8 Best Facts Short Term Health Insurance Florida
1. What is Short-Term, Limited-Duration insurance?
- Short-term insurance was primarily designed to cover short term gaps in coverage. With the return to a longer initial coverage term of “less than 12 months” (no more than 364 days), consumers may determine that it is coverage that will work for their health insurance needs and their pocketbook. Short-term policies are not for everyone, so each consumershould review a short-term policy carefully to determine if the coverage meets their health care needs.
2. Can I renew coverage after the initial “less than 12 months” policy ends?
- The new rule establishes a maximum limit of “no longer than 36 months” for a short-term policy.
- The initial policy would need to include the terms of the renewals or extensions, to allow a term of “no longer than 36 months”.
- However, if each policy is a separate contract, (“less than 12 months”), each stands alone and the 36-month maximum does not apply.
- A short-term insurance policy is not required to be renewable, meaning that the insurance company does not have to continue your short-term policy or issue you a new policy once the short-term policy ends. If guaranteed availability and renewability of coverage is important to you and your health needs, you may want to purchase health insurance that meets the requirements of the Affordable Care Act.
- While short-term plans used to have a three-month cap, Americans can now buy short-term health plans that offer coverage for a longer period of time. Coverage can now span less than a year, and extensions and renewals can last as long as three years, depending on what states decide.
3. How can I make a comparison of the coverage provided in a short-term policy to coverage provided in an ACA policy?
- Ask the insurance company or insurance producer if a proposed policy meets the requirements of the ACA. If it does not, ask how the benefits and cost of the short-term policy compare to an ACA policy, taking into consideration any premium subsidies you may be eligible for with an ACA policy.
- Following is a list of services required in a policy under the ACA:
- Ambulatory patient services (outpatient care you get without being admitted to a hospital)
- Emergency services
- Hospitalization (like surgery and overnight stays)
- Pregnancy, maternity, and newborn care (both before and after birth)
- Mental health and substance use disorder services, including behavioral health treatment (this includes counseling and psychotherapy)
- Prescription drugs
- Rehabilitative and habilitative services and devices (services and devices to help people with injuries, disabilities, or chronic conditions gain or recover mental and physical skills)
- Laboratory services
- Preventive and wellness services and chronic disease management
- Pediatric services, including oral and vision care (but adult dental and vision coverage aren’t essential health benefits)
- Birth control coverage
- Breastfeeding coverage
- Medical management programs (for specific needs like weight management, back pain, and diabetes)
- See at: https://www.healthcare.gov/coverage/what-marketplace-plans-cover/
- The plans have lower price tags than traditional policies. The average monthly premium for short-term health plans was $124 in 2016, compared to $393 for unsubsidized individual market plans. The trade-off? Coverage is less extensive. Short-term health insurance plans are not required to comply with consumer protections established by the ACA, such as the requirement to cover essential health benefits and pre-existing conditions.
- Short-term plans still use medical underwriting, and don’t cover pre-existing conditions. The application still asks about medical history in order to determine eligibility for coverage. And although the list of medical questions on a short-term insurance application is much shorter than the list of questions that used to be on a standard major-medical insurance application prior to 2014, short-term policies come with a blanket exclusion on all pre-existing conditions.
- If you’re healthy, a short-term plan’s medical underwriting and pre-existing condition exclusions won’t be a problem. But keep in mind that your eligibility to purchase a second short-term plan when the first expires is contingent upon remaining healthy.
4. Will the short-term policy have a network?
- It depends on the policy. If the short-term policy includes provider networks, determine if your physician and medical providers are included. Also review terms that apply to charges from physicians or medical providers that are out of network.
5. Are subsidies or premium tax credits available for short-term insurance?
- No – Subsidies or premium tax credits are not available for short-term insurance policies.
6. Where can I purchase a short-term policy?
- Short-term coverage may be purchased directly from an insurance company or from an insurance producer offering the product . Insurers and producers must be authorized or licensed in your State. Short-term insurance is not available on the exchange where ACA compliant coverage is purchased.
7. Are short-term policies subject to regulation by the Insurance Commissioner?
- Yes – All insurance companies selling short-term policies are required to have a certificate of authority to sell the policies in your State. Regular financial monitoring and review of the insurer and approval of policy forms are key functions in regulating short-term coverage. Insurance producers offering any insurance coverage must also be licensed in your State.
8. What if I need help or have additional questions?
- You should always confirm that the company, agent or broker offering insurance coverage is authorized to provide information or coverage before you sign any documents or give any personal information.
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