Short-term health insurance is a convenient health insurance option, offered by private insurance companies, that keeps you from being uninsured for a temporary, specific period of time. This could be a good coverage option if you:

• Missed the Affordable Care Act (ACA) open enrollment period
• Are waiting until your coverage from a new employer begins
• Need quick proof of insurance (to engage in a special activity or trip)
• Are waiting until you can enroll in Medicare

Before you decide whether short-term coverage is the best choice for you, you might want to know what is required to qualify for this type of insurance. If you are within the yearly open enrollment period or may have experienced a major life event that could make you eligible for a special enrollment period, you can shop for an ACA-compliant plan on eHealth.

Understanding Short-Term Health Insurance

Curious about short-term health insurance? Let’s delve into what it is, how it works, and whether it might be the right fit for you.

Benefits of Short-Term Health Insurance

Short-term medical insurance, also known as temporary health insurance or term health insurance, offers a flexible solution to address temporary gaps in coverage.

There are several scenarios where short-term health insurance can come to the rescue. If you’re in a transitional period, such as switching jobs, short-term coverage can temporarily fill in the gap of coverage until your new benefits kick in. For college students and recent graduates who are no longer covered by their parents’ insurance, or for early retirees waiting to qualify for Medicare, short-term health insurance can bridge the gap.

Short-Term Health Insurance coverage

If you are interested in the short-term health insurance, which may also be called temporary health insurance, you need to know what this policy covers. In general, temporary health insurance will provide coverage for three separate medical scenarios. You should have coverage for medical expenses arising from visits to the doctor’s office, emergency room, and hospital stays. Similar to traditional insurance policies, you may be required to pay a copay or a deductible when you receive medical care.

On the other hand, short-term health insurance is not required to provide full comprehensive coverage under the Affordable Care Act. This temporary, limited policy offers fewer benefits and federal protections compared to more comprehensive health insurance options available on HealthCare.gov. It may exclude coverage for preexisting conditions such as diabetes, cancer, stroke, arthritis, heart disease, and mental health and substance use disorders. Additionally, the policy might not cover essential health services including prescription drugs, preventive screenings, maternity care, emergency services, hospitalization, pediatric care, and physical therapy. Furthermore, this type of insurance does not need to meet federal standards for comprehensive health coverage.

Short-Term Health Insurance costs

As you look for the best short-term health insurance, you should consider the costs involved. In general, ACA major medical plans can be cheaper than short-term after the ACA subsidies are applied. Additionally, short-term health insurance does not provide all types of coverage, and can provide less coverage when compared to traditional individual or family insurance plans. In addition to short-term plans providing less care, these plans are not eligible for ACA government subsidies. A short-term health insurance plan for a single person may cost under $100 a month, depending on their needs, location, the duration of the plan itself, age, and other factors. It’s important to keep in mind that there is often no cap on what you pay out-of-pocket for care un short-term policies, and you won’t qualify for federal financial assistance to help with premiums and out-of-pocket costs. However, it’s likely that you may have less coverage than a typical ACA plan.

The cost of a short-term health insurance plan can vary significantly depending on the type of coverage you choose. You might be able to find short-term health insurance for a very low rate, but there are other plans that can be very expensive. It can depend on:

• How many people you are trying to cover
• The type of coverage you want
• The length of time you want that coverage to last

Eligibility criteria: Who qualifies for Short-Term Health Insurance?

When it comes to short-term health insurance, understanding who qualifies is essential. Typically, to be eligible for short-term coverage, you’ll need to complete a health questionnaire provided by the insurance company. This questionnaire delves into your medical history, including inquiries about any past diagnoses or treatments for conditions like cancer, heart disease, or emphysema. Additionally, the insurance company may inquire about any recent indicators of these illnesses within the past five years. Let’s explore the eligibility criteria in more detail to help you determine if short-term health insurance is right for you.

Age requirements

Short-term health insurance typically has age requirements that vary depending on the insurer and the state regulations. Generally, individuals between the ages of 18 and 65 are eligible for coverage. Some insurers may extend coverage to individuals up to the age of 75, but it’s essential to check with the specific insurance provider for their age limits. Whether you’re a young adult just starting out on your own or a senior seeking temporary coverage, short-term health insurance may offer options tailored to your age group.

Health status

One of the defining features of short-term health insurance is its limited coverage, which often excludes individuals with pre-existing conditions. While eligibility criteria may vary among insurers, many short-term plans may not require applicants to meet strict health status requirements to enroll. Short-term policies offer fewer benefits and federal protections compared to more comprehensive health insurance options available on HealthCare.gov. It may exclude coverage for preexisting conditions such as diabetes, cancer, stroke, arthritis, heart disease, and mental health and substance use disorders. However, it’s crucial to disclose any pre-existing conditions during the application process, as coverage for these conditions may be excluded. Short-term health insurance can provide a temporary safety net for individuals seeking coverage outside of traditional health plans, for up to three months with an option to renew for one additional month.

