Understanding Short-Term Medical Insurance
Short-Term Medical insurance, also known as Short-Term, Limited Duration Insurance (STLDI), is designed for people under age 65 who need fast, affordable health coverage during a temporary gap. It offers an alternative for individuals who:
- Missed the Health Insurance Marketplace Open Enrollment (November 1- January 15)
- Are between jobs or recently lost job-based coverage
- Are self-employed or waiting for Medicare eligibility to begin
If any of the above situations apply to you, these plans can provide you with peace of mind in the interim.
What Do Short-Term Medical Plans Cover?
Benefits vary by plan and insurer, but most cover:
- Doctor’s office visits
- Emergency room services
- Hospital stays and surgeries
- X-rays and lab tests
- Prescription drug coverage (in select plans)
Some policies also provide limited coverage for preventive care, though it’s important to note that these services are not guaranteed. Additionally, newer Short-Term Medical plans in certain states may offer pre-existing condition coverage after a waiting period.
Here’s What It Doesn’t Cover:
Unlike ACA Marketplace plans available through Healthcare.gov, Short-Term Medical plans generally do not cover:
- Maternity and newborn care
- Mental health or substance abuse treatment
- Vision and dental care
If you need these services or qualify for subsidies, an ACA plan may be a better fit.
How Long Can I Keep a Short-Term Medical Plan?
Where offered, Short-Term Medical plan durations can range from 1 to 36 months. Keep in mind that maximum duration and renewability depend on the plan and state where you live. Additionally, Short-Term Medical plans do not have an enrollment period, therefore you can purchase one at any time and drop it whenever you need to—all without penalty.
Pros and Cons at a Glance
Pros:
- Lower premiums than ACA plans
- Flexible coverage durations, including multi-month options in some states
- Apply at any time during the year
- Cancel at any time without penalty
- Fast approval, easy online application
Cons:
- Pre-existing conditions may not be covered
- Limited benefits compared to ACA
- Not available in all states
- Medical underwriting may be required
Is Short-Term Medical Right for You?
Short-Term Medical insurance is a cost-effective safety net for people under age 65 who need coverage quickly. Whether you’ve lost job-based coverage, aged off a parent’s plan, or missed the ACA enrollment window, Short-Term Medical insurance provides a practical solution.
These plans don’t meet Affordable Care Act requirements, so they may not be ideal for individuals with chronic health needs or those who qualify for Marketplace subsidies. Always weigh out your options before committing, and work with a trusted AMAC insurance agent to make sure your coverage matches your needs.
Need coverage fast? Contact AMAC’s Individual Major Medical insurance team today to review your options and secure the Short-Term Medical plan that works best for you. Call 1-800-255-4199 or click the button below to get your quote now.
