Client asking questions about short term medical insurance

Short-term medical insurance is a temporary solution that helps pay for healthcare costs when you don’t have major medical insurance. Below are a few common questions that you may come across while researching.

When should I consider short-term medical insurance?

If you’re faced with a gap in medical coverage due to any of the following reasons, you should consider a short-term medical plan.

  • You’re between jobs
  • You’re not eligible for COBRA or want an affordable alternative
  • You’re waiting for other coverage to begin
  • You’re waiting until you’re eligible for Medicare
  • You missed open enrollment

Does short-term medical insurance cover pre-existing conditions?

Unfortunately, most short-term insurance plans do not cover pre-existing conditions. Generally, a pre-existing condition is defined as an illness, disease or injury that you have received a diagnosis or treatment for in the last two to five years.

However, it is worth checking both your policy and state’s definition. If you have a pre-existing condition, you may want to explore alternatives such as extending your current health insurance or investigating an Obamacare subsidy for an Affordable Care Plan.

What will a short-term medical insurance plan cover?

Short-term medical insurance plans are not designed to replace major medical insurance. Therefore, they are not legally required to meet the minimum essential benefits set out by the Affordable Care Act (ACA).

Nevertheless, short-term plans do provide a range of benefits. You can usually expect the following medical care to be covered:

  • Emergency room visits
  • Hospitalization and general nursing care
  • Inpatient doctor visits
  • Doctor’s office visits
  • Surgical services
  • Intensive or specialized care
  • X-Rays
  • Laboratory tests
  • Some prescription medication

What doesn’t a short-term medical plan cover?

A short-term plan is not required to cover all preventative service outlined in the Affordable Care Act (ACA). As a result, temporary plans typically don’t cover the following:

  • Pre-existing conditions
  • Preventative care (common exceptions include a pap smear, mammogram, and prostate test)
  • Immunizations
  • Pregnancy and maternity
  • Dental care
  • Vision care
  • Foot care

Are short-term medical insurance plans affordable?

Short-term plans have considerably lower premiums than major medical plans. At the end of 2016, the average monthly premium on an ACA plan was $269 more expensive than a short-term medical plan.

If you’re looking for the most affordable option, you can always opt for fewer benefits, or a higher deductible in exchange for lower monthly premiums. You may also be able to contribute single upfront payment to reduce monthly premiums.

Are tax subsidies available to help pay for short-term medical insurance?

No. As short-term plans are not subject to the Affordable Care Act (ACA), they do not meet the mandated coverage necessary to warrant a tax subsidy.

Does a short-term insurance plan cover prescription medication?

Prescriptions are included under some short-term plans. It’s worth checking the exact details of each plan with your insurance provider.

Can I continue seeing my current doctor?

Yes. It is possible to receive coverage for visits with your current doctor, provided the doctor is within the plan’s network doctors. Each insurance company will have their own network of pre-approved doctors, usually within a specific location.

Is it possible to supplement another plan with a short-term medical plan?

Yes. One of the primary purposes of a short-term plan is to supplement other health insurance plans due to temporary need for additional coverage.

Any other questions?

If you have any further queries regarding short-term medical insurance, don’t hesitate to give Your Insurance Gal a call today on (360) 771-1155.