What You Need to Know
Short-term health plans in Kentucky last up to 364 days, renewable for up to 36 months.
Premiums are usually lower than for traditional health insurance plans.
Short-term plans may offer limited coverage and don’t have to provide essential health benefits.
What Is Kentucky Short-Term Health Insurance?
Short-term health insurance, sometimes called limited-duration or temporary health insurance, is one of the types of coverage available to residents of Kentucky. It’s meant to cover you during a temporary gap in your medical insurance, not as long-term health coverage.
You might need short-term insurance after graduating from college, losing your job, missing the annual enrollment period for Affordable Care Act (ACA) coverage, or while you wait for Medicare eligibility at age 65.
Kentucky follows the federal guidelines that were issued in 2018 for short-term policies. Kentuckians can buy a policy that lasts up to 364 days and can be renewed for up to 36 months.1
No Enrollment Period
You can sign up for a short-term plan any time of year.
Who Should Buy Short-Term Plans in Kentucky?
A short-term plan might be a good choice if you’re relatively healthy and need health insurance coverage until you can get a more comprehensive policy.
Affordability: These plans provide another option for Kentucky residents who can’t afford the ACA individual health insurance market, especially those who don’t qualify for subsidies on ACA-compliant policies. Temporary health insurance might help if your income is too high to qualify for Medicaid or lose your job and can’t afford the high premiums for the COBRA medical insurance your former employer offers.
Enrollment: You can enroll in a short-term health plan whenever you want. When your plan ends, though, you won’t qualify for a Special Enrollment Period if you want to buy an ACA policy. Instead, you’ll have to wait until the next ACA Open Enrollment Period.2
Relatively healthy: Short-term health insurance could offer enough coverage if you don’t have significant health issues and only expect to need routine doctor visits.
The bridge between coverage: A short-term policy can offer a temporary solution if you’re waiting for a new employer’s plan to go into effect or if you missed the Open Enrollment Period for an ACA-compliant plan.
Insurers can reject you for health issues. Keep in mind that even if you could pass medical underwriting with a preexisting condition like diabetes or cancer, a temporary health plan likely wouldn’t offer enough coverage. Short-term insurance plans don’t have to cover the “essential health benefits” the ACA requires, such as maternity care or prescription drug coverage.
Pros and Cons of Short-Term Plans
Here are some things to consider about Kentucky short-term health insurance plans:
- Short-term plans tend to be cheaper than plans available through the ACA Marketplace or COBRA.
- Signing up for short-term health insurance is easy, and you can do it anytime. Your policy can start immediately if you enroll online.
- If you’re healthy, a short-term plan can provide peace of mind about routine health services or emergency care.
- You have to answer extensive questions about your health to pass medical underwriting. A preexisting condition can mean being rejected for coverage.
- Short-term plans offer less coverage than you would get with an ACA-compliant policy.
- The ACA doesn’t regulate short-term plans, so you can’t get premium subsidies like you could for an ACA-compliant policy through the Marketplace.3
What’s Not Covered
Short-term plans generally don’t cover preexisting conditions or other health issues.
How Much Are Kentucky Short-Term Plans?
With short-term health plans, you have several costs to consider. You’ll likely have to pay a monthly premium. You’ll also have a deductible, which is the amount you’ll pay before the plan starts to pay medical claims.
After you meet your deductible, you’ll pay a percentage of medical expenses, called coinsurance, plus a set amount charged for each service called a copayment. Check the details of your out-of-pocket costs before you sign with an insurer.
An out-of-pocket maximum will limit how much you have to pay yourself. Total policy coverage is the maximum amount the insurance company will pay for eligible expenses during the policy period. After the maximum is reached, you’re responsible for 100% of your medical bills.
Each of those costs and limits will vary from plan to plan. For example, Pivot Health offers 79 short-term plans for 35-year-old women who live in Louisville, Kentucky.4
Monthly premiums range from $92.49 to $448.77, with only one plan costing under $100 per month, but 29 between $100 and $200. Deductibles range from $1,000 to $10,000, and coinsurance is typically 0%, 20% or 30%. The out-of-pocket maximum ranges from $1,000 to $10,000, and total policy coverage runs between $100,000 and $1,000,000.
One economy plan for a 35-year-old woman in Louisville includes:
- $92.49 premium
- $10,000 deductible
- 30% coinsurance
- $10,000 maximum out-of-pocket
- $100,000 total policy coverage
A 35-year-old woman in Lexington also has 79 plans to choose from, but premiums run a little lower: from $87.31 to $418.14. Deductible, coinsurance, and out-of-pocket maximum ranges are the same. She could buy the same economy plan for a few dollars less or a deluxe plan as follows:
- $418.14 premium
- $1,000 deductible
- 20% coinsurance
- $3,000 maximum out-of-pocket
- $1,000,000 total policy coverage
What Are Rules Governing Short-Term Plans in Kentucky?
In 2018, the U.S. Department of Health and Human Services (HHS) issued rules extending the duration of short-term policies. In response, the Kentucky Department of Insurance issued a Consumer Alert that answers frequently asked questions about those policies.
Under the new federal guidelines, initial short-term insurance policies increased from three to 12 months and became renewable for a period of up to 36 months with the same policy. In Kentucky, you can have separate policies for more than 36 months.
Kentucky’s short-term medical insurance plans are not guaranteed issue or guaranteed renewable, and they can be canceled under certain conditions (nonpayment of premiums or misrepresentation on the application).5
Insurers can charge higher premiums based on health status, exclude coverage for preexisting conditions, impose annual or lifetime benefit limits, exclude entire categories of benefits (such as prescription drugs and preventative health screenings) and deny coverage.
Short-term policies offered by insurance carriers must be approved by the Kentucky Department of Insurance and follow the department’s checklist of requirements. They must include a “free look” of at least 10 days. If you change your mind on a plan within that period, you can cancel without a penalty.6
Who Sells Short-Term Plans in Kentucky?
Private health insurance providers sell short-term plans. Some of the companies that offer short-term medical insurance in Kentucky are:
If Kentucky temporary health insurance makes sense for your current situation, research the available insurance companies to find a plan that gives you the most coverage for your money. You can contact an insurer directly or reach out to an insurance agent. Make sure you understand your needs and the plan’s limitations before you sign up.