Medical treatment is costly when you’re uninsured, making health insurance essential. Until you can get health insurance from your employer or a government marketplace, the best short-term health insurance can fill your coverage gap at a reasonable cost. While you won’t enjoy permanent health insurance benefits, like pre-existing conditions or maternity care, these policies can cover doctor visits and emergency care for less than $100 per month.
Table of Contents
- What Is Short-Term Health Insurance?
- How Much Does Short-Term Health Insurance Cost?
- How Does Short-Term Health Insurance Work?
- Individual or Family Coverage
- Plan Duration
- Plan Deductibles
- Medical Coverage Benefits
- Vision and Dental Coverage Are Separate
- Coverage Network
- No Pre-Existing Conditions Coverage
- No Maternity Care Benefits
- Limited Prescription Coverage
- No ACA Coverage Penalty
- Best Short-Term Health Insurance Plans
- Final Thoughts on Short-Term Health Insurance
What Is Short-Term Health Insurance?
Short-term health insurance provides temporary medical coverage before you’re eligible for employer or government medical insurance. Also known as “catastrophic insurance,” its primary purpose is to cover expensive medical bills like a trip to the emergency room, surgery, and hospitalization.
Some policies may also cover routine visits and preventative care but charge higher premiums. You can purchase these policies monthly when you’re uninsured or lose your existing benefits. For example, you might buy a short-term policy for a month or two until you start a new job. Some of the reasons to get short-term health insurance include:
- Waiting for open enrollment
- Are uninsured and do not qualify for a special enrollment event
- Switching employers
- Want a low-cost COBRA alternative
- Turn 26 and can no longer be on your parent’s plan
- Retirees waiting for Medicare coverage to begin
This coverage can be cheaper than traditional health insurance, so you may decide to keep this insurance product for as long as possible if you’re healthy and comfortable with having reduced coverage benefits. Pre-existing conditions are ineligible, for instance. Depending on your state and plan options, it’s possible to have short-term coverage for up to 36 months.
How Much Does Short-Term Health Insurance Cost?
Short-term health plans don’t qualify for any tax credits like a federal exchange plan that you purchase from healthcare.gov. But the cost can be notably cheaper than a Marketplace plan if your tax credits are minimal. Here are some sample quotes for a 35-year-old non-smoker male:
- Short-term provider #1: $61.50
- Short-term provider #2: $88.50
- gov Marketplace: $418
Sample quote details: These estimated monthly premiums are for a $5,000 deductible and a 60/40 coinsurance benefit (you pay 40% of eligible expenses after the deductible). Policies can cost between $200 and $300 per month for an individual plan when you want a low $1,000 deductible and generous coinsurance benefit where the insurer pays at 80% or 100% of the post-deductible balance.
Each provider offers a variety of plans, so you will need to spend a few minutes comparing the benefits to get the most coverage at the best price. In addition to the 30-day monthly premium, you can also expect a one-time application fee. This fee is usually between $20 and $50.
No Federal Tax Credits
Sadly, short-term plans don’t qualify for federal tax subsidies. Depending on your annual income, you may be eligible for a premium tax credit subsidy on a Marketplace plan (sadly, short-term plans don’t qualify for federal tax subsidies.) However, short-term policies can still be significantly cheaper if you’re comfortable forfeiting certain coverage benefits, even if you are eligible for a subsidy.
How Does Short-Term Health Insurance Work?
Like traditional health insurance, you can purchase short-term policies for these services:
- Medical: Emergency visits, inpatient care, prescription drugs (inpatient only), telehealth, and critical illness
- Dental: Preventative, basic, and major services
- Vision: Eye exams, glasses, and contacts
Like long-term insurance, you will need to purchase add-on policies for dental and vision benefits. But at least it’s possible to get coverage at any time. You begin the insurance shopping process by entering your zip code to view your available providers. You must also decide if you need individual or family coverage to see the accurate plan pricing. Once you choose a plan, you can pay for coverage and immediately get coverage for new events. Waiting periods may apply for major procedures with dental and vision plans.
Individual or Family Coverage
It’s possible to get policies only for yourself and also for others in your household. You can add the age of your spouse and dependents to update your pricing. For family plans, compare the coverage benefits and deductibles, so you understand your out-of-pocket deductible and coinsurance benefits. There can be some age eligibility restrictions.
