Searching for the right health insurance can be overwhelming. With so many different health insurance companies and coverage options to choose from, it can be challenging to know where to begin. However, we’re here to break down individual ACA major medical insurance and Short-Term Medical insurance (STM) so that you can understand the ins and outs of your coverage options. Whether you have a chronic medical condition and need more coverage or you’re only looking for a health insurance plan to have in place for emergencies or unexpected medical events, we can help you understand which type of coverage is best for you.
Key Differences Between STM and Major Medical Insurance
STM plans provide coverage for many basic medical needs (e.g., doctor visits and urgent care trips), and emergencies (e.g., ground ambulance rides and emergency room benefits). In contrast to ACA major medical insurance, STM does not provide coverage for pre-existing conditions, such as diabetes, epilepsy, migraines, or depression. Also, STM generally does not provide benefits for pregnancy or mental health and substance abuse treatment. If you have a chronic medical condition, need mental health or substance abuse services, or plan on being pregnant soon, then an ACA major medical plan that provides coverage for pre-existing conditions and all of the essential health benefits would be a better fit for you.
STM and ACA major medical are both flexible in their own ways, but STM offers a lower-cost option that works with your budget. ACA plans are renewable, but STM plans are also available for up to 12 months with the option to renew coverage for up to three years, depending on the state where you bought your plan. ACA major medical insurance provides some room for customization, like choosing a high deductible health plan (HDHP) or choosing between PPO, HMO, and EPO health insurance plans.
While STM coverage provides more flexibility with more plan design options, ACA major medical insurance includes more benefits and ways to enhance your health insurance plan.
You can also get more coverage in addition to your STM or ACA major medical plan by adding ancillary products to help you cover more out-of-pocket costs.
Due to the limited amount of covered benefits provided by Short-Term Medical insurance, the cost is less expensive than many ACA major medical plans. STM provides you with some financial protection from expensive medical costs after unexpected emergencies, injuries, and illnesses with monthly premiums that are often more affordable than what you can expect from ACA major medical insurance.
3. Availability Throughout the Year
Are you looking for health insurance outside of the Affordable Care Act (ACA) Open Enrollment Period? You can only buy ACA major medical insurance during this time. However, you can still get health insurance outside of Open Enrollment.
Health Insurance Options Outside of Open Enrollment
- Short-Term Medical insurance
- ACA major medical insurance if you qualify for a Special Enrollment Period due to a qualifying life event, such as:
- Losing or changing a job
- Getting married
- Having a child
- Moving to a new county
- Turning 26 and losing access to your parents’ coverage
- Becoming a U.S. citizen
Short-Term Medical insurance is an excellent option for those who need health insurance outside of Open Enrollment. With nearly immediate coverage, STM can provide you with some financial protection from unexpected, expensive medical costs and emergencies.
For a more in-depth look at how coverage differs between STM and ACA major medical insurance, see our comparison chart to help you choose which type of health insurance would better fit your health needs, budget, and lifestyle.
Think Short-Term Medical Insurance Could Be for You?
Short-term medical insurance can be a great option for those who do not need comprehensive coverage. If you think you could benefit from an affordable STM plan, then contact a Vera Health expert today to learn more about our flexible, personalized options. If you are looking for more coverage than STM offers, we can help you find coverage that fits your needs, even if it’s not with us. Give us a call at 844-961-9645 to learn more about Vera. No mystery, no fluff, no hassle.