Short-Term Health Insurance: What It Covers and What It Does Not

What is short-term health insurance?

Short-term plans are individual policies sold outside the ACA Marketplace, usually with terms measured in months rather than a full plan year. Carriers use medical underwriting, which means they review your health history before deciding whether to accept you and on what terms.

What short-term plans typically do not cover

Because short-term plans are not required to follow ACA rules, coverage varies widely by carrier and state. Read the certificate of coverage carefully — these are the exclusions people most often discover only after a claim.

• Pre-existing conditions, and anything the carrier links to them
• Maternity and newborn care on many plans
• Mental health and substance use treatment on many plans
• Prescription drugs, or only a limited list
• Preventive care and routine physicals
• Annual or lifetime limits on what the plan will pay

Short-term vs. ACA Marketplace coverage

When a short-term plan can make sense

A short-term plan can work as a bridge for a healthy applicant with a short, known gap: between jobs, waiting for employer benefits to start, or waiting for Medicare eligibility. It is a poor fit for anyone managing a chronic condition, planning a pregnancy, or who wants predictable costs.

What to do instead if you need comprehensive coverage

If you lost qualifying coverage, you may be able to enroll in an ACA plan through a special enrollment period — which is usually the better long-term choice even at a similar price. Supplemental products like accident, hospital indemnity or critical illness coverage can add protection on top of a major medical plan, but they are not a replacement for one.