Whether you already live in Connecticut or are moving there, if you’re changing jobs or switching to part-time work or self-employment, you’re probably wondering how you’ll get health insurance to cover you during this transition period.
That’s where short-term health insurance — which is coverage that typically lasts less than 12 months — can help. The trouble is, in Connecticut you won’t find many options for this kind of insurance.
What You Need to Know
Connecticut allows for short-term health insurance but no carrier offers them in the Consitution State.
For temporary coverage, consider applying for an ACA plan, COBRA or Medicaid.
An ACA plan or Medicaid could be the most affordable while COBRA generally costs more.
Connecticut does allow short-term insurance (not all states do) and makes it possible to renew or extend a plan for up to 36 months in total.1 The state also prohibits insurers from denying coverage to anyone with a preexisting condition as long as the plan lasts longer than six months and the person wasn’t diagnosed with the condition within the two years prior to the start of coverage.
What’s more, all plans in Connecticut have to provide what are called “essential health benefits” after six months of coverage. (These benefits are established by the Affordable Care Act, aka Obamacare, and include things like outpatient care, emergency services and prescription drugs; a full list of what’s included is at the link above.)
The problem is that currently no insurance company in the state offers short-term insurance that covers most of the care you’re likely to want and need. Your only option is to purchase minimal coverage for specific needs, such as in the event of an accident or for dental or vision care.
The Golden Rule Insurance Company offers three versions of its Accident SafeGuard plan to Connecticut residents, with a monthly premium ranging from $16 to $32. This plan, though, will only cover losses from an accident that causes bodily injury, such as a burn, concussion or broken bone and services like X-rays, ambulance, surgery and ER visits resulting from the accident.
Other Options to Short-Term Health Insurance in Connecticut
There are three main alternatives to temporary health insurance if you live in Connecticut: choosing an Affordable Care Act plan, using COBRA from a previous job, or going on Medicaid, if you qualify.
Affordable Care Act (ACA) Plans
You can sign up for an Obamacare (ACA) plan through Connecticut’s Health Insurance Marketplace, called Access Health CT, which offers coverage through Anthem BlueCross BlueShield and ConnectiCare Benefits, Inc.
There are five “metal” tiers of coverage: bronze, silver, gold, platinum and catastrophic. Each tier is based on the percentage the plan pays of the costs to provide essential health benefits. On average, bronze will pay for 60% of costs; silver, 70%; gold, 80%, and platinum, 90%.
If you’re under 30 and/or qualify based on your income, you can opt for catastrophic coverage, which has a low monthly premium but offers only the lowest amount of coverage and doesn’t help you pay the monthly premium. Access Health CT also includes a dental marketplace.
The benefits of getting your care through Connecticut’s healthcare marketplace include:
- Tax credits that reduce your premiums, if you qualify based on income.
- Special enrollment periods (SEP) for major life events. This allows you to sign up for a plan outside of the annual Open Enrollment Period,2 which in Connecticut runs from November 1 to January 15 of the following year. A SEP is available if you just moved to Connecticut; just got married, divorced or legally separated; you’re pregnant or just had a baby or adopted a child; or you lost your health coverage due to a job change. You’ll typically have 60 days before or after one of these events to sign up for a plan. (Keep in mind that you aren’t eligible for ACA healthcare if you can purchase the plan through your employer.)
If you lost your job, the Consolidated Omnibus Budget Reconciliation Act (COBRA) allows you to continue with the same health insurance plan even after you leave your job.
That said, your premiums are likely to go up since your employer subsidized them while you worked there, so after you leave you’ll need to make up the difference. It may benefit you to choose a short-term health plan if the premium is too high for you to afford.
Be aware that:
- You can get COBRA if you quit or are fired for any reason but gross misconduct.
- You have to notify your employer if you want to continue your coverage through COBRA.
- You have 60 days from the day you lose coverage or are notified of your COBRA eligibility to decide whether to use it or not.
- Your COBRA plan is good for 36 months from the time your employer terminated your original plan.
Medicaid is a program for Connecticut residents who aren’t able to pay for their healthcare. You may qualify based on various factors, including whether you earn Supplemental Security Income, your medical expenses and/or your income.
The following people can apply for Medicaid through Access Health CT:
- Adults ages 19 to 64 who aren’t eligible for Medicare.
- Pregnant women and infants.
- Children up to age 18.
- Parents and caretaker relatives.
All other applicants should apply through their local Department of Social Services.
The Pros & Cons of Short-Term Insurance
Although you can’t buy temporary health coverage in Connecticut right now, it’s possible that these plans may be available in the future, or you may find yourself living in a place where short-term plans are an option. If so, you may want to know the advantages and disadvantages:
- Short-term plans are usually cheaper than plans you can get through the Affordable Care Act (ACA) Marketplace. They’re designed to have a low premium (though your deductible is likely to be high), and that alone may be the reason you choose one.
- It’s easy to sign up for a short-term plan and get coverage quickly when you really need it, such as if you missed out on the ACA deadline to enroll in your state or you’re waiting for a new employer’s health insurance to start.3 With a short-term plan, you’ll have some coverage in the event of a medical emergency.
- If you’re healthy, a short-term plan could be an excellent fit. As mentioned, the least expensive plans tend to have a high deductible, but if you hardly ever have to go to the doctor, you’re unlikely to incur those higher costs.
- If you have a condition that requires frequent doctors’ visits, medical procedures, or medication, a short-term plan probably isn’t best. Your out-of-pocket costs are likely to be high and in some cases, insurers won’t approve coverage via a short-term plan for those with a preexisting condition.
- There’s a limit to what the most short-term plans will cover. So, if yours has, say, a $200,000 limit and the cost of your care reaches that amount, you’re responsible for all fees beyond that until your plan ends.
What Is The Cost of a Short-Term Plan?
Again, these plans aren’t available in Connecticut at the moment, so you can’t purchase one. But if you’re planning to get this temporary coverage in a state that does offer them, the cost will vary depending on your coverage.
All plans include four main expenses: premiums (the amount you pay monthly to keep your coverage); deductibles (the total you spend out-of-pocket on healthcare before your plan’s coinsurance starts to pay), copayments (a set cost you pay for medical services prior to reaching your deductible), and coinsurance.
Coinsurance kicks in after you’ve met your deductible and is typically the greatest cost of a short-term health plan. Simply put, it’s the share you pay for medical services. If, say, your doctor orders a $400 X-ray and you’ve reached your deductible for the year and your coinsurance percentage is 20%, you’d pay $80 for the X-ray (or 20% of the total). If you haven’t yet met your deductible, you’d be responsible for the full $400 fee.
When choosing a short-term insurance plan, consider:
- Your plan’s deductible.
- How often you go to a primary care doctor or specialists.
- Any ongoing medical conditions you’re managing, including the cost of medication.
Because there’s no short-term coverage in Connecticut right now, you might be tempted to go without insurance during a gap period. But if a medical emergency should happen, remember that it could be financially devastating.
With that in mind, it’s a good idea to explore other options to get you through, such as applying for an ACA plan or Medicaid (if you qualify), or using COBRA through a former employer, if that’s an option.
Search for a plan on HealthCareInsider.com or call 844-702-9346 to speak with an agent.