Written by Michael LaPick
Healthcare Writer
We want to help you make educated healthcare decisions. While this post may have links to lead generation forms, this won’t influence our writing. We adhere to strict editorial standards to provide the most accurate and unbiased information.
What You Need to Know
- Short-term health plans, also known as Short-Term Medical (STM) insurance, offer fast, flexible coverage from 1 month to less than 12 months in West Virginia. Plans can be renewed for up to 36 months.
- These plans allow you to enroll online in minutes, with coverage starting as soon as the next day. Premiums are usually lower than ACA Marketplace plans without subsidies, but coverage is less comprehensive.
- Short-term health insurance typically excludes preexisting conditions and essential health benefits such as maternity, prescriptions, and mental health services.
What Is West Virginia Short-Term Health Insurance?
Short-term health insurance in West Virginia provides temporary medical coverage for people who need an alternative to ACA-compliant plans. Policies last for less than 12 months and can be renewed for a total of up to 36 months, as allowed under federal law.
Rates vary by age, gender, and health status.
Important: These plans are not required to follow the Affordable Care Act (ACA) rules, which means they may:
- Deny coverage based on health history
- Exclude preexisting conditions
- Omit key benefits such as maternity care, prescriptions, or mental health services
The Department of Health and Human Services (HHS) has updated the definition of short-term health insurance, but strict enforcement is being delayed while regulators consider additional changes.
Healthcare.com, the parent company of Healthcare Insider, develops and markets short-term and supplemental insurance products under the Pivot Health brand. These plans are underwritten by Companion Life Insurance Company, The North River Insurance Company (an affiliate of Crum & Forster), and Pan-American Life Insurance Company.
What Short-Term Health Insurance Includes
In West Virginia, short-term medical plans may provide benefits such as:
- Doctor visits
- Emergency care
- Hospitalization
- Surgical procedures
- X-rays and lab tests
Limitations and Common Exclusions
Short-term health insurance is not designed to meet every medical need. Common exclusions include:
- Preexisting conditions
- Maternity services
- Preventive care
- Dental and vision care
- Mental health treatment
These plans are best used as temporary protection and are less comprehensive than ACA-compliant major medical coverage.
Who Should Consider a Short-Term Plan in West Virginia?
Short-term health insurance may be a good fit for:
- People without employer coverage who want lower premiums
- Those who missed Open Enrollment for ACA plans
- Healthy individuals who need minimal coverage
- People between jobs or waiting for new coverage to begin
- Healthy individuals who don’t qualify for ACA plan subsidies and want more affordable options
When it may not be a good fit:
- You have ongoing or preexisting medical conditions
- You require essential benefits like maternity or mental health services
Learn more about when short-term medical plans make sense.
Pros and Cons of Short-Term Plans
Pros
- Lower monthly premiums
- Available year-round
- Useful for temporary coverage gaps
Cons
- May deny applicants based on health
- No coverage for preexisting conditions
- Excludes essential health benefits
How Much Do Short-Term Plans Cost in West Virginia?
Costs vary depending on plan design, age, and coverage options. Typical costs include:
- Premiums: Monthly payments to keep your plan active
- Deductibles: What you pay before your plan contributes
- Copayments: Flat fees for certain services like doctor visits
- Coinsurance: Your share of covered costs after meeting your deductible
- Out-of-pocket maximum: The most you’ll pay during your plan’s term
Rules for Short-Term Health Insurance in West Virginia
West Virginia follows federal rules for short-term health insurance. Plans must:
- Last less than 12 months per term
- Be renewable for up to 36 months in total
- Clearly disclose that they do not cover ACA essential health benefits
Other Alternative ACA Plan Options to Consider
Supplemental Health Plans
Supplemental insurance helps cover costs that primary insurance doesn’t, such as accident or critical illness expenses.
Dental and Vision Insurance Plans
Bundled dental and vision coverage can reduce out-of-pocket costs for preventive and major services.
Health Care Sharing Ministry Programs
These faith-based plans allow members to share medical costs. They are not insurance, but may be budget-friendly alternatives.
Fixed Benefit Medical Insurance
Fixed benefit medical insurance pays set amounts for covered services, offering predictable costs and flexibility.
Next Steps: Is a Short-Term Plan Right for You?
Here’s how to evaluate your options:
- Compare short-term plan quotes with ACA Marketplace or employer-sponsored plans
- Review policy details: premiums, deductibles, coinsurance, copays, and exclusions
- Determine whether the plan covers your likely medical needs
If you’re ready to explore health insurance in West Virginia, licensed agents can help you find a short-term plan that works for your situation.
A friendly team of licensed insurance agents is here to guide you.
Thank you for your feedback!
“Short-Term, Limited-Duration Insurance Final Rule.” cms.gov. Accessed August 2, 2021.
“Marketplace.” healthcare.gov. Accessed August 2, 2021.
“Understanding Short-Term Limited Duration Health Insurance.” kff.org. Accessed August 2, 2021.
“What Marketplace Health Insurance Plans Cover.” healthcare.gov. Accessed August 2, 2021.
“Deductible.” healthcare.gov. Accessed August 2, 2021.
“Coinsurance.” healthcare.gov. Accessed August 2, 2021.
“Copayment.” healthcare.gov. Accessed August 2, 2021.
“Out-of-Pocket Maximum/Limit.” healthcare.gov. Accessed August 2, 2021.
