What You Need to Know
Short-term health insurance plans in Georgia can provide coverage for up to 364 days, renewable up to 36 months.
In general, monthly premiums are lower for a short-term plan than for plans available through the Affordable Care Act (unless you qualify for a subsidy).
Short-term health plans don’t provide the comprehensive coverage that ACA plans offer.
What is Georgia Short-Term Health Insurance?
Short-term health insurance is a temporary option for people experiencing a gap in their healthcare coverage. Such gaps are often associated with life changes, like finding a new job or retiring early. During these times, it may not seem like a big deal to go without health insurance. But doing so may be risky for your health and your finances.
In some cases, a short-term plan is a quick and inexpensive health insurance option that makes sense for your situation. It’s important, though, to look closely at the coverage details and out-of-pocket costs.
Who Should Buy Short-Term Plans in Georgia?
As you weigh your decision to purchase a short-term plan, consider the following factors:
- Affordability: Compared with ACA plans, you may find that short-term plans are a less expensive option, especially if you don’t qualify for a subsidy. However, the tradeoff for low monthly premiums is higher out-of-pocket costs and less extensive coverage.
- Enrollment: With a short-term plan, you can enroll at any time. But you’ll need to plan ahead for when your short-term coverage ends. Such a situation doesn’t qualify you for an ACA special enrollment period. You’ll have to wait for an Open Enrollment Period if you want to sign up for an ACA plan, which runs between November 1 and January 15 each year.
- Your Health Status: A short-term plan may be a good option if you’re relatively young and don’t have any medical conditions. Short term plans aren’t required to cover preexisting conditions or the ACA’s 10 essential benefits. Coverage for maternity care, mental health services, or prescription drugs may be limited or not covered at all.1 Before you purchase a short-term health insurance plan, make sure you understand the coverage you’re getting.
- Life Events: Short-term insurance makes the most sense when you experience a loss or delay in health coverage due to a life event, such as:
- A job loss
- A new job
- Your 26th birthday
- A divorce
- Retirement before the age of 65
When might short-term health insurance not be your best option? If you have any current medical conditions or need the ACA’s essential benefits, a short-term plan may not provide adequate coverage. In this case, you should consider another type of plan.
The pros and cons of short-term health plans include:
- Offer fast, affordable health insurance coverage
- Provide protection from unexpected illnesses and injuries for a short period of time – up to 36 months in Georgia
- May be a good option if you are young and relatively healthy
- Have higher deductibles and other out-of-pocket costs
- May not cover pre-existing conditions or the 10 essential health benefits that are included under all ACA health plans
Know What’s Covered
If you have a preexisting condition or need regular medical care, a short-term plan may not be right for you.
How Much Are Georgia Short-Term Plans?
To compare health insurance, you’ll need to understand all the costs. Here are descriptions of the costs you’ll find listed on most health insurance policies:
- Premiums — your monthly payment for your health plan.
- Deductibles — the amount you pay before your insurance starts to share your medical expenses.
- Coinsurance — a percentage of your medical costs that you pay after you’ve met your deductible.
- Copayments — a fixed fee for a covered service that you are responsible for, after you’ve met your deductible. Copayments may vary by the type of visit, service or provider.
According to Pivot Health, Georgia residents have many short-term health plans to choose from. For a 35-year-old woman with no dependents, monthly premiums range from:
- $112 to $569 in Atlanta
- $104 to $519 in Augusta
In general, plans with lower monthly premiums have higher deductibles. For the plans listed above, deductibles are $10,000 for the low premium plans and $1,000 for the plans with high premiums. All plans have a coinsurance of 20% to 30% and cover mental health services and physical therapy. The higher premium plans also cover primary care and specialist visits.
Bridging a Gap
A short-term plan can be an affordable option if you’re healthy and need temporary coverage.
What Are Rules Governing Short-Term Plans in Georgia?
Federal law permits short-term policies up to 364 days, renewable up to 36 months.2 Georgia does not regulate short-term health insurance, so short-term plans sold in the state follow the federal requirements.
Some short-term plans may require medical underwriting, which means the insurance company may evaluate your health to determine whether you qualify. The company may also require underwriting with each renewal. So, if you develop any health conditions while you are covered, you may not be able to renew for an additional term.
Who Sells Short-Term Plans in Georgia?
In Georgia, some of the companies that offer short-term plans include:
- Companion Life Insurance Company (Pivot Health)
- Independence American Insurance Company
- UnitedHealthcare (Golden Rule Insurance Company)
- Everest Reinsurance Company
- National General Insurance Company
Short-term health insurance is one of many options Georgia residents have for health coverage. Whether a short-term plan is your best choice will depend on your life circumstances, health needs, and budget. Before you decide, take time to do some comparison shopping. Research the insurance carriers and their policies. This way you’ll find a plan that gives you the coverage you need at a price you can afford.