Sometimes you’re faced with a gap in medical coverage. This could be for a few reasons: you’re waiting for your Affordable Care Act coverage to kick in or you missed open enrollment; you’re turning 26 and getting off your parents’ insurance; or you’re waiting for your benefits to start at your new job. Regardless of the reason you’re in this coverage gap, you’re looking to close it. Now.
What Is Short-Term Health Insurance?
Also called temporary health insurance, short-term medical insurance plans are meant to bridge the gap from one longer-term policy to the next. You may be eligible if you are:
- Waiting for Medicare eligibility
- Anticipating the beginning of other coverage
- Not working but expecting new employment soon, with benefits
- Outside the open enrollment period for the Affordable Care Act (ACA)
Because short-term plans are made to be supplemental, not a replacement for primary insurance, they’re not required to follow the same eligibility and coverage rules as ACA plans.
How Long Do Plans Last?
Virginia short-term health insurance plans1 last up to six months and are not renewable. While federal laws say these plans can last 36 months with renewals, Virginia has continued to stick to the six-month limit.
Are There State-Specific Laws and Regulations You Should Know About?
In July 2021, short-term insurance in Virginia will be sharply limited by legislation that was signed in April 2020.2 While Virginia now has short-term policies that last as long as 364 days, the new law will limit these terms to just three months. In addition, sale of these policies would be prohibited during open enrollment for the Affordable Care Act.
A few things to know about this legislation:
- Short-term plans can’t be offered in situations where an enrollee would get more than six months’ worth of short-term coverage during any consecutive 12 months.
- These plans also can’t be offered during the ACA’s yearly open enrollment, from November 1 to December 15.
- While renewals will be allowed, a short-term plan can’t last more than six months in total.
How Much Do Short-Term Plans Typically Cost in Virginia?
According to PivotHealth.com, monthly premiums for short-term health plans in Virginia range from $69.83 to $314.77 for a single 35-year-old woman, with most ranging between $100 and $200 monthly. Deductibles — the amount you pay before your coverage kicks in — start at $1,000 and run all the way up to $10,000 for the plan with the least expensive monthly premium. This applies to services including office visits, emergency care, surgery, and hospital stays.
Copayments, the set amount you pay for each covered service after you pay your deductible, can range from $1,000 to $10,000, depending on the service. Coinsurance, the share of the cost you pay after you’ve met your deductible, is 20 to 30%.
How Can You Buy a Short-Term Insurance Plan in Virginia?
The Virginia Bureau of Insurance3 lists eight companies that offer short-term insurance plans. These are:
- Aspen American Insurance Company
- Companion Life Insurance Company
- Everest Reinsurance Company
- Golden Rule Insurance Company
- LifeShield National Insurance Company
- Standard Security Life Insurance Company of New York
- Standard Life and Accident Insurance Company
If you’re looking for an easier, more streamlined way to research short-term health insurance, just enter your ZIP code on our home page to get quotes and information on Virginia short-term plans.
Is Short-Term Health Insurance Right for You?
Before purchasing short-term health insurance, you need to know that this is the right decision for your situation. Let’s break down some of the main concerns here:
- Affordability. Since short-term policies are less expensive than other longer-term choices, you may like how much your wallet benefits from this choice. Keep in mind, however, that this affordability is because these policies aren’t required to cover those who are less healthy or who have preexisting conditions.
- Enrollment. As previously noted, pending state legislation will make enrollment periods for Virginia short-term health plans more limited as of July 2021. Like Washington and Maine, Virginia will ban the sale of these policies during the ACA’s open enrollment period, from November 1 to December 15.
- Are you in good health? These policies usually allow for medical visits, emergency and urgent care, and preventive care, as well as some leeway for prescriptions. If this is all you need from your insurer, short-term medical insurance may be the way to go.
- Does your personal situation lend itself to a short-term health insurance policy? There are certain situations where a short-term health insurance plan makes sense — for example, if you’re between jobs, or if you’ve gotten a new job but are waiting for your benefits to kick in. In addition, if you are 26 years old and just getting off your parents’ plan, a short-term policy might be a smart landing point while you figure out your next move.
When Might Short-Term Health Insurance Not be the Right Choice for You?
Short-term health coverage does not address everyone’s situation. If you have preexisting medical conditions or believe you might have a significant medical issue, the relatively low level of coverage won’t fit your needs. In fact, you’ll likely have no coverage here. Short-term plans tend to address medical problems in the future, not in the past or present.
Moreover, if you need essential health benefits4 offered by the ACA, you may be out of luck with a short-term policy. These essential benefits are:
- Emergency services
- Maternity and newborn care
- Prescription drugs
- Ambulatory services
- Mental health and substance abuse treatment
- Laboratory work
- Pediatric services
- Chronic disease management
- Rehabilitative services
If you need any of these benefits, you might want to think twice about opting for a short-term health insurance policy.
If you’re in the right position, a short-term health insurance policy may be the right answer for your needs. However, there are a lot of potential limitations on coverage. It’s worth doing your research and deciding what works best for you before signing on the dotted line.
1. Rodriguez Espinoza, Alan. “Health Insurance Reform Bills Push for Short Term Plan Limits, State-Based Marketplace.” VPM News, January 28, 2020 (accessed May 30, 2020).
2. Virginia’s Legislation Information System. “HB 1037 Health insurance; short-term limited-duration medical plans, definitions, effective date.” lis.virginia.gov (accessed May 30, 2020)
3. Commonwealth of Virginia State Corporation Commission. “Insurance Agents & Agencies.” scc.virginia.gov (accessed May 29, 2020).
4. U.S. Government Website for the Federal Health Insurance Marketplace. “Essential Health Benefits.” healthcare.gov (accessed May 30, 2020).