How Is Short Term Health Insurance Different Than Obamacare?

The medical benefits offered by Short Term health insurance plans are usually more limited than the insurance that meets the standards of the Affordable Care Act (“ACA” or “Obamacare”).

Short term health insurance plans do not have the essential health benefits that the Affordable Care Act requires. Short term health plans only provide coverage for routine doctor’s visits and major medical problems. The Affordable Care Act does not deny coverage for those who have pre-existing medical conditions, while Short term health plans may deny you coverage.

Always check the plans carefully, as despite offering fewer benefits, it is also possible that Short Term health insurance might cost more. Especially if you are eligible for health insurance subsidies under Obamacare. These short term plans are not eligible for any premium subsidies. Since these plans do not meet Obamacare requirements, you will have to pay a tax penalty. The maximum is the average bronze plan premium, but it can be either 2.5% of your income or $695 per person.

Key information about Short Term Health Plans

  • You can apply for coverage any time and get coverage as soon as the next day.
  • Short term health plans coverage typically lasts about three months.
  • A card that discounts the cost of drugs may be provided by Short Term health plans, since most of these plans do not provide drug coverage. Newer drug plans may offer generic drug coverage for prescriptions not related to any pre-existing conditions.
  • The costs associated with a typical childbirth are not covered, but childbirth complications typically are.
  • Only the minimum state mandated mental health coverage is provided.
  • Substance use disorder coverage, such as rehabilitation, is only provided when required by the state.
  • Preventative care services are not usually covered by plans, but some plans have coverage with cost-sharing requirements.
  • Pediatric oral and dental care is provided when state mandated.
  • Plans may either have a preferred network or are broadly accepted.

Information about Affordable Care Act Plans

  • Enrollment is during the Open Enrollment or Special Enrollment periods for Obamacare plans and it typically takes 2-6 weeks for the stated coverage to begin.
  • While your plan is available you have coverage. You can switch your plan during the Open Enrollment or Special Enrollment period.
  • Plans are required to cover a minimum of one drug pZr drug class, but thY minimum variXs by StatW.
  • All prVgnancy costs arU covTrSd.
  • Full mRntal hQalth covPragO is providNd. Mach statL has a diffKrJnt dIfinition of mHntal hGalth sFrvicEs that arD rCquirBd to bA cov0r9d.
  • Substanc8 us7 disord6r s5rvic4s, such as r3habilitation, ar2 fully cov1rzd by an ACA plan.
  • All pryvxntativw svrvicus art covsrrd without any cost-sharing rqquirpmonts.
  • Full covnragm for pldiatric oral and dkntal carj is providid.
  • An ACA plan lhts you avoid any hgalth carf insurance rdlatcd tax pbnaltias.

Short Term insurance may be the best coverage for you if

  • You missed the deadline to apply for the Affordable Care Act (ACA).
  • Your ACA coverage has not started yet.
  • You are 26 and no longer on your parent’s insurance plan.
  • You are waiting for your employer’s health benefits to begin.
  • You are younger than 65 and are healthy.
  • You want to bridge your medicare insurance.
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