Short Term Medical gives you the flexibility to get the coverage you need when you need it most. Short term medical provides all of the options you need to protect you and your family when you are out of work, furloughed, or in-between plans and left without health insurance. Short term medical insurance in Kentucky is provided on an initial term for between 30 and 364 days but can be renewed for up to three years.
At Braden Insurance, we sell Short Term Health Insurance through National General and United HealthOne. The federal laws that apply in Kentucky and Indiana also require that insurers must make the terms and provisions of short-term medical insurance clear to consumers. At Braden, we break down short term health insurance to make it simple and easy to understand. We want you to know what it is, who needs it, what’s covered, how to get it, and how much it will cost.
What is Short Term Health Insurance?
Short term health insurance is designed to provide you with temporary medical coverage. Your policy will be sold with a term limit of up to 364 days. However, if necessary, your policy can be automatically renewed for up to 36 months (3 years). Short term health insurance is commonly used when you are between health plans, outside enrollment periods, or need some coverage in case of an emergency.
Who Needs Short Term Medical Coverage?
To be eligible for short term health insurance, you must be under 65 and live in a state where it is available. It’s a viable option for many who may be without health insurance for a variety of reasons including:
- You’ve got a gap in coverage due to a new job
- You don’t qualify for a special enrollment period
- Losing a job
- Furloughed and left without health insurance
- Aging off of parents’ health insurance plan at 26 years old
- Early retirees who don’t yet qualify for Medicare
- College students who need coverage during the school year, or don’t yet have a job
- People who don’t qualify for an ACA Special Enrollment period/missed the enrollment period
- New US immigrants
- US citizens returning from living abroad
What is Covered By Short Term Insurance?
Short term health insurance coverage varies greatly depending on the plan and the insurance company you buy from. This is partly because temporary health coverage is not required to meet the same standards as the Affordable Healthcare Act. There are no minimums or required levels of coverage, so it’s important to understand your plan completely and read through the “exclusions and limitations” information thoroughly.
Short term medical insurance typically provides some level of coverage for:
- Preventive care
- Doctor visits
- Urgent care
- Emergency care
Here is a breakdown of the types of coverage that is available.
|Type of Coverage||Is It Covered?|
|Doctor visits for illness and injury and other outpatient care (ambulatory services)||Yes|
|Maternity & Newborn Care||Pregnacy not covered, except for complications. Newborn care limited.|
|Mental health & substance use disorder services||No coverage or limited coverage, depending on your plan.|
|Prescription drug coverage||Possibly, depending on your plan.|
|Rehabilitative and habilitative services and devices||Limited. Check your plan.|
|Laboratory tests and services||Yes|
|Preventive and wellness care||Possibly, depending on your plan.|
|Pediatric services (including both oral care and vision care)||Possibly, depending on your plan and state.|
To help find the best temporary health care policy for you, give Braden Insurance a call today.
How much does short term health insurance cost?
No two short term insurance plans are the same. Even if your neighbor is in a similar situation and they have a short term health insurance plan, yours will likely look (and cost) very different. The cost of your temporary medical coverage includes five areas you may already be familiar with:
- Premium: This is the monthly fee you pay for having coverage.
- Deductible: This is what you will pay for services until you meet your deductible. Then your plan starts sharing costs. The deductible for short term health insurance is typically much higher than traditional insurance coverage.
- Coinsurance: This is the percentage of costs you share with your plan after you meet your deductible.
- Copay: This is a fee you may have to pay when you visit a doctor regardless of deductible or coinsurance. Some short term plans have a copay, but not always.
- Other out-of-pocket costs: There may be some health care services that aren’t covered by your short term plan, and you are responsible for all costs. This may include maternity care, mental health, substance abuse services, vision, or dental care.
To figure out the exact cost of a specific plan, give Braden Insurance a call. One of our independent agents will be glad to help.
Pros and Cons of Short Term Health Insurance
Short Term Health Insurance Benefits:
- Fast Coverage. Get health coverage as soon as the day after applying, sometimes even within minutes of applying you can be approved and have working coverage.
- Several Options. You choose how much you want to spend per month on your premium and what deductible you are comfortable with.
- Pick your length of coverage. Whether you need coverage for just a few weeks or several months, your plan can be renewed or cancelled anytime.
- Drop coverage with no penalty. When you receive more permanent health insurance you can cancel coverage with no penalty.
- Vast list of doctors to choose from. Short term insurance is widely accepted among doctors so you can still go to the doctors you already know and trust with no restrictions.
- Emergency Coverage. Short term insurance is there for emergencies and unexpected illnesses.
- Fill in the gap. Designed to fill short-term gaps in coverage should you need it, so you don’t have to worry about losing health insurance when you need it most.
- There's no enrollment period. You can enroll anytime you need it and get coverage as soon as the next day.
- They're a security blanket. Short term insurance gives you the peace of mind knowing you have coverage in case of major accident or unexpected illness.
- Flexibility. You can choose how much coverage you need, and for how long you need it.
- Affordable. Short term health insurance is often cheaper than COBRA options. In addition, some doctors have preferred pricing for those with short term insurance, so your overall costs are lower.
Disadvantages of Short Term Insurance Plans
- Limited Coverage. There is usually no coverage for pre-existing conditions and limited coverage for some services.
