500 or $10,000|
|Pivot Health||varies||$100,000 to $1 million||5 days - 6 months||$1,000, $2,000, $2,500, $3,000, $5,000, $7,500 or $10,000|
|IHC Health Group||varies||Up to $2 million||Varies||$2,500, $5,000, or $10,000
|United Healthcare||varies||$500,000 to $2 million||6 - 12 months||$2,500, $5,000, $7,500, $10,000, or $15,000|
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Not all states offer short-term health insurance plans. They’re not permitted in Colorado, Connecticut, New Mexico, and Rhode Island.
California, Massachusetts, New Jersey, and New York prohibit the sale of these plans if they don’t cover preexisting conditions.
Delaware, Hawaii, Illinois, Maine, Maryland, Vermont, and Washington maintain strict limits on short-term health insurance policies.
How do I enroll in a short-term health insurance plan?
If you are considering a short-term health insurance plan, start by doing research first. Find out what each policy will and won’t cover along with your out-of-pocket expenses for copayments, coinsurance, and deductibles.
Determine whether or not there are caps on out-of-pocket expenses and total policy coverage. Check to see if there are in-network doctors and providers available near you.
Don’t forget that this is a temporary insurance plan. You will need to be prepared to find other coverage when your policy expires.
Find the best health insurance plans for you. Enter your ZIP code to obtain a free quote today.