Short-term health insurance offers many attractive features like flexible, affordable coverage, making it a viable option for many people. However, everyone’s health care needs are different, so short term coverage won’t work for everyone. If you’re interested in this type of coverage, you may wonder, can you get short-term health insurance? Who qualifies for short-term health insurance?
Before you start applying for coverage, it’s important to understand who is eligible for short-term medical insurance. Keep reading to learn about what is required to qualify, what can make you ineligible, and more.
Who is Eligible for Short-Term Medical Insurance?
Many may apply and be subsequently approved for short-term health insurance. However, you may be ineligible in some cases due to a number of disqualifications (keep scrolling to see what can get you denied for short-term health insurance).
Your eligibility for short-term health insurance is determined through an application process that contains several questions about your medical history. Still, there are ways to tell whether short-term health insurance is a good option for you before you apply. Short-term medical insurance can be a good option if you:
- Do not need coverage for any pre-existing conditions
- Are not pregnant or planning a family
- Do not need mental health services
- Live in a state that allows short-term medical coverage to be sold
In the past, many short-term health insurance plans only included coverage for three months. However, changes to federal laws allow short-term policies to cover a person for up to one year with the option to renew coverage for up to two years, depending on the state.* Additionally, there is no longer an individual mandate penalty for not having qualifying health insurance in most states either, making short-term health insurance an appealing option for anyone shopping for affordable, flexible coverage.
Should I get short-term health insurance?
Although short-term health insurance is not a good fit for everyone and every situation, it might be if you:
- Lost your employer-based health care
- Are between jobs or waiting for benefits to begin at a new job
- Are turning 26 and aging out of your parent’s plan
- Cannot apply for Affordable Care Act (ACA) coverage because you missed Open Enrollment or do not qualify for a Special Enrollment Period
- Are waiting for your ACA coverage to kick in
- Want coverage until you are eligible for Medicare
Applying for Short-Term Health Insurance
The short-term health insurance application process involves a health application from the insurance company. You’ll share information about yourself, your health history, and any pre-existing conditions. For example, you’ll have to disclose whether you’ve been diagnosed or treated for certain illnesses like heart disease, diabetes, or cancer within the last five years.
What Can Get Me Denied for Short Term Health Insurance?
Short-term medical plans are not always guaranteed issue, so there is a chance you may be ineligible for coverage. You will be automatically disqualified for short-term medical insurance if you:
- Are pregnant
- Are a man who weighs over 300 pounds or a woman who weighs over 250 pounds, in some states
- Are a man or woman who weighs more than 300 pounds, in some states
- Have been diagnosed or treated for certain conditions, including but not limited to, heart disease, diabetes, or cancer
- Have been diagnosed with or treated for HIV or AIDS
- Qualify for government-sponsored health insurance, such as Medicare or Medicaid, in some states
- Live in a state that does not allow short-term health insurance to be sold
Please note that plan qualifications vary from provider to provider, and this list is not comprehensive. Also, while short-term health insurance is available in most states, regulations vary widely from state to state. There may some state-specific differences when it comes to disqualifying conditions. Click here to use our plan builder tool and determine your eligibility for short-term health insurance.
What Does Short-Term Health Insurance Cover?
Short-term health insurance is not required to comply with the regulations set by the ACA. There isn’t a set list of benefits that short-term plans must cover, so coverages vary. For example, a short-term health plan through Vera Health typically includes access to the Aetna Open Choice® PPO network and benefits for:
- Doctor visits
- Urgent care
- Ground ambulance trips
- Emergency room care
- Home health care
- Child immunizations
- Physical therapy
- Diagnostic testing
- Emergency surgery
- Prescription drugs, in some states**
Interested in learning more about who qualifies for short-term health insurance? Curious whether you’re a candidate for a short-term insurance plan? Talk to a Vera Health pro at 888-499-1187 or get a free quote online.
*Maximum 12 months less one day/364 days in NE
**Covered services may be subject to waiting periods, visit limitations, deductible, coinsurance, or copays, and/or benefit maximums depending on the plan you purchase.
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.