Short-Term Medical Plans

Short-term medical (STM) plans were originally made for transitional periods such as waiting to start Medicare, the you’re between jobs, and waiting for other coverage to begin. Recent regulations have changed these plans and, in some states, you may renew these plans for up to three years. People with minor or no pre-existing conditions gravitate towards these plans, since short-term medical plans are typically a more affordable alternative to ACA/Marketplace coverage options. 

These plans will require you to pass a few simple underwriting questions before they will accept you.* Because short-term health plans are on the private market outside of the Affordable Care Act, they are not required to cover everything that those marketplace plans cover, including mandated preventive care services. Short-term medical plans also will not cover pre-existing conditions or pregnancy. Please see the list below for more health issues and conditions these plans often don’t cover.** 

You can join a short-term medical plan anytime of the year and do not need to wait for a specific enrollment period. The people who join an STM plan often do so because they are fairly healthy and they do not receive any Advanced Premium Tax Credit (APTC) / subsidy from the Marketplace. 

* Typical declinable conditions for short-term health plans

  • Weight greater than 250 lbs if female or 300 lbs if male
  • Expectant parent or in the process of adopting
  • Pending/upcoming testing/treatment/surgery
  • Within the last five years, diagnosis or treatment of: A-fib, AIDS/HIV, alcohol/drug abuse/treatment, bipolar, blood disorders, cancer, COPD, eating disorders, emphysema, melanoma, heart disorders, heart attack, stroke, type 1 diabetes, hepatitis C, liver or kidney issues, rheumatoid arthritis, Multiple sclerosis, schizophrenia

**Conditions/Treatments Usually Not Covered Under Short-Term Medical Plans

  • Abortions
  • Acupuncture
  • Acne
  • Adenoids (unless an emergency)
  • Alcohol/drug treatment
  • Allergies
  • Bones, connective tissue, tendons, ligaments, joints, or cartilage treatments unless due to injury
  • Cataracts
  • Chiropractor and other spine treatments
  • Cosmetic surgeries (including gender reconstruction)
  • End Stage Renal Deficiency (ESRD)
  • Experimental treatments
  • Foot care/treatment/supplies (special shoes, bunions, toe nails, etc.)
  • Hemorrhoids (unless an emergency)
  • Hernia (unless an emergency)
  • Holistic care
  • Hyperhidrosis (excessive sweating)
  • Immunizations 
  • Mental Health
  • Organ or tissue transplants
  • Pregnancy
  • Pre-existing conditions for the first 12 months
  • Routine physicals and preventive care
  • Routine pre-natal/pregnancy/child birth/post-natal care
  • Skin tags
  • STD testing/treatment
  • Sterilizations and reverse sterilizations
  • Tonsils (unless an emergency)

 

For a free, no-obligation short-term medical insurance quote, call us at 402.661.0395 or fill out our quote form online by going here.