Can You Get Short-Term Health Insurance?

Quick Answer

You can get short-term health insurance, but it’s not available in every state and some conditions will disqualify you from coverage.

A doctor writes on a piece of paper while her patient is across from her.

You can apply for short-term health insurance when you are outside an open enrollment period, are between health plans, can't afford major medical insurance or need additional coverage for an emergency.

While short-term health insurance can provide temporary medical coverage that helps protect you from astronomical out-of-pocket costs in case of unexpected hospitalization or injury, it's not available in every state.

Here's what you need to know about qualifying for short-term health insurance.

How Short-Term Health Insurance Works

Short-term coverage, like the name implies, is a temporary solution to a lack of health care coverage due to job loss, job change or for other reasons. These plans are offered by some private insurance companies but not all, and premiums, deductibles, coinsurance, copays and other out-of-pocket costs can vary by insurer. Plans are not available through the government health insurance marketplace and do not conform to the guidelines laid out by the Affordable Care Act (ACA).

Federal rules now allow short-term health plans to fill the gaps in coverage for up to 12 months, and insurers can renew coverage for up to three years. However, the maximum duration of each policy may vary by state. Short-term policies aren't available in 12 states.

Prescription drugs, maternity care and preexisting medical conditions may or may not be covered under short-term health insurance plans. Plans can also cover doctor visits, preventive care, urgent or emergency care, and dental and vision care. Keep in mind that even if an insurer offers prescription drug coverage, it may apply a maximum dollar amount on the benefit, such as $3,000.

What Does Short-Term Health Insurance Cost?

Monthly premiums for short-term health coverage vary widely from one insurer to the next. Your age, gender, location and other factors also play a part in determining what you'll pay. There are also varying levels of benefits, with benefit amounts as high as $1 million on some policies.

The average short-term policy starts at about $100 per month, according to HealthInsurance.org. Short-term plans are available for as little as $55 per month, according to the private online insurance marketplace eHealth, while some major medical plans charge as much as $225.

However, it's common for short-term plans to carry high deductibles, which means you'll pay upfront before your insurance coverage kicks in. For example, United Healthcare has a $15,000 deductible on all short-term plans.

You'll want to consider the effect out-of-pocket costs can have on your finances, especially if you have a costly hospitalization or illness. With a high deductible, you'll have to pay a significant amount out of pocket before you hit your coverage limit. While ACA plans cap these out-of-pocket costs so they aren't any higher than your deductible, most short-term policies have no limits.

Do You Need Short-Term Health Insurance?

While there are obvious drawbacks to short-term health insurance, such as the fact that most policies rarely cover preexisting conditions and generally have high deductibles, short-term health insurance can be very helpful to some people.

Short-term health insurance might be useful in a number of scenarios:

  • You can't apply for ACA coverage because you missed the open enrollment period.
  • You don't qualify for special enrollment under the ACA.
  • The copays, coinsurance, premiums and deductibles that come with most major medical insurance plans are unaffordable.
  • You're waiting for your ACA coverage to begin.
  • You just turned 26 and can no longer be covered under your parent's policy.
  • A COBRA policy is too expensive.
  • You're not quite old enough for Medicare or you're waiting for Medicare to begin.
  • You lost coverage under your previous employer.
  • You're currently unemployed or just started a new job and waiting for benefits to start.

How to Get Short-Term Health Insurance

Short-term health insurance isn't available in every state, and not all providers provide this coverage. Before looking elsewhere, you may want to check with your current health insurance provider as they may provide this coverage or offer other alternatives, such as fixed-benefit indemnity medical or critical illness insurance.

You can apply for coverage online or in person at some providers. Some short-term plans have waiting periods before coverage begins, during which time some conditions will not be covered. Plus, if you develop a condition that is commonly excluded during the initial period, you might lose coverage.

During the application process, your insurer may ask a few general health questions, such as if you have a preexisting illness such as cancer, heart disease or emphysema. They may also ask if you've shown signs of any of these illnesses within the past five years. If so, you may be denied insurance.

You might also be disqualified for short-term insurance for any of these reasons:

  • You are pregnant.
  • You have been diagnosed or treated for AIDS or HIV.
  • You are a woman who weighs over 250 pounds or a man who weighs over 300 pounds.
  • You already have health insurance under another policy.
  • You qualify for a government program, such as Medicaid.
  • You are not a citizen or legal resident of the United States.

Coverage, but With Potential Compromises

Short-term health insurance can fill a gap in health care coverage. But it does come with a few disadvantages that must be carefully weighed. If you're young and healthy, in between plans or you just can't afford major medical insurance, a short-term plan may satisfy a temporary need. Developing a long-term financial plan may make it easier to decide whether you need long-term health insurance or if a short-term plan will be enough.

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