For example, adults are only eligible for coverage through age 64 and must then apply for Medicare. Children may also have to be two years or older to be eligible. Each plan is medically underwritten, so every insured person must pass a basic health questionnaire. As pre-existing conditions are ineligible, qualifying can be relatively easy. You may not qualify if you have recently been denied insurance or exceeded a certain weight.
Your plan duration can also determine your monthly premium. Most providers have two different pricing plans:
- Six months or less
- Up to 12 months
Shorter terms can result in cheaper premiums, so choose the six months pricing plan if you only need gap coverage for a few months. You can select a specific start and end date to get the total price that you will pay. If you decide to cancel your coverage early, you might get a refund for the remaining period. You will have the option of paying monthly or making a one-time upfront payment. Compare the total cost to see if you can get a discount by paying upfront if you have additional savings.
Your monthly premium depends on your coverage benefits, plan duration, and plan deductible like regular insurance. Depending on the provider, your deductible can be as low as $1,000 or as high as $15,000. Your coinsurance benefits won’t kick in until you pay the deductible to help offset the remaining bill amount. While a higher deductible reduces your plan costs, you must spend more upfront before the insurance company starts chipping in.
After reaching your annual deductible, the insurance company begins paying part of the remaining balance with your coinsurance benefit. For example, a 50/50 coinsurance benefit means you pay 50% of the balance, and the provider pays the other 50%. An 80/20 coinsurance level means you pay 20% of the medical charges. After reaching the maximum out-of-pocket limit, the insurance company covers the remaining costs.
Medical Coverage Benefits
You will most likely have several different plans from which to choose. It’s also important to compare several providers to ensure you get the best price for your desired benefits. Some of the additional benefits to compare include:
- Doctor visits and preventative care (illness and injury)
- Prescription drugs (inpatient and outpatient)
- Inpatient care
- Outpatient care
Most plans don’t cover routine care. As a result, you will most likely pay out-of-pocket for primary care and well visits.
Vision and Dental Coverage Are Separate
Short-term insurance doesn’t provide dental and vision benefits. Some plans might offer a bundle that can be cheaper than buying each policy a la carte. However, these policies don’t come with employer or exchange medical plans either. The good news is that you can purchase add-on coverage. If you do, you might be able to keep the dental and vision coverage when you get long-term medical insurance again. An insurance comparison website can also help you find the best rates for vision and dental coverage.
If you have a preferred family physician, you can see which short-term insurance plans they cover. As the coverage benefits for routine care are relatively scant, your visits might be out-of-pocket until you go back to a permanent plan. But it can still be worth comparing provider networks to maximize your benefits with a doctor you trust.
No Pre-Existing Conditions Coverage
While you can get instant coverage for new medical incidents, this insurance doesn’t cover pre-existing conditions like permanent health insurance. If you happen to find a plan that offers some coverage, the benefit amounts are relatively minimal. Another potential downside is renewing your policy after seeking medical treatment in the original policy term. Any follow-up expenses might be ineligible because they are for a pre-existing condition.
As a result, this insurance isn’t a long-term solution if you or a family member need pre-existing coverage. If you have a current or previous condition, you should research the waiting period from the last time you received treatment so future care can be a new condition once again. This period is usually between 2-5 years and differs by state. Other uncovered events can include:
- Expenses exceeding the Maximum Allowable Expense (MAE)
- Incidents happening outside the United States
- Non-medically necessary treatment
- An injury or illness that’s self-inflicted or while engaged in a felony, hazardous occupation, or intercollegiate sports
No Maternity Care Benefits
Unfortunately, short-term plans are anything but an excellent health coverage option for maternity care. Maternity care for expecting and soon-to-be expecting moms will most likely be a pre-existing condition ineligible for coverage.
Limited Prescription Coverage
Short-term medical plans typically only cover prescriptions you receive during covered hospitalizations. However, you might be able to get discounts for outpatient drugs. For medications that aren’t covered, consider using Fetch Rewards to save on medicine.
No ACA Coverage Penalty
Short-term health plans are a legit health insurance option that has been around for years. But, unfortunately, these plans can be less attractive since the passage of the Affordable Care Act (Obamacare) because these plans didn’t satisfy the individual mandate. If you went too long without an ACA-compliant health care plan or have a qualifying exemption, you would pay a Shared Responsibility Payment fee on your federal tax return.
Federal lawmakers repealed the individual mandate starting with the 2019 tax year so you can have a short-term policy without worrying about an IRS penalty. While the federal government no longer requires having minimum health insurance coverage, your state may have a mandate. If so, having a short-term policy for too long can result in a fee.
