It’s vital to have health insurance so you can get the care you need to stay healthy, prevent serious illnesses, and avoid expensive out-of-pocket costs. Still, an estimated 8.5% of Americans were without health insurance in 2018. That’s the equivalent of 27.5 million Americans.
Many struggle with finding insurance coverage because it’s too expensive, too complicated, or they lost their job-based health insurance. Short-term medical insurance is an option for some. If you’re looking for health care options outside of major medical plans, you may be considering short-term medical insurance and probably have some questions.
Is short-term medical insurance good? Is it affordable? Does it provide decent protection in the event of illness or injury? Read on to learn about the features of short-term medical insurance and whether it could be a good choice for you.
What Is Short-Term Medical Insurance?
Short-term medical insurance is an affordable health insurance option for those who do not need comprehensive major medical coverage. These plans tend to have limited coverage and higher deductibles, which results in lower premiums. Still, short-term medical insurance can give you some financial protection in the event of a real need or emergency.
People often opt for short-term coverage when they lose their insurance and can’t enroll in another plan because it is not an open enrollment period. Or, you might know you only need coverage for a short time, which could make short-term medical insurance a good option.
Some states require more regulations on short-term policies, but still allow them to be sold. However, not all states allow the sale of short-term medical coverage. These include:
- New Jersey
- New York
Vera Health sells short-term health plans in:
- North Carolina
- West Virginia
What Is Covered Under Short-Term Medical Insurance?
Short-term medical coverage does give you some coverage for doctor visits, emergency room care, and prescription drugs in some states. Yet, when you shop around for a plan, be sure to pay attention to the limitations and exclusions. Short-term medical insurance offers many benefits, but plans do not always cover everything.
In most cases, you can choose a plan that works for you and gives you the kind of coverage you want. Depending on the plan you choose, one may be more expensive than another.
Because short-term plans are not required to adhere to federal guidelines for coverage, there are some conditions and health care services they typically do not cover. For example, short-term health insurance plans do not cover costs related to pre-existing conditions, mental health services, maternity care, or substance abuse programs.
Cost of Short-Term Medical Insurance
The cost of short-term medical insurance is determined by how you set up the policy. Many short-term health care carriers have options, so you can select a short-term medical plan that works for you.
There are several factors to consider when building your short-term plan. These include:
- Out-of-pocket maximums
Generally speaking, short-term medical insurance can be less expensive than major medical health insurance. A short-term health insurance plan through Vera Health typically includes access to the Aetna Open Choice® PPO network and benefits for the following:
- Doctor visits
- Urgent care
- Ground ambulance trips
- Emergency room care
- Home health care
- Child immunizations
- Physical therapy
- Diagnostic testing
- Emergency surgery
- Prescription drug benefits, in some states*
Depending on your plan selection, you will pay more for lower deductibles and more benefits.
When Is Short-Term Medical Insurance Good?
While short-term medical insurance can be a good option for someone who needs a plan short-term, it’s not the best choice for everyone. For example, short-term insurance plans don’t cover pre-existing conditions, mental health services, and prenatal care.
Short-term medical care can be a good option for someone who needs medical insurance for a short time and wants fewer comprehensive benefits.
If you are a person who doesn’t go to the doctor often but still wants benefits for things like doctor’s visits and emergencies, short-term medical insurance could be a good choice for you.
How Long Can You Keep Short-Term Medical Coverage?
Short-term medical insurance, as the name implies, is only available short-term. It is sometimes called “term insurance” for this reason.
You can design your plan based on what works best for you. Some people choose only a month of coverage, while others keep coverage for a year. You can renew your short-term medical plan for up to three years, depending on state law.
Short-Term Medical Insurance Vs. Affordable Care Act
Short-term medical insurance is not required to comply with the Affordable Care Act (ACA). The ACA regulated health insurance and created a Health Insurance Marketplace.
ACA-compliant major medical plans sold on the Marketplace are regulated by the federal government and must meet certain criteria. For example, Marketplace plans must cover pre-existing conditions, the 10 essential health benefits (which include prescription drug coverage), pediatric care, and more.
Of course, when insurance covers more, it usually costs more. Short-term insurance does not offer all the benefits of major medical insurance, but you can get some coverage for a lower premium.
Benefits of Short-Term Medical Insurance
Is short-term medical insurance good? There are many good reasons to consider short-term medical insurance. It can give you the insurance coverage you want at a more affordable rate than a major medical plan.
Coverage doesn’t have to cost a fortune. If you need medical insurance for a short period of time, short-term health insurance could be a viable option.
Are you interested in learning more about short-term health benefits? Curious what your short-term policy might look like? Vera Health can help. Talk to a Vera Health pro at 888-499-1187, or get a free quote online.
*Covered services may be subject to waiting periods, visit limitations, deductible, coinsurance, copays, and/or benefit maximums depending on the plan you purchased.
Short Term Medical coverage is not required to comply with federal market requirements for health insurance, principally those contained in the Affordable Care Act. Be sure to check your policy carefully to make sure you are aware of any exclusions or limitations regarding coverage of pre-existing conditions or health benefits (such as hospitalization, emergency service, maternity care, preventive care, prescription drugs, and mental health and substance use disorder services). If this coverage expires or you lose eligibility for this coverage, you might have to wait until an open enrollment period to get other health insurance coverage.