Short Term Health Insurance
A Short Term Medical Plan is temporary medical insurance that provides comprehensive protection against unexpected health care health care expenses. Policies can be purchased from 30 to 90 days. The application process is simple with only a few qualifying questions to answer and coverage can begin as early as the next day.
Short Term Medical Insurance is perfect for individuals who are:
- Recent college graduates
- Between jobs or laid off
- Waiting for employer-sponsored coverage
- Losing dependent status
- Looking for a lower-cost alternative to COBRA
- Recently retired and not eligible for Medicare
- On strike
Short Term Health Insurance Carriers
Texas has two top-rated short term carriers to choose from.
*Note: Almost all major health companies no longer offer short-term care as an option.
UHC Short Term Insurance
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UnitedHealthCare Choice Network Advantages
United HealthOne Golden Rule plans use a large PPO network of doctors, hospitals, and other providers that offer you quality health care. Receive quality care at reduced costs because the network providers have agreed to lower fees for covered expenses. The large network of doctors and hospitals offer choices across the nation, so even when you’re traveling, you’re likely to find in-network care. You must use a network doctor or hospital unless it is an emergency.
Find A Doctor to search for UnitedHealthcare Choice network providers.
National General Short Term Medical
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Company Information
National General’s Short Term Medical insurance gives you a plan to face those unpredictable moments in life with confidence. It provides the financial protection you need from unexpected medical bills and other health care expenses, including:
- Doctor visits and some preventive care
- Emergency room and ambulance coverage
- Urgent care benefits, and more
National General Health Insurance Feature Highlights
- Coverage Period Maximum of $250,000 and $1,500,000
- Deductible options of $1,000, $2,500, or $5,000
- Coinsurance Percentage of In-Network plan 100/0, 80/20, 70/30, and 50/50
- Doctor Office Visit and Urgent Care Co-pay of $50
Short-Term Medical Secure Plans – Plan Comparison
| Plan Designs | Secure Edge | Secure Bridge | Secure Net |
| Office visit copay | $50
1 copay for 30-90 days 2 copays for 91-180 days 3 copays for 181-364 days |
$50
1 copay for 30-90 days 2 copays for 91-180 days 3 copays for 181-364 days |
$50
1 copay for 30-90 days 2 copays for 91-180 days 3 copays for 181-364 days |
| Deductible | $1,000
$2,500 $5,000 $7,500 |
$1,000
$1,500 $2,500 $5,000 $7,500 $10,000 |
In-Network:
$3,500 $5,000 $7,500 $10,000 Out-of-network deductible is two times the in-network deductible. |
| Coinsurance and out-of-pocket
(not including deductible) |
20% – $1,000, $2,000, $3,000,
$4,000 50% – $2,500, $5,000, $7,500, $10,000 |
20% – $1,000, $2,000, $3,000,
$4,000 30% – $1,500, $3,000, $4,500, $6,000 50% – $2,500, $5,000, $7,500, $10,000 |
In-Network:
0%1 – $0 20% – $3,500, $5,000, $7,500, $10,000 30% – $3,500, $5,000, $7,500, $10,000 Out-of-network coinsurance is 50% and the out-of-pocket is two times the in- network out-of-pocket ($7,000 for 0%/$0). |
| Maximum benefit | $1,000,000 | $2,000,000 | $2,000,000 |
| Covered Expenses | Secure Edge | Secure Bridge | Secure Net |
| Doctor administering anesthetics | Up to 20% of the surgeon’s benefit2 | Up to 20% of the surgeon’s benefit | No benefit-specific limit |
| Assistant surgeon | Up to 20% of the surgeon’s benefit2 | Up to 20% of the surgeon’s benefit | No benefit-specific limit |
| Surgeon’s assistant | Up to 15% of the surgeon’s benefit2 | Up to 15% of the surgeon’s benefit | No benefit-specific limit |
| Ambulance, ground or air services | Up to $250 per occurrence | Ground: Up to $500 per occurrence
Air: Up to $1,000 per occurrence |
No benefit-specific limit |
| Organ, tissue or bone marrow transplants | Up to $150,000 per coverage period | Up to $150,000 per coverage period | Up to $150,000 per coverage period |
| Acquired Immune Deficiency Syndrome (AIDS) | Up to $10,000 per coverage period | Up to $10,000 per coverage period | Up to $10,000 per coverage period |
| Emergency room | Up to $500 per day | No benefit-specific limit | No benefit-specific limit |
| Outpatient hospital surgery or ambulatory surgical center | Up to $1,000 per day | No benefit-specific limit | No benefit-specific limit |
| Hospital room, board and general nursing care | The amount billed for semi- private room or 90% of the private room billed amount, up to $5,000 per day | The amount billed for semi- private room or 90% of the private room billed amount | The amount billed for semi-private room or 90% of the private room billed amount |
| Intensive care unit | Three times the amount billed for a semi-private room or three times 90% of the private room billed amount, up to
$6,250 per day |
Three times the amount billed for a semi-private room or three times 90% of the private room billed amount | Three times the amount billed for a semi- private room or three times 90% of the private room billed amount |
| Inpatient doctor visits | Up to $500 per confinement | No benefit-specific limit | No benefit-specific limit |
| Includes one-time $25 enrollment fee | |||
| 1The $3,500 deductible is not available with the 0% in-network coinsurance selection. | |||
National General Provider Network
Choose Your Provider
National General’s Short Term Medical insurance gives you access to the Aetna Open Choice PPO network, one of the largest networks in the country with no referral required.