Citizenship or legal residency

Short-term health insurance is typically available to U.S. citizens and legal residents who meet the age and health status requirements. Proof of citizenship or legal residency may be required during the application process. While short-term plans may offer coverage for temporary stays abroad, coverage is primarily intended for individuals residing within the United States. If you’re unsure about your eligibility based on citizenship or legal residency status, consult with the insurance provider for clarification.

State-specific regulations

State regulations play a significant role in determining the availability and features of short-term health insurance. Some states have stricter regulations governing short-term plans, while others offer more flexibility. Not all states sell short-term health insurance policies. It’s essential to be aware of state-specific regulations regarding coverage duration, renewal options, and benefits. Additionally, certain states may have limitations on the types of conditions that can be covered or the duration of coverage. Before purchasing a short-term health insurance plan, familiarize yourself with the regulations in your state to ensure compliance and optimal coverage.

Duration of coverage

The duration of coverage is a key consideration when evaluating short-term health insurance options. Short-term plans typically provide coverage for a limited period, ranging from 30 days to 3 months, depending on state regulations and insurer policies. Plans may offer the option to renew coverage, limited to one additional month, while others may have limitations on the total duration of coverage. Understanding the duration of coverage is essential for planning your healthcare needs and ensuring continuous coverage during transitional periods. Whether you need coverage for one month or up to three months, short-term health insurance offers flexibility to temporarily match your specific needs.

Who may not qualify for Short-Term Health Insurance?

While short-term health insurance offers flexibility for many individuals, there are certain groups who may not qualify. Those with pre-existing conditions may face limitations or exclusions in coverage. Additionally, individuals seeking comprehensive coverage for ongoing medical needs may find short-term plans inadequate. Those eligible for Medicaid or other government programs may not qualify for short-term insurance. Furthermore, individuals requiring preventive care or maternity services may not find sufficient coverage options with short-term plans.

Automatic disqualifications

Some insurance companies will automatically disqualify you for short-term insurance if you:

• Are pregnant
• Are a man who weighs more than 300 pounds or a woman who weighs more than 250 pounds
• Have been diagnosed with, or treated for, HIV or AIDS
• Are currently insured under another policy
• Qualify for Medicaid
• Aren’t a citizen or legal resident of the United States

Short-Term Health Insurance FAQs

How long do short-term insurance plans last?

If you are looking for short-term insurance qualification, you need to be aware of how long these plans last.  Typically, short-term plans can be sold with initial terms of up to three months and can only be renewed for one additional month for a total of four months of coverage in total. 

Unlike traditional medical insurance plans, they do not automatically renew, so you will have to look at the details of your plan to see what you have to do if you want to renew the plan.

In general, you should be able to renew a short-term health insurance plan for up to three months, but every plan is different. You have to look at the details of your specific plan to learn more.

What is the difference between long and short-term insurance?

There are several differences between long-term health insurance and short-term health insurance. For example, long-term health insurance intends to provide coverage for a bigger array of issues, and they tend to conform to the essential benefits under the ACA. Long-term health insurance tends to renew automatically on an annual basis, but short-term health insurance is not. There is also a time limit on how long you can have short-term health insurance before you need to switch to long-term health insurance. Short-term health insurance also has significantly less coverage compared to a comprehensive plan. This policy is meant to be temporary and only offer limited coverage in the meantime until you can enroll in a comprehensive plan.

What are the limitations of short-term insurance?

Because short-term insurance policies don’t offer the minimum essential benefits of the Affordable Care Act (ACA), also known as care, these policies are not guaranteed-issue. This means you can be denied coverage for pre-existing medical conditions or your medical history. In addition, because these plans don’t meet the ACA requirements, you may be subject to a state tax penalty even if you have short-term insurance. And, do be aware that there are no government low-income subsidy programs to help pay for your short-term health insurance, as there are for ACA-compliant major medical plans.

What are some alternatives to short-term insurance?

If you don’t qualify for short-term insurance, you have some other options. You can either wait for the next ACA open enrollment period or check now to see if you qualify for a special enrollment period. In these cases, you will be able to purchase an ACA-compliant plan. Another option to consider is to see if you can purchase other types of catastrophic insurance policies, such as:

• Fixed-benefit indemnity medical insurance, which gives you a cash payout for covered conditions, which you can use to pay for office visits, hospitalizations, and surgery

Choosing a Short-Term Health Insurance plan

If you are interested in buying a short-term health insurance plan, you need to compare all the options available. You should think about:

• The type of coverage you need
• How much money you can afford to spend
• How long you will need short-term health insurance

Because there are a lot of options available, you may want to consider contacting a licensed health insurance agent who can help you find the right short-term health insurance plan.

Find out if you qualify and sign up for Short-Term Health Insurance

Don’t wait to get short-term health insurance if you’re currently going without coverage. It can be intimidating to navigate the process, but our licensed health insurance agents can help you understand short-term insurance qualifications and find a plan that’s best suited to your needs. You can also use our free tool to find and compare plans with ease. Get started today to make sure you get coverage before you find yourself needing it.

Our short-term insurance page contains more information and can help you find and enroll in a short-term health policy.