Temporary Health Insurance: Everything You Need to Know

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 Health Insurance Marketplace program. Most people who enroll in these plans do so because their employer does not offer health insurance benefits.

Private insurance plans can be expensive, so it’s important to explore all of your options. Use our guide to find out how much private health insurance costs to compare rates and policies. Keep reading to learn more about what temporary health insurance is and which companies offer policies in your area.

Temporary Health Insurance Explained

Temporary healthcare plans are a kind of private health insurance that typically bridges a short-term gap in coverage — it is not designed as a long-term solution. This 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 expensive unforeseen accidents or illnesses.

Typically, short-term coverage plans last for one year, but in some cases — if you re-apply — you can have temporary coverage for up to three years. 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.

Any medical conditions you have or develop during your short-term plan period could also be considered a pre-existing condition when you reapply for a new plan.

Who Needs Temporary Health Insurance

Those who need temporary health insurance are:

• 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.

What Temporary Health Insurance Covers

Although temporary health insurance does not cover preexisting conditions, it can provide coverage for certain services such as routine office visits, preventive care, mental health services, and prescription drugs.

However, U.S. law does not require short-term health insurance to cover the Affordable Care Act’s 10 essential benefits. Check your policy to confirm it includes:

• Prescription drugs
• Pediatric services
• Preventive and wellness services and chronic disease management
• Emergency services
• Hospitalization
• 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, they are not required to be covered. Be aware that temporary health insurance does not cover maternity care or wellness visits. Other exclusions include:

• 43% do not cover mental health services
• 62% do not cover substance abuse
• 71% do not cover outpatient prescription drugs

Check with the plan’s benefits before you enroll.

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How to Get Temporary Health Insurance Coverage

If you are considering a short-term health insurance plan, start by researching first. Find out what each policy will and won’t cover, along with your out-of-pocket expenses for copayments, coinsurance, and deductibles.

Use this table to compare short-term health insurance by company with coverage limits, deductibles, availability, and prescription coverage.

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

If you find a company you like, determine whether or not there are caps on out-of-pocket expenses and total policy coverage. Check to see if in-network doctors and providers are available near you and ensure that coverage is available in your state.

Not all states offer short-term health insurance plans. They’re prohibited in Colorado, Connecticut, New Mexico, and Rhode Island. The following states maintain strict limits on short-term health insurance policies:

• Delaware
• Hawaii
• Illinois
• Maine
• Maryland
• Vermont
• Washington

However, residents of California, Massachusetts, New Jersey, and New York have access to temporary health insurance that covers pre-existing conditions.

What You Need to Know About Temporary Health Insurance

Temporary medical insurance is a type of health insurance plan offering short-term coverage for those in-between policies. You might need temporary insurance if you just started a new job or are waiting to be added to a spouse’s policy.

Availability and restrictions vary by state, so you research your options to find the most affordable temporary health insurance plan near you. Don’t forget that this coverage is temporary, so you will need to be prepared to find other coverage when your policy expires. Take advantage of our free comparison tool below to get free health insurance quotes from local companies.

Case Studies: Temporary Health Insurance

Case Study 1: John’s Temporary Health Insurance Coverage

John, a 32-year-old freelance graphic designer, recently left his full-time job to pursue his own business. As he transitioned into self-employment, John faced a gap in health insurance coverage. To protect himself from unexpected medical expenses, he decided to enroll in temporary health insurance.

John’s temporary health insurance plan provided coverage for a period of one year. During this time, he had access to routine office visits, preventive care, mental health services, and prescription drugs.

However, his plan did not cover pre-existing conditions, maternity care, or wellness visits. John understood the limitations of temporary coverage but found it to be a suitable option for his current situation.

Case Study 2: Sarah’s Experience With Temporary Health Insurance

Sarah, a 28-year-old recent graduate, was in between jobs and waiting for her employer-sponsored health insurance to begin. During this waiting period, she decided to enroll in temporary health insurance to ensure she had some form of coverage.

Sarah’s temporary health insurance plan offered coverage for accidents or major illnesses that might occur during the gap period. It included routine office visits, preventive care, mental health services, and prescription drugs.

However, it did not cover pre-existing conditions or maternity care. Sarah used this temporary coverage as a safety net until she could transition to her employer’s health insurance plan.

Case Study 3: Mark’s Limited Coverage With Temporary Health Insurance

Mark, a 45-year-old self-employed contractor, needed temporary health insurance while he explored his options for long-term coverage. He understood that temporary health insurance was not a substitute for comprehensive coverage but saw it as a temporary solution.

Mark’s temporary health insurance plan provided coverage for a period of six months, as per his state’s regulations. The plan covered routine office visits, preventive care, mental health services, and prescription drugs.

However, it excluded coverage for pre-existing conditions, maternity care, and wellness visits. Mark used this limited coverage to bridge the gap while he researched and compared different long-term health insurance options.

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