Q&A: Short Term Health Insurance FAQs

Are you long on questions about Short Term health insurance, but short on time? At GetHealthInsurance.com Agency Inc., we hope these FAQs have the quick answers you’re looking for.

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Short Term insurance is also called Temporary health insurance or Term health insurance. It is designed to bridge temporary gaps in medical insurance coverage. That means it can be a good solution for a wide variety of people with all sorts of different needs, including those…

These are just some of the situations where Temporary insurance fits for people. If you’re facing a change in your life that leaves you with a gap in your health insurance coverage, then taking a look at Short Term medical insurance plans may help you take a long step toward finding the best health insurance for your current needs.

That depends on what you mean by cheap health insurance. Short Term health insurance, what others might call Temporary health insurance or Term health insurance, is generally less expensive than a health plan that is in line with the requirements of the Affordable Care Act (ACA). That’s true.

However, it is less expensive for a reason. Short Term medical insurance isn’t required to cover the essential health benefits that ACA plans have to by law. So what’s covered by any given Short Term insurance plan can vary. Check the plan details carefully to make sure what you’re buying covers what you need.

Also, because Short Term medical insurance does not provide the coverage required by the ACA, you could face a tax penalty. You’ll want to figure that into your costs as well.

The ACA, what is often referred to as Obamacare, requires coverage in all these areas:

1. Doctor visits for illness and injury and other outpatient care (ambulatory services)
2. Emergency services
3. Hospitalization
4. Maternity and newborn care
5. Mental health and substance use disorder services
6. Prescription drug coverage
7. Rehabilitative and habilitative services and devices (for example, relearning to walk after a stroke)
8. Laboratory tests and services
9. Preventive and wellness care
10. Pediatric services (including both oral care and vision care)

Short Term health insurance does not meet this minimum essential coverage standard outlined in the ACA and may not provide mandated coverage for Essential Health Benefits.

No. Short Term health plans are not minimum essential coverage as defined by the Affordable Care Act (ACA), often called Obamacare. If you don't have minimum essential coverage for any month in 2018, you may have to make a payment when you file your federal tax return unless you qualify for an exemption from the requirement that you have health coverage for that month. For 2019, the federal tax payment for not having minimum essential coverage is no longer applicable. If you are looking at Short Term plans for 2018, take into account that potential tax penalty costs.

Short Term is not required to comply with certain federal market requirements for health insurance, principally those contained in the Affordable Care Act. Be sure to check your policy carefully to make sure you are aware of any exclusions or limitations regarding coverage of preexisting conditions or health benefits (such as hospitalization, emergency services, maternity care, preventive care, prescription drugs, and mental health and substance use disorder services). Your policy might also have lifetime and/or annual dollar limits on health benefits. If this coverage expires or you lose eligibility for this coverage, you might have to wait until an open enrollment period to get other health insurance coverage. This coverage is not “minimum essential coverage.”

No. Some health care plans require you to designate a primary care provider or primary care physician (PCP) as your main health care professional. Under those plans, your PCP must then officially refer you to another doctor or for a specific service if you want that visit or service to be covered.

You don’t have to deal with those types of pre-approvals and network issues when you have a Short Term health insurance plan. Generally speaking, you can go directly to any doctor, specialist or health care service without needing a referral. As always, check the specific plan for more details.

Don’t forget, though, that if you do stay in your Short Term insurance plan’s network for your care, you can often save money because of the lower rates doctors and providers in the network have agreed to charge.

Possibly. GetHealthInsurance is a multicarrier agency, so we offer Short Term health insurance plans from several carriers. Some carriers do charge application fees, so check the specific plan for details on whether applying for that carrier’s Short Term insurance plan includes a fee, and factor that into your decision.