Short Term Limited Duration Insurance, also known as short term health insurance, can provide you with health care coverage for a temporary period of time.. But before you apply, it’s important to understand what these plans cover — and what they don’t.
Life doesn’t always line up with health insurance enrollment periods. You might be starting a new job and waiting for benefits to begin. Or perhaps you missed the annual Affordable Care Act (ACA) Open Enrollment Period or are no longer covered by your existing health plan. Even a short gap in coverage can leave you with unexpected medical bills.
Short Term Limited Duration Insurance is one way to help fill a temporary gap in coverage between major medical insurance policies. This type of healthcare coverage can often start quickly and may cost less than other types of coverage. However, Short Term Limited Duration Insurance plans aren’t regulated by the ACA, do not qualify as “minimum essential coverage,” and do not include all the essential health benefits of ACA plans.¹
Before applying, here are seven essential questions to ask.
1. What do Short Term Limited Duration Insurance plans cover?
Coverage varies by plan, but many Short Term Limited Duration Insurance plans offer coverage for unexpected illnesses and injuries. Common covered services may include:1, 2
- Doctor office visits
- Urgent care visits
- Emergency room care
- Hospital stays and surgery
- Prescription medicines
- Lab work and imaging
Before applying for Short Term Limited Duration Insurance, review the plan details carefully. This helps ensure the plan covers the services that matter most to you.
If you may have a gap in healthcare coverage, call 844-306-8319 to speak with a licensed insurance agent and explore Short Term Limited Duration Insurance options.
2. Do Short Term Limited Duration Insurance plans cover preexisting conditions?
A preexisting condition is usually any illness, injury or symptoms you had before applying for a health insurance plan. In most cases, Short Term Limited Duration Insurance does not cover preexisting conditions.¹
When you apply, you’ll answer questions about your health history. This process is called medical underwriting. Your answers help determine your eligibility and what the plan will cover.
Conditions that may be considered preexisting include:
- Current treatment for a condition
- Taking prescription medicines
- Recent symptoms or medical care
- Chronic conditions such as asthma or diabetes
- Pregnancy before coverage begins
3. How long does Short Term Limited Duration Insurance last?
Short Term Limited Duration Insurance is designed to help fill a temporary gap in coverage between major medical policies for a limited period of time.
The coverage period depends on your plan and the state where you live, but it may be nearly 12 months.¹ Some extended short term health insurance plans may allow you to have coverage for up to three years.
You can apply at any time, and coverage may begin as soon as the next day.¹ Once your plan starts, you’ll stay covered for the full term as long as you continue paying your monthly premium.
You can cancel your plan at any time. For example, if your new health coverage begins before your short term health insurance plan ends, you can cancel your Short Term Limited Duration Insurance so you’re not paying for overlapping coverage.
4. What costs should I expect with a Short Term Limited Duration Insurance plan?
Your monthly payment, or premium, is only one part of your total cost. Short Term Limited Duration Insurance also includes out-of-pocket expenses when you receive care.
Key costs to understand include:
- Monthly premium. The amount you pay each month to keep your coverage active. Plans with lower premiums may have higher out-of-pocket costs.
- Deductible. The amount you pay before your plan begins paying for covered services.
- Copays. A fixed fee for certain services, such as doctor or urgent care visits.
- Coinsurance. The percentage of costs you pay after meeting your deductible.
- Benefit maximums. Some plans limit how much they pay for certain services or during the coverage term.
Understanding these costs can help you choose a plan that fits your budget and coverage needs.
Need temporary healthcare coverage? Call 844-306-8319 to speak with a licensed insurance agent who can help you find a plan that fits your needs and budget.
5. Can I keep my current doctor and pharmacy?
Short Term Limited Duration Insurance plans often use provider networks. Before applying, check whether your doctor and pharmacy are included.
If your doctor is out of network, you may still be able to see them, but it may cost more.¹ Checking the provider network ahead of time can help you avoid unexpected costs.
6. Do Short Term Limited Duration Insurance plans cover emergency care while traveling?
Many Short Term Limited Duration Insurance plans cover emergency medical care, even when you are away from home.2 This can help you get medical care if you experience a sudden illness or injury while traveling.
It’s helpful to understand the difference:
- Emergency care: Treatment for serious or life-threatening conditions
- Urgent care: Treatment for non-life-threatening conditions, with coverage depending on your plan
If you travel frequently, review how your plan handles emergency and out-of-area care.
7. Who can benefit from a Short Term Limited Duration Insurance plan?
Short Term Limited Duration Insurance can help fill a temporary coverage gap between major medical policies for a limited period of time. Some people may find these plans especially helpful during life transitions.
You may benefit from Short Term Limited Duration Insurance if you:
- Are waiting for employer benefits to begin
- Missed the annual ACA Open Enrollment Period
- Are generally healthy with no pre-existing conditions
- Need temporary coverage during a gap
Short Term Limited Duration Insurance plans can provide coverage during transitions, but they are not designed to replace long-term comprehensive healthcare coverage. Before applying, review plan details carefully so you know what to expect.
Have questions about Short Term Limited Duration Insurance or your coverage options? Call 844-306-8319 to speak with a licensed insurance agent.
For informational purposes only. This information is compiled by HealthMarkets Insurance Agency and does not diagnose problems or recommend specific treatment. Services and medical technologies referenced herein may not be covered under your plan. Please consult directly with your primary care physician if you need medical advice.
