Short-Term Health Insurance FAQ

Short-term health insurance is a temporary medical coverage plan designed to provide benefits during transitional periods, such as between jobs, waiting for employer benefits, or outside open enrollment. Plans typically last from 30 days up to 364 days, depending on your state's regulations. These plans offer basic coverage for unexpected illnesses and injuries but do not meet ACA requirements for comprehensive health insurance.

Short-term plans differ from ACA plans in several key ways: (1) They do not cover pre-existing conditions, while ACA plans must cover them. (2) Short-term plans are not required to cover essential health benefits like maternity care, mental health services, or preventive care. (3) Premium tax credits and subsidies are not available for short-term plans. (4) Short-term plans can deny coverage based on health status, while ACA plans cannot. (5) Short-term plans have limited durations, while ACA plans provide year-round coverage with guaranteed renewability.

No. Catastrophic plans are ACA-compliant plans available to people under 30 or those who qualify for a hardship exemption. They cover essential health benefits and pre-existing conditions but have very high deductibles. Short-term plans are not ACA-compliant, don't cover pre-existing conditions, and may not include essential health benefits. However, short-term plans are available to anyone who qualifies regardless of age.

Technically yes, but it's generally not recommended. Short-term plans are designed to be your primary coverage during a gap period, not a supplement to ACA coverage. Having both types of coverage can create complications with coordination of benefits and may result in higher total costs without additional protection.

Coverage varies by plan and provider, but most short-term plans include: doctor visits and specialist consultations, emergency room and urgent care, hospitalization and surgical procedures, diagnostic tests and lab work, and some prescription drug benefits. Premium plans may also include telehealth services and specialist visits. Always review the specific plan details before purchasing.

No. Short-term health insurance generally does not cover pre-existing conditions. A pre-existing condition is any health condition you had before the policy effective date, even if you weren't diagnosed yet. This includes diabetes, heart disease, asthma, cancer, pregnancy, and many other conditions. If you need coverage for pre-existing conditions, you should explore ACA-compliant plans through the marketplace.

It depends on the plan. Basic short-term plans typically do not include prescription drug coverage. Standard and premium plans may offer some prescription benefits, but coverage is usually limited to generic medications and may not include brand-name drugs. If prescription coverage is important to you, make sure to select a plan that includes this benefit and review the formulary carefully.

Generally, no. Unlike ACA plans that must cover preventive care at no cost-sharing, short-term plans typically do not cover routine preventive services such as annual physicals, screenings, immunizations, or wellness visits. Some plans may offer limited preventive benefits, but you should not expect the same level of preventive coverage as an ACA-compliant plan.

No. Short-term health insurance plans do not cover maternity care, prenatal care, or childbirth. Pregnancy is considered a pre-existing condition under short-term plans. If you are pregnant or planning to become pregnant, you should enroll in an ACA-compliant plan that includes maternity coverage as an essential health benefit.

Short-term health insurance plans typically cost between $50 and $400 per month for an individual, depending on your age, location, coverage level, and deductible. Basic plans start around $50/month, standard plans average $120-250/month, and premium comprehensive plans range from $250-400+/month. Visit our Costs Guide for detailed pricing information.

No. Premium tax credits and cost-sharing reductions available under the Affordable Care Act do not apply to short-term health insurance plans. If you qualify for subsidies, an ACA marketplace plan with subsidies may actually be more affordable than a short-term plan. Use the ACA marketplace to check your subsidy eligibility before deciding on short-term coverage.

A deductible is the amount you pay out-of-pocket before your insurance starts covering costs. For example, with a $5,000 deductible, you pay the first $5,000 in medical expenses, then the insurance begins covering its share. Higher deductibles mean lower monthly premiums but more upfront costs when you need care. Short-term plans often have deductibles ranging from $1,000 to $10,000.

Duration varies by state. Under federal rules, short-term plans can last up to 364 days with renewals up to 36 months. However, many states have stricter limits: California and Oregon limit plans to 90 days; Colorado, Connecticut, Minnesota, and Virginia limit to 6 months; Maryland and Washington limit to 3 months. Some states like New Jersey, New York, Massachusetts, Vermont, and Rhode Island have banned short-term plans entirely. Check our state guides for your state's rules.

Unlike ACA plans, short-term health insurance has no open enrollment period. You can apply for a short-term plan at any time of the year. Coverage can typically begin as soon as the next day after approval, making it a convenient option when you need coverage quickly. However, you must meet the plan's eligibility requirements, which may include a health questionnaire.

Yes, you can typically cancel a short-term health insurance plan at any time. However, refund policies vary by provider. Some plans offer pro-rated refunds for unused coverage, while others may not refund premiums for partial months. Check the cancellation policy before purchasing. If you're canceling because you've obtained other coverage (like an ACA plan or employer coverage), make sure your new coverage is active before canceling.

Renewal depends on your state and the specific plan. Under federal rules, you can renew short-term coverage for up to 36 months. However, many states restrict or prohibit renewals. Even when renewals are allowed, you typically need to reapply and may need to pass the health questionnaire again. If your health has changed, you could be denied renewal. Also, any conditions that developed during your previous coverage period would be considered pre-existing.