Short Term Health Insurance: What It Is and Who It Suits

Losing health cover, even for a few months, can feel risky. Short term health insurance is designed to fill a gap between longer-term plans, but it works very differently from the comprehensive cover most people are used to. This guide explains what it is, who it may suit, what it usually does and does not cover, and what to check before choosing a plan.

What Is Short Term Health Insurance?

Short term health insurance is temporary medical cover that lasts for a limited period, often a few months and sometimes up to a year, depending on the rules where you live and the plan you choose. It is meant to bridge a gap in cover, not to replace a full health insurance plan over the long term.

These plans are generally aimed at people who need cover for a short, defined period. For example, someone who has left a job and is waiting for a new employer’s plan to start, a recent graduate who is no longer covered by a parent’s plan, or someone waiting for the next open enrolment period may consider a short term plan.

Who Might It Suit?

Short term health insurance may suit people in a genuine gap between plans, who are generally healthy and mainly want protection against an unexpected illness or injury during that gap.

It may be worth considering if you are between jobs and waiting for new employer cover to begin, a recent graduate who has come off a parent’s plan, waiting for the next enrolment period for a longer-term plan, or newly self-employed and still arranging permanent cover.

What Does It Usually Cover?

Short term plans vary a great deal, so there is no single list of what is included. In general, they are designed to help with unexpected medical events rather than routine or ongoing care. A typical plan may include some cover for doctor visits for new illnesses or injuries, emergency care and hospital stays, some diagnostic tests such as X-rays or lab work, and surgery linked to a new illness or injury.

What It Usually Does Not Cover

The exclusions are where short term plans differ most from comprehensive cover. Many short term plans do not cover, or cover only in a very limited way, pre-existing conditions, preventive care such as routine check-ups and vaccinations, prescription medicines, mental health and substance use treatment, maternity care, and ongoing care for chronic conditions. Dental care is often excluded too, so a major dental procedure would be paid for separately — for a sense of what that can cost, see the cost of dental implants.

Pre-existing conditions are one of the most important differences. Illnesses or conditions you already had before the plan started are often excluded, or covered only after a waiting period. If any of these apply to you, a short term plan may leave you with large bills even though you are insured. That is why it is important to think about your actual health needs, not just the monthly price.

What Affects the Cost?

The cost of a short term plan varies depending on several factors, including your age and health, where you live, the level of cover, the length of the plan, and how many people are covered. Younger, healthier applicants are generally quoted lower prices, and some plans ask health questions before accepting you. Prices and the rules on how long a plan can last also vary by state or region.

A plan with a lower deductible and higher limits costs more than a plan with a high deductible and low limits. Because prices vary so much, it is worth getting quotes from more than one provider and comparing the cover, not just the monthly price. A cheap plan with a very high deductible and many exclusions may cost you more in the end if you need care.

What to Check Before Choosing

Before you buy a short term plan, work through this checklist. First, how long can the plan last? Check the maximum term allowed where you live and whether the plan can be renewed, since a plan that ends before your next cover starts leaves you unprotected.

Second, what is excluded? Read the exclusions list in full, especially for pre-existing conditions, prescriptions, and maternity care. Third, what are the limits? Look for the total maximum payout, the deductible, and any per-day or per-visit limits.

Fourth, which doctors and hospitals are in the network? Check whether your usual doctor or local hospital is included. Fifth, can you be turned down? Some short term plans ask health questions and can refuse cover, unlike comprehensive plans that usually cannot refuse you for health reasons. If any of these points are unclear, ask the provider to explain them in writing before you buy.

Short Term vs. Comprehensive Cover

It helps to keep the two types of cover separate in your mind. Comprehensive health insurance is designed for the long term. It usually covers pre-existing conditions, preventive care, prescriptions, mental health care, and maternity care, and it has an out-of-pocket maximum that limits what you pay in a year.

Short term health insurance is designed for a gap. It is usually cheaper and simpler, but it covers less and gives you fewer protections than comprehensive cover. It is best thought of as a temporary bridge, not a substitute for long-term cover. For the federal rules behind these differences, see the fact sheet from the Centers for Medicare and Medicaid Services.

Frequently Asked Questions

Can I buy short term health insurance at any time?

In many places you can apply for a short term plan at any time of year, unlike comprehensive plans that are often limited to an open enrolment period. However, the rules vary by state or region, and some plans ask health questions and can refuse your application. Check the rules where you live.

Does short term health insurance cover pre-existing conditions?

Usually not, or only in a limited way. Most short term plans exclude conditions you had before the plan started, or apply a waiting period before they are covered. This is one of the biggest differences from comprehensive cover, so check the policy wording carefully if you have any existing condition.

What happens when my short term plan ends?

When the plan ends, your cover stops. If your next plan has not started yet, you will be uninsured until it does. Some plans can be renewed or extended, but the rules and the maximum length vary. Plan ahead so there is no gap between one plan ending and the next starting.

Is short term health insurance cheaper than a full plan?

It is usually cheaper month to month, because it covers less and excludes more. But the total cost can be higher if you need care that the plan does not cover. Compare the monthly price with the deductible, the limits, and the exclusions before deciding which plan is better value for your situation.

Conclusion

Short term health insurance can be a useful bridge when you are between longer-term plans and mainly need protection against an unexpected illness or injury. It is generally simpler and cheaper than comprehensive cover, but it covers less and excludes much more, especially pre-existing conditions, preventive care, prescriptions, and maternity care.