Short-Term Health Insurance

What short-term health insurance covers

Short-term health insurance provides temporary medical coverage for acute illnesses and injuries. It is not ACA-compliant and does not include all the protections and essential health benefits required of major medical plans. Coverage is limited, exclusions are common, and the protection is meant to be temporary only.

• Emergency room visits — coverage for emergency care, subject to deductible and co-insurance.
• Hospital inpatient care — coverage for hospital admission and inpatient treatment.
• Urgent care and office visits — coverage for urgent-care centers and primary-care office visits, often with high co-pays.
• Prescription drugs — limited coverage for prescription medications, often subject to high deductibles or exclusions.
• Limited surgical coverage — coverage for surgical procedures, subject to high deductibles and co-insurance.

What it doesn’t cover

• Pre-existing conditions are excluded or limited — conditions treated in the 6 months before coverage typically excluded for 12 months
• Preventive care (vaccines, screenings, wellness visits) — not covered, unlike ACA plans
• Maternity and newborn care — typically excluded entirely
• Mental health and behavioral health — often excluded or severely limited
• Substance-use disorder treatment — may be excluded or covered only at emergency level
• Prescription drug coverage — often excluded or limited to emergency use only
• Rehabilitation and physical therapy — typically not covered
• Chronic disease management — limited or no coverage for ongoing chronic-condition management
• Coverage is temporary — policy ends after the stated term, and you must find new coverage

What drives the cost

• Age. Younger applicants pay lower premiums. Short-term plans are age-rated, often allowing up to 5x variation between oldest and youngest applicants.
• Coverage duration. Shorter terms (1–3 months) are cheaper than longer terms (6–12 months).
• Deductible selected. Higher deductibles lower premium. $10,000–$15,000 deductibles are common in short-term plans.
• Co-pay and co-insurance structure. Plans with higher co-insurance (30%, 40%, 50%) are cheaper than low co-insurance.
• Maximum out-of-pocket. Short-term plans may have unlimited out-of-pocket maximums or very high caps ($50k–$100k+), unlike ACA plans with capped out-of-pocket maximums.
• Health profile and exclusions. Pre-existing conditions, chronic illnesses, and behavioral health history increase premium or may result in denial or exclusions.

Cost factors are general industry guidance. Premium ranges vary widely by carrier, state, and individual risk — get a quote before assuming the cost. Varies by state — verify your state's current rules with your state insurance commissioner.

Related

FAQ

What is short-term health insurance?

Short-term health insurance is temporary medical coverage designed to bridge gaps in coverage — typically for 1 to 12 months (varies by state). Unlike ACA-compliant major medical plans, short-term policies are not subject to the same regulatory requirements and can exclude pre-existing conditions, have higher deductibles, and limited benefits. They are cheaper than ACA plans but offer much less protection.

How is short-term health insurance different from ACA-compliant major medical coverage?

ACA-compliant plans must cover the 10 essential health benefits, cannot exclude pre-existing conditions, and have out-of-pocket maximums and deductible caps. Short-term plans are exempt from ACA requirements and are not considered minimum essential coverage. Short-term plans can exclude conditions, have no preventive-care coverage, and unlimited out-of-pocket costs. Short-term coverage is significantly cheaper but provides much less protection.

Which states restrict or ban short-term health insurance?

Several states including California, New York, New Jersey, and others have banned or severely restricted short-term plans to protect consumers from inadequate coverage. Rules vary by state — some allow 3 months, others 12 months, and some prohibit them entirely. State regulations have also tightened post-pandemic. Verify your state's current rules with your state insurance commissioner or a health insurance broker.

Can short-term health insurance satisfy the Medicare Part B enrollment period?

No. Short-term health insurance is not credible coverage and does not satisfy Medicare enrollment period requirements. If you are approaching Medicare eligibility age (65) and decline to enroll in Medicare Part B because you have short-term coverage, you may face lifetime penalties. Use ACA-compliant major medical or Medicare, not short-term plans, for Medicare planning.

What pre-existing conditions and exclusions are typical?

Short-term plans typically exclude or limit coverage for pre-existing conditions. A condition that was treated in the 6 months before the policy started may be excluded from coverage for the first 12 months of the policy. Some plans also exclude behavioral health, maternity, and specific treatments. Always review the exclusions schedule carefully.