Short term health insurance plans, sometimes referred to as “catastrophic” plans, are growing in number since the government removed the mandate to have a qualifying health plan. If you live in “417-land,” you may already know the only qualifying health plan is Ambetter, available on the Health Insurance Marketplace (www.healthcare.gov). Pricing for Ambetter is usually based on household income. Many people who don’t want to be insured on the Marketplace, or whose income doesn’t qualify them for reduced premiums through Ambetter, are forced to look elsewhere for coverage.
I’ve seen an uptick in short term enrollments this year, and they are well-priced if what you’re looking for is truly “catastrophic” in nature.
Short term plans may be ideal if you:
- Have a DPC (Direct Primary Care) membership which allows for doctor visits but not hospital coverage.
- Must wait until the next Open Enrollment (November 1st-December 15th) for qualified health insurance.
- Are between jobs.
- Retired early and need coverage before Medicare eligibility at age 65.
- Have little need for up-front medical services or prescriptions, but want catastrophic medical/financial protection.
Important points to note if/when you consider a short-term plan.
- You can enroll and/or cancel coverage AT ANY TIME.
- You select the term of coverage from 30 days to 6 months, and the policy is renewable for up to another 6 months.
- There are flexible premium options with the ability to select deductibles from $2,500 to $12,500.
- Short-term plans must use in-network doctors or hospitals except in emergencies. Most plans include both Mercy and Cox in their provider networks.
- Plans offer coverage for doctor visits, hospitalization and outpatient services after deductibles are met.
- Copays are standardized at urgent care facilities (usually $50 or $75 per visit).
- Prescriptions or pre-existing conditions are not covered, and plans are subject to health questionnaires.
If you are looking for a short-term plan, I would be happy to answer any questions.