Short Term Health Insurance and Network Breadth
While more than half of ACA plans lack out-of-network coverage,14 all short term insurance plans offered through AgileHealthInsurance have broad network coverage ensuring that an enrollee has access to quality health care providers. If an enrollee goes out of network and finds that the provider does not accept their short term insurance, in many cases, the enrollee can get reimbursed by submitting their claim to the insurance company. To be sure, enrollees should check with their insurance company first.
Short Term insurance plan premiums are also significantly less expensive than unsubsidized premiums for health plans sold on the exchanges. Compared to the average costs for 2016 Obamacare bronze plans for individuals aged 30, 40, and 50, short term insurance plans are 25 percent less expensive. Savings are greater for younger individuals without pre-existing conditions. For healthy males, aged 30, a short term insurance premium is 54.93% less expensive than an Obamacare Bronze plan.15
It should be noted that unlike ACA plans, short term insurance plans do not cover medical conditions that existed prior to enrollment.
How Is Short Term Health Insurance Different Than Obamacare?
Affordable Care Act plans typically have broader benefits than found in Short Term health insurance and, without the premium subsidies available to some qualified purchasers, cost much more than Short Term plans.
All health plans that fit in the Affordable Care Act must have “10 Essential Health Benefits.” Short Term health insurance plans, in comparison, do not have a standardized set of benefits. Short Term plans usually offer what would be described as “major medical coverage” that covers healthcare costs in the event of serious medical issues. Most Short Term plans also cover normal doctor visits for routine illnesses and injuries.
Considering the prevalence of ACA insurance plans with narrow networks, consumers should heavily research plans before enrolling to ensure that they are not putting themselves at risk for high out-of-network costs.
For those needing broad coverage, short term insurance may be a good option. 100 percent of short term insurance plans sold through Independent Health Agents have out-of-network coverage. Enrollees in these plans can be ensured that they will have access to high quality providers without incurring unknown and potentially sizable costs.
The chart below details some of the major benefit differences between Short Term health insurance plans and Affordable Care Act plans. It is important to note that Affordable Care Act plans do not deny care for pre-existing conditions nor do they reject applicants based on health problems.
| Short Term Health Insurance Plans | Affordable Care Act Plans | |
| Coverage availability | Apply any time and get coverage as early as the next day | Apply only during Open Enrollment (or Special Enrollment due to a qualifying event) and get coverage in 2-6 weeks |
| Coverage duration | Coverage duration is less than three months. Many plans can be cancelled at any time. | As long as the plan is available. You can change plans during Open Enrollment (or Special Enrollment with a qualifying event) |
| Prescription drug coverage | Many Short Term health insurance plans provide a drug discount card but do not provide drug coverage. Some newer plans have a prescription drug coverage option for generic drugs not associated with a pre-existing condition. Brand name drugs and specialty drugs are typically uncovered. | Minimum of 1 drug per class must be covered but the minimum number of drugs per class is often more due to the benchmark chosen for each particular state. |
| Maternity and newborn care | Complications of maternity are covered but not standard childbirth services. | Full coverage. Applicants cannot be denied based on pregnancy as a precondition. |
| Mental health services | Coverage is included only when mandated at state level. | Coverage included, but states vary on their definition of “mental health” services, so while some do include learning disabilities or conditions like Autism, other states do not. |
| Substance use disorder services | Coverage is included only when mandated at state level. | All ACA plans have full coverage. |
| Rehabilitative and habilitative services | Coverage is included only when mandated at state level. | All ACA plans have full coverage. |
| Preventive care | Some plans have selected preventive care benefits with cost-sharing. However, most plans do not cover preventive care services. | Preventative services must be provided without cost-sharing (cf.https://www.healthcare.gov/preventive-care-benefits) |
| Pediatric services – oral and dental care | Coverage is included only when mandated at state level. | All ACA plans have full coverage. |
| Healthcare provider networks | Short Term plans typically have broad acceptance among healthcare providers. Some have a preferred network with negotiated pricing for healthcare services and a larger non-preferred network where the plans pay ‘usual and customary’ fees for covered healthcare. | These plans have been noted for a significant use of “narrow networks” to increase the ratio of enrollees to healthcare providers. |
| Uninsured tax penalties | The maximum penalty is the national average premium for a bronze plan. For 2016, the tax is 2.5% of modified adjusted gross household income or $695 per person, whichever is greater. | ACA plans meet the requirements for avoiding the tax penalty. |
| Coverage of pre-existing conditions | These plans evaluate health status and pre-existing conditions when processing an insurance application and determine whether the applicant is approved or rejected for coverage. | These plans do not consider health status or pre-existing conditions when processing an insurance application. |
Short Term Medical – Frequently Asked Questions
Short Term Medical Plan Exclusions
Short Term Medical Insurance coverage is designed to protect you in the event of an unexpected illness or injury. Because of this, medical insurance coverage for preventive care, pre-existing conditions, physicals, pregnancy, immunizations, dental or eye care services are not covered by short term medical plans. Any medical expense incurried outside the U.S. or Canada is also excluded from temporary insurance plans. Individuals that need medical coverage outside the country can get an international travel insurance policy.
