A Short-Term Medical Plan May Be the Right Solution

Health insurance premiums continue to rise, leaving many facing a difficult decision.

Some individuals and families have found that Marketplace (ACA) plans now come with monthly premiums that strain their budgets while still requiring high deductibles and significant out-of-pocket costs before many benefits begin.

As a result, many people have made the difficult decision to go without health insurance altogether.  This can be a life altering financial decision in a health emergency.

For healthy individuals, there may be another option.

What Is a Short-Term Medical Plan?

Short-term medical insurance is designed to provide temporary protection against unexpected illnesses and injuries. Think: Catastrophic Insurance. These plans can run anywhere from 1 to 6 months at a time.   The state law limits one company to 185 days of coverage per 365 days as a maximum, however, some carriers only allow shorter durations with their own internal rules.  If you need coverage for more than 185 days, you must switch to another carrier for insurance.

These plans are intended for people who want coverage for major medical events, while understanding that certain services, like preventative care, are not covered.

If you qualified, a short-term plan can provide valuable financial protection at a fraction of the monthly cost of traditional health insurance.

What Does a Short-Term Medical Plan Cover?

Most short-term medical plans help pay for expenses related to:

• Hospitalizations
• Emergency room visits
• Surgery
• Physician visits for new illnesses
• Diagnostic testing
• Major accidents
• Serious illnesses

If an unexpected medical event occurs, these plans can help protect you from the financial impact of large medical bills.

What Isn’t Covered?

Short-term medical plans are not comprehensive health insurance and generally do not cover:

• Pre-existing medical conditions
• Routine preventive care
• Annual physicals
• Immunizations
• Maternity care
• Mental health services
• Chiropractic care
• Most prescription drug benefits
• Routine wellness services

Short Term policies are not “qualifying insurance” and therefore do not follow the rules set forth in the Affordable Care Act. Because of these limitations, short-term plans are generally best suited for individuals who are relatively healthy and primarily want protection against unexpected medical emergencies.

Is a Short-Term Medical Plan Right for You?

Every situation is different.

A short-term medical plan may be worth considering if you:

• Missed the Marketplace Open Enrollment Period.
• Are between jobs or waiting for employer coverage to begin.
• Recently lost other health insurance coverage due to non payment.
• Are healthy and primarily want protection against major medical expenses.
• Are looking for a lower monthly premium than many Marketplace plans.

Rather than remaining uninsured, many Michigan residents choose a short-term plan to help protect themselves financially until they become eligible for other health insurance options.

We’re Here to Help

At Health Insurance Experts, we’ll explain your options and help you determine whether a short-term medical plan makes sense for your situation.  Give us a call and we can provide quotes for you and/or your family ranging from just the basic emergency coverage to those options with a few more advantages.

Curious is you would qualify?  If you have to answer yes to any of the below, we would NOT be able to submit an application for short term coverage.

Are you 65 and 11 months or older?

Over 300 lbs (if male) or over 250 lbs (if female)?
Now pregnant, an expectant parent, in the process of adopting a child or undergoing infertility treatment?

For any of the following conditions within the last 5 years, have you or any person to be insured received any abnormal
test results or medical or surgical treatment, or consulted a health care professional, or taken medication for:
Any heart disorder?
Any emphysema or chronic obstructive pulmonary disease (COPD)?
Any Crohn’s disease, ulcerative colitis or hepatitis B, C, D or other?
Any AIDS or tested positive for HIV?
Any stroke?
Any diabetes, except gestational diabetes?
Any cancer or tumor (except basal cell skin cancer) which has been removed?
Any alcoholism, chemical dependency, drug or alcohol abuse?

A notable drawback: If any of the above conditions do occur while you are on coverage, you will not be able to apply for new coverage with another carrier once your plan expires. This is important for those who are looking to utilize a couple of different companies for coverage beyond 6 months in a year.

Coverage availability and plan benefits vary by state, carrier, eligibility, and underwriting. Short-term medical plans are not ACA Marketplace plans and do not provide all of the essential health benefits required under the Affordable Care Act.