Best Short-Term Health Insurance Plans
Unlike an employer who might only offer one or two medical insurance providers, you most likely have several options to find the best short-term coverage and pricing. Here are several providers that may offer plans in your zip code.
UnitedHealthcare (Golden Rule Insurance Company)
Most people recognize UnitedHealthcare for offering traditional medical coverage. In addition, the carrier provides short-term policies that the Golden Rule Insurance Company underwrites. Short-term policies from 1-12 months are available in most states. It’s also possible to get coverage of up to 36 months with a TriTerm Medical plan. You may have to renew your plan annually to retain coverage. Some of the other products you can purchase include:
- Hospital and Doctor (wellness exams and office visits)
- Supplemental insurance for accidental injury and hospitalizations
You will need to see if your primary care provider is in the service network. Fortunately, you won’t need a referral to visit specialists.
Why We Like UnitedHealthcare Short-Term Insurance
- Short-term policies of up to 12 months
- Medium-term policies of up to 36 months (TriTerm)
- Supplemental health add-ons
An Everest FlexHealth Insurance Term policy provides short-term medical coverage for up to 6 months or 12 months. Your plan may cover doctor’s office visits and annual physical exams with a $50 copay. You also have the option to choose any primary care provider (PCP) you want. It’s also possible to purchase these supplemental policies:
- Accidental injury
Why We Like Everest
- Coverage up to 12 months (364 days)
- Can use any primary care provider
- Can make copays (instead of coinsurance) for doctor visits
- Some supplemental policies
Pivot Health lets you customize your plan options by answering five questions to recommend a policy for your healthcare needs. Your plan might cover these expenses:
- Doctor visits
- Labs or tests
- Prescription drugs
- Hospital visits
- Emergency room visits
You can then speak with an agent by phone or live chat to compare your plan options and answer your coverage questions.
Why We Like Pivot Health
- Can easily customize health plans
- Phone and live chat advisor support
- Free and unlimited telemedicine consultations
The IHC Group offers a variety of insurance products in addition to short-term medical coverage. You can purchase plans with a maximum 12-month term, and maximum benefit amounts can be as high as $2 million.
Some providers may cap the maximum benefit at $1 million or less. Your plan may also offer a copay on outpatient prescriptions, while other platforms may only provide a pharmacy discount. For example, your copay for generic medications may only be $20. Several supplemental policies are available too.
Why We Like IHC Group
- High maximum coverage amounts
- Can get outpatient prescription benefits
- Several supplemental insurance products
National General plans can help reduce the following medical bills:
- Doctor visits
- Preventative care
- Emergency room
- Ambulance coverage
- Urgent care
Coverage periods range from 30 days to one year and usually start the next day. Unlike some other insurance platforms, you will need to submit your phone number instead of an email address to get an initial quote. If you don’t want to receive phone calls, consider another service.
Why We Like National General
- Coverage terms of up to 1 year
- Flexible deductibles and coinsurance
Here are some common questions about short-term medical insurance.
Yes, you can buy a short-term medical policy any day of the year. There isn’t an enrollment period like qualified long-term plans require. While you can obtain next-day coverage in most instances, you must pass a basic health questionnaire to verify the eligibility for you, your spouse, and your dependents.
It’s possible to buy short-term medical coverage for as little as 30 days. The cheapest plans cost under $100 monthly. Some services let you schedule your coverage for a specific number of days. For example, you might get coverage for 45 days or 93 days.
It’s possible to have short-term coverage for up to 364 days. However, your maximum coverage period can be shorter depending on your state laws. UnitedHealthcare offers a hybrid policy with its TriTerm Medical product that can let you enjoy short-term benefits and pricing for up to 36 months.
Short-term medical coverage is designed to provide a coverage gap when you transition between traditional insurance programs you get from an employer, government healthcare exchange, or Medicare.
These policies can reduce your total medical bills for unexpected injury and illness that can create medical debt. Consider these policies in these situations: Switching employers, seasonal or temporary employment, graduating from college, waiting to enroll in Medicare.
Final Thoughts on Short-Term Health Insurance
The best short-term health insurance is budget-friendly and can protect your finances if you have a medical emergency. These policies can help you navigate life events when you don’t have access to traditional coverage. Be sure to compare the right deductible and coinsurance for your spending power and medical needs.