Payment Options
Single payment option: This is ideal if you know the exact number of days that your coverage is needed. The minimum number of days you may apply for is 30 days, the maximum is 90 days as of April 1, 2017. No refunds are available after the 10-day free look period.
Monthly payment option: If you are unsure of how long you will need coverage, this option would be the best for you. The “pay as you go” option gives you the flexibility to continue coverage for as long as it is needed, or simply stop payments and discontinue the plan once your temporary health insurance need ends.
Purchasing an Additional Plan
Short term health insurance plans are not renewable. However, if your temporary health insurance need continues beyond your policy period, you may apply for a new plan under the following circumstances:
- No claims were submitted while covered under a previous short term medical insurance plan
- There has been no significant change to your health
- Any previous or current health condition or symptom will be considered a pre-existing medical condition that will not be covered under a new plan.
How HIPPA Legistlation affects Short Term Medical Plans
Under HIPAA, short term medical policies are generally exempt from the Federal Health Insurance Portability and Accountability Act (HIPPA). This means that when issuing a Short Term Medical policy, insurance carriers do not have to: guarantee renewability, guarantee issue or waive the pre-existing condition limitation for federally eligible individuals.
In Texas, an individual must maintain health coverage for 18 consecutive months without any break in coverage longer than 63 days to avoid pre-existing condition limitations. Previous creditable coverage includes:
- A group health plan
- Health insurance coverage
- Part A or Part B of title XVIII of the Social Security Act (Medicare)
- Title XIX of the Social Security Act, other than coverage consisting solely of benefits under section 1928 (Medicaid)
- Chapter 55 of title 10, United States Code (Champus)
- A medical care program of the Indian Health Service or of a tribal organization
- A state health benefits risk pool
- A health plan offered under chapter 89 of title 5, United States code (Federal Employee Health Benefit Plan)
- A public health plan (as defined in regulations)
- A health benefit plan under section 5(e) of the Peace Corps Act
What does short-term health insurance cover?
Short-term health insurance is major medical insurance for a set period of time. It covers doctor visits, hospitalizations, emergency care, lab tests, x-rays, and other common medical needs.
Is short-term health insurance Obamacare?
No. Short-term health insurance is a streamlined insurance plan. While it includes many benefits, it does not cover all 12 of the minimum essential benefits that the Affordable Care Act plans are required to cover. For example, in most cases, short-term health insurance will not include maternity care or mental health services.
In addition, short-term health insurance involves an application. Depending on your health status, your application may be declined or your pre-existing condition may be excluded. Obamacare guarantees that all applicants and their pre-existing conditions will be covered, no matter what your health status.
Is short-term health insurance “creditable coverage” under federal law?
Yes, short-term health (STH) insurance is considered “creditable coverage” under the Health Insurance Portability and Accountability Act (HIPAA). Under federal law, if you have a gap in insurance coverage longer than 63 days, and you are diagnosed with a serious illness or become pregnant during that time, you will lose your health insurance rights to have these conditions covered by your next health insurance plan. Instead, the new health plan can impose a wait period of several months before you will be insured for these conditions. That is why it’s important to have continuous health coverage under a “creditable” plan, such as short-term health insurance. Illnesses and conditions developed while on a creditable coverage plan will be covered on the date your new health plan becomes effective.
IWhen can I apply for short-term health insurance?
You can apply at any time. There is no fixed open enrollment period. On Agilehealthinsurance.com, you can submit your application and, if approved, your insurance can be effective within as little as 24 hours.
Can I cancel a short term plan at any time?
Within the first ten days of the effective date of your plan, you can cancel and will receive a full refund. For cancellation beyond the ten days, you simply email or call the insurance company with your reason for cancelling. If you cancel before your policy period is over, in most cases you will be given a prorated refund based on the unused benefit.
What conditions on the application will make me ineligible for a short term plan?
Within the last 5 years if you have been diagnosed, treated, or taken medication for any of the following conditions, term health insurance cannot be issued: Cancer or tumor, stroke, heart disease including heart attack, chest pain or had heart surgery, COPD (chronic obstructive pulmonary disease) or emphysema, Crohn’s disease, liver disorder, degenerative disc disease, rheumatoid arthritis, kidney disorder, diabetes, degenerative joint disease of the knee, alcohol abuse or chemical dependency, or any neurological disorder; HIV or AIDS; or if you are now pregnant or in the process of adoption.
If you are looking for insurance to cover your pre-existing conditions, we can refer you to an agent who can help you find a health insurance plan that to cover these conditions:
- For ACA/Obamacare Plans: 312-726-6565