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short-term/temporary coverage

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Short-Term/Temporary Medical (STM) insurance coverage is the lowest cost option for those in need of a temporary solution to their medical insurance needs; e.g. recent college graduates, persons between jobs, or laid-off.  However, it is imperative that anyone contemplating such coverage, also evaluate other coverage options they might have (e.g. COBRA, eligibility as a dependent on group plan) considering their medical history, as there are some potentially serious considerations.  The following will give you a brief overview of these plans.

WHO'S ELIGIBLE FOR A SHORT-TERM MEDICAL POLICY?

• Adults under age 65 and dependents, typically from 15 days to 25 years old, IF they:

   

  • Have no other hospital/medical coverage in force

  • Are not pregnant

  • Have not received treatment within the time period indicated for any conditions listed in the medical questions on the application

  • Possess a valid social security number

  • Have resided in the US for the last 6 months

  • Have NOT been previously declined medical insurance coverage*

                    * NOTE:  Some companies DO NOT ask the "previously declined" question.  If you've been declined medical coverage before, it is imperative that you use one of these companies.

WHAT ARE THE "GOOD POINTS" ABOUT SHORT-TERM/TEMPORARY PLANS?

• Coverage can be bound effective at 12:01 am on the day after your application is postmarked

• Rates are typically the lowest available for major medical coverage

• Premiums can often be paid by VISA/MasterCard

• Most plans allow the use of ANY facility - NO network considerations

• Coverage may be available, even if you've been previously declined coverage (See above for carrier considerations and also, see the "Special Concerns" for  these plans.)

• Coverage is usually available on a monthly, as needed basis, for up to a maximum of 6 months

• Coverage can usually be renewed for 1 additional period; e.g. another 6 months - total 12 months

what "special concerns" are there about these plans?

• They DO NOT typically cover any condition that you've been treated for in the past 5 years; i.e. pre-existing conditions

• They may not cover things typically covered by many major medical plans; e.g. removal of tonsils

• Deductibles may be a "per cause" deductible, instead of the more common "all cause"

• Even though plans may be renewable one time, any  condition(s) you're treated for during the 1st policy period will be considered "pre-existing" and NOT COVERED under the subsequent policy period

• These plans DO NOT satisfy the "prior qualifying coverage" requirements of HIPAA, to provide you time insured credit for any pre-existing condition limitation period of subsequent group medical coverage for which you become eligible

In summary, these plans may be excellent TEMPORARY solutions to your medical insurance needs.  However, you MUST fully understand the potential pitfalls and shortcomings.  Make sure you evaluate all your coverage options.

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