Individual & family health
Short-term medical insurance
Temporary coverage for a defined gap — between jobs, waiting for a start date, or bridging to a Marketplace effective date. Cheaper than major medical because it covers less, and the difference is not small.
Worth considering if
- You have a defined gap — a new job starts in six weeks, and benefits start after that
- You missed Open Enrollment and have no qualifying event
- You are waiting for a Marketplace or employer plan effective date
- You are in good health and need catastrophic protection for a short window
Watch out for
- Pre-existing conditions are excluded — not merely rated, excluded
- Maternity, mental health and prescription coverage are often absent or minimal
- It is medically underwritten; you can be declined
- It does not satisfy state coverage mandates in states that have them
- Duration limits and renewal rules vary significantly by state
What it is honestly good for
Short-term medical solves one problem well: you are healthy, you have a gap with a known end date, and you want protection against a catastrophic event during that gap. A car accident or an appendectomy during an eight-week window between jobs is exactly the scenario the product exists for, and it will do that job at a fraction of an unsubsidised major-medical premium.
Used that way, it is a sensible purchase. Used as a permanent substitute for comprehensive coverage — which some people are steered into because the monthly number looks attractive — it exposes you to precisely the risks insurance is supposed to remove.
Short-term medical versus an ACA plan
| Short-term medical | ACA Marketplace plan | |
|---|---|---|
| Can you be declined | Yes | No |
| Pre-existing conditions | Excluded | Covered from day one |
| Prescription coverage | Limited or absent | Required essential benefit |
| Maternity care | Typically excluded | Required essential benefit |
| Mental health care | Typically limited | Required essential benefit |
| Preventive care at no cost | Not required | Required |
| Annual out-of-pocket cap | Not required | Required |
| Subsidy available | No | Yes, if income-eligible |
| Monthly premium | Lower | Higher before subsidy, often lower after |
Before you buy one, check this first
In our experience, roughly half the people who ask us about short-term medical turn out to qualify for a subsidised Marketplace plan that costs less and covers vastly more. We check that first every time. If the comprehensive route is available and affordable, we will tell you to take it — even though the short-term product would have been the easier sale.
- Whether you qualify for a Special Enrollment Period — job loss almost always opens one
- What a Silver Marketplace plan costs after your premium tax credit
- Whether COBRA is available and what it would cost
- Whether a spouse’s employer plan has a qualifying-event window open
- Whether Medicaid eligibility applies at your current income
Frequently asked questions
Does short-term medical cover pre-existing conditions?
No. Conditions you have been diagnosed with or treated for before the policy started are excluded, and carriers do investigate claims that look related to prior history. If you have an ongoing condition, this is not the right product for you.
How long can I keep a short-term plan?
It depends entirely on your state. Some states permit terms approaching a year with renewals; others restrict them to a few months; a few prohibit them. We will tell you exactly what your state allows before you apply.
Can I be declined?
Yes. Short-term medical is medically underwritten, so the carrier can decline your application based on your health history. This is the fundamental difference between it and an ACA plan, which must accept you.
Does it count as creditable coverage for Medicare?
For Part B and Part D purposes, short-term medical generally does not count as creditable coverage. If you are approaching 65, do not rely on a short-term plan to avoid a late-enrollment penalty — talk to us about the timing before you make that assumption.
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