- Can be denied. A medical questionnaire may be required to be approved for coverage.
What’s the Difference between Short-term Health Insurance and Obamacare?
All ACA individual health plans must have the "10 essential health benefits." Short Term Medical Insurance plans, in comparison, do not have a standardized set of benefits.
Standard benefits include maternity coverage and preventative care, mental health, and substance abuse benefits. Short term health insurance typically doesn’t cover any of these areas. Short-term insurance plans usually offer "major medical” type benefits that cover healthcare costs in the event of unexpected accidents and illnesses.
|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 on a standardized effective date 2-6 weeks in the future.|
|Coverage duration||1 month to 12 months depending on the state. Many states allow you to reapply for back-to-back coverage.||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 one drug per class must be covered but the minimum number of drugs per class is often more due to the benchmark formulary chosen for each particular state.|
|Maternity and newborn care||Complications of maternity may be covered but not standard childbirth services.||Full coverage. Applicants cannot be denied based on pregnancy as a precondition.|
|Mental health services||Some plans offer a limited benefit. In some states coverage is included because the state mandates it.||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 generally is included only when mandated at state level.||Covered. Benefit amounts, services and networks are defined by the State and the plans available.|
|Rehabilitative and habilitative services and devices||Coverage is generally included only when mandated at state level.||Covered. Benefit amounts, services and networks are defined by the State and the plans available|
|Preventive care||Some plans have selected preventive care benefits with cost-sharing. However, many plans do not cover preventive care services.||Preventative services must be provided without cost-sharing.|
|Pediatric services - oral and dental care||Coverage is included generally when mandated at state level.||Covered. Benefit amounts, services and networks are defined by the State and the plans available.|
|Healthcare provider networks||Short Term Health Insurance 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 networks and some have been noted for a significant use of "narrow networks" to increase the ratio of enrollees to healthcare providers.|
|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.|
How To Choose Short Term Medical Insurance
Thinking of buying a short-term health plan? Here are some things to keep in mind:
Read the fine print of what the plan covers, and especially what it doesn't cover.
Understand how much you'll pay out of pocket.
How much is the deductible?
What percentage of covered medical expenses do you pay after the deductible?
What is the maximum amount you will have to pay out of pocket?
What is the dollar cap on coverage?
If the plan has a network of medical providers, make sure the network includes doctors and hospitals you would use.
Understand that if you enroll in a short-term plan instead of choosing COBRA coverage, you will lose eligibility for COBRA after the short-term plan expires.
Short Term Insurance from National General
At Braden Insurance, we provide coverage through National General Insurance. National General is one of the top 10 providers for home, auto, and short term health insurance. These short term insurance options work through Aetna or Cigna’s Open Choice PPO Network, which provides a range of over 5,000 doctor and specialist options. This makes it easy to see your favorite doctor without worrying about an additional out-of-network fee imposed by some competitors.
Co-pays for National General short term insurance range between $50 and $250 per month, which is significantly more affordable than COBRA or other short-term plan options. Your deductibles can be set between $1,000 and $25,000. National General’s insurance policies cover emergency care, ER visits, and ambulance fees so you know you’re taken care of if the unexpected happens.
Frequently Asked Questions
How do you buy a short-term health insurance plan?
- Short-term health plans are sold through Braden Insurance. We offer short term insurance provided with coverage through National General. To buy a short term medical plan you can simply contact our office and we’ll walk you through the entire process to ensure you get the coverage that fits your needs and your budget.
Is health insurance required?
- No, the federal mandate that required health insurance has been lifted. Insurance is no longer required in the state of Kentucky. You still have to report your coverage status on your tax return, but you won't have to pay a penalty. However, even when it’s not required, health insurance can protect your family against catastrophic healthcare costs that can drive a family into bankruptcy.
Is short term health insurance available for families?
- Yes, spouses and dependents can be covered under a short term insurance plan. However, all family members will need to meet the medical requirements of the plan.
Does short term health insurance provide coverage for preexisting conditions?
- Maybe not. Insurers will often review up to five years of your health history and can deny your application based on your current and past health conditions.
Is short term medical insurance limited to annual enrollment periods?
- No! Short Term health insurance plans can take effect as soon as the day after your application is received.
What if I don’t need my temporary insurance coverage for as long as I had planned?
- No problem. Your short term health insurance plan can be canceled at any time without penalty. If you need coverage longer than anticipated, it can also be renewed.
Can I pair other plans with a temporary health insurance plan?
- Short Term is often combined with other supplemental health insurance plans to help provide adequate coverage.
Is Temporary Health Coverage Right For Me?
The right coverage for you depends on your individual situation, health, and needs. Ask yourself a few questions to see if this might be a good option for you:
- Do you qualify for a short-term health insurance plan?
- Are you in good health, with no pre-existing conditions?
- What monthly premium can you afford?
- Do you qualify for Medicaid in your state?
- How long do you need coverage for?
- Do you need additional benefits like maternity care, dental, or vision?
- How quickly do you need coverage?
The answers to these questions can help the specialists at Braden Insurance guide you to the next step. We can sit down with you, discuss your needs, and find the best short term health insurance policy for you and your family. Give us a call today!