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Q: Are ACA Essential Health Benefits Covered Under Short-Term Health Insurance?

Asked by Anonymous on October 11, 2017

Hal Levy October 11, 2017

Short-term health insurance is different from other types of coverage. These plans are designed to keep you protected from medical or financial catastrophe in case of an emergency. Short-term insurance isn’t a reliable way to maintain your health for long periods of time.

While traditional health insurance plans must help you pay for the 10 ACA essential health benefits, short-term plans don’t cover these benefits very well. In fact, short-term health insurance plans are under no obligation to offer any specific benefits.

Short-term health insurance can safely get you through a variety of temporary situations. However, short-term plans aren’t designed to compete with major medical health insurance (popularly known as Obamacare) when it comes to taking care of your ongoing medical issues.

For instance, short-term plans will almost certainly cover hospitalization bills, yet almost certainly exclude maternity coverage. Most short term plans will offer you at least one doctor’s checkup at a low cost over the course of your plan, but they won’t cover treatment for management of a pre-existing condition.

Ongoing Health Problems Are Not Covered: Since short-term health policies are designed to take care of immediate health needs, they are unsuitable for long-term maintenance of health issues. Short-term plans rarely cover medical devices, dental care, or vision care. Prescription costs are typically the planholder’s responsibility outside of a hospital setting as well.

You Will Get Emergency Care: Peace of mind from unexpected medical costs is a major benefit of short-term coverage. If you’re seriously ill or injured, short-term health insurance will cover the costs of your hospital visit. Short-term policies also cover follow-up care for acute medical issues until your coverage ends.

You Can See a Primary Care Doctor: Nearly all doctors accept short-term insurance. You will receive a welcome letter, insurance card, and other familiar benefits when you enroll. Although you have to pay for care on your own before hitting your deductible, the costs for a visit once you do reach your deductible are generally low. Some plans also include a checkup, free of charge.

You Can See a Specialist: Specialized doctors (such as a dermatologist, orthopedist, or neurologist) are frequently covered by short-term plans. Medical imaging (like x-rays) and mental health care are also common short-term benefits.  Short-term plans often bundle in additional benefits such as life insurance or prescription drug discounts.

If you’re considering a short-term health insurance plan, you probably understand that your coverage will be limited compared to what you’d get with a major medical plan. Different short-term plans will cover Obamacare’s 10 essential health benefits in different, limited ways. Don’t expect your coverage to take care of your long-term needs.

If you compare plans before you buy, you’ll have a better idea of what’s covered. Short-term plans may look similar to other forms of health insurance, but they won’t operate in the same way when it comes time to pay. Since these plans don’t give you comprehensive health coverage, you’ll still pay a fee at tax time.

There are many unique situations where buying a short-term health plan makes sense. If you’re not able to buy a traditional plan until open enrollment, short-term insurance is a great option. Students, travelers, and new employees waiting for their coverage to begin have traditionally been safeguarded by short term health insurance as well.

Taking the Next Steps

It’s time to browse our collection of temporary health insurance plans. You can compare plans and enroll in your favorite one today. If you’re looking for a more comprehensive plan covering the ACA essential health benefits, we can help you find a major health insurance policy.

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