If you don’t have insurance coverage, it can be a pretty scary time – always wondering: “What if something happens?”
On the flip side, the thought of spending money on insurance when money’s tight can be equally as scary.
That’s why Temporary Medical plans exist – to provide short term medical coverage without a major price.
It’s important to point out Temporary Medical plans shouldn’t be considered a substitute for Affordable Care Act (ACA) plans. In other words, you’re not going to get the in-depth coverage of an ACA plan, but at a cheaper price. You will, however, get coverage until you can figure out a longer-term solution.
Simply put, if you find yourself with a gap in coverage, Temporary Medical can certainly be the right choice for right now.
The Centers for Medicare and Medicaid Services (CMS) estimates that as many as 1.6 million people could own Temporary Medical plans in 3 years.1
The Congressional Budget Office is projecting even higher numbers, expecting that 2 million people will be enrolled in Short Term plans by 2023.2
In 2019, CMS expects about 100,000 to 200,000 people to switch from the ACA individual market to Short Term plans.3
1 Randy Pate press call, The Centers for Medicare and Medicaid Services (CMS); July 2018. Retrieved from https://www.advisory.com/daily-briefing/2018/08/01/short-term
2 The Congressional Budget Office; May 2018; Retrieved by https://www.cbo.gov/system/files?file=2018-06/53826-healthinsurancecoverage.pdf
3 The Centers for Medicare and Medicaid Services (CMS); February 2018. Retrieved from https://www.cms.gov/newsroom/fact-sheets/fact-sheet-short-term-limited-duration-insurance-proposed-rule
A Temporary Medical plan fills a need for consumers without insurance to receive Short Term, budget-friendly coverage for unexpected illnesses, accidents, and emergencies.
1) Major Medical Coverage
A Temporary Medical plan covers a lot more than people might think: doctor and specialist visits, emergency care, x-rays, lab tests, and hospitalization. Drug coverage is included in some, but not all plans.
Short Term plans are generally less expensive than traditional medical plans.
3) The Power Of Choice
Many Temporary Medical plans are supported by a large network of health providers giving you the freedom to choose the doctors and hospitals you want, with virtually no restrictions.
Many Temporary Medical plans allow you to choose to apply for coverage lasting from one month to nearly one year1, with the option to reapply in many states.
Most carriers offer a variety of customizable plans so you can choose the coverage, premium, and deductible you want.
You can obtain Short Term insurance any time of year and are not limited to the Open Enrollment period. You can also cancel whenever you’d like.
7) Approval Time
The approval process usually takes only a few minutes and, in many cases, you can use your new insurance the next day.2
8) Coverage Length Options
A Temporary Medical plan gives you the control to choose your coverage length, from one month to nearly one year1 in many states.
Although it doesn’t provide the all-around coverage that COBRA or ACA plans do, a Temporary Medical plan is a lot better than having no insurance at all.
Spouses and dependents can be covered under a Short Term insurance plan.
1 In many states, the maximum duration for Short Term plans is just under 12 months.
2 Waiting periods for some coverages may apply.
The big reason Short Term health insurance plans offer such attractive rates is because they don’t offer the kind of in-depth coverage and number of services that a major medical insurance plan would.
1) Doesn’t Cover Preexisting Conditions
If you have received treatment for a health condition in recent years or experienced certain symptoms indicative of a condition, then a Temporary Medical plan probably won't cover an issue related to it. For example, if you have cancer, diabetes, or asthma, you won’t be able to get coverage.*
2) Falls Short Of “Minimum Essential Coverage”
Temporary Medical plans do not cover all 10 essential health benefits as defined by the Affordable Care Act (also known as Obamacare). In other words, many plans do not provide maternity and newborn care, or mental health and substance abuse disorder services.
3) Limited Coverage For Prescription Drugs
Many Short Term plans won't cover the cost of prescribed medication, especially specialty drugs.
4) Imposed Maximums
Many Temporary Medical plans put a limit on how much they’ll cover over the course of your term, and for particular types of services.
5) No Guarantees
Unlike ACA plans that guarantee medical coverage, there is a possibility that your application for a Temporary Medical plan may be denied.
*The definition of preexisting condition varies by state, in general, Short Term health insurance plans exclude coverage for conditions that existed, were diagnosed or treated within the previous 2 to 5 years, which includes, but is not limited to, cancer, diabetes and asthma.
Short Term plans have been around a lot longer than people think, over 3 decades. And throughout that time, policies such as these have provided medical coverage for millions of Americans during periods of transition and different stages of life.
1) In-between Jobs
The most common reason people find themselves without coverage is due to loss of a job. A Temporary Medical plan may provide a budget-friendly option.
2) Young And Healthy
For a lot of people, especially young healthy people, it’s hard to justify spending a lot of money on insurance. That said, many realize the importance of having at least something in case emergencies arise.
3) A Temporary Or Seasonal Employee
Part-time employees typically aren’t offered benefits from their employer. Often, part-timers are on a tighter budget, which limits their choices, making a Temporary Medical plan a viable option until they can find a long-term solution.
4) Just Out Of School
Being fresh out of school is an exciting time, but it’s also a time many find themselves without coverage as they look to land their first job.
5) Fresh Off Parents’ Insurance
When an individual turns 26, staying on his/her parents’ insurance is no longer an option in most states.
6) In Good Health And Waiting For Medicare
Many people who retire before the age of 65 (when Medicare kicks in) find themselves without insurance.
7) Missed Open Enrollment
Life can get crazy sometimes, and a large number of people miss the Open Enrollment period or don’t qualify for Special Enrollment.
8) Worried About Affording Any Coverage
A lot of people live paycheck to paycheck. A Short Term medical plan may give an option for coverage to some people who don't have any.
9) Waiting For Your ACA Coverage To Begin
There are a number of people who know they want ACA coverage, but they’ve got to wait it out until the next Open Enrollment comes along.
10) Losing Coverage After A Divorce
Many people across the United States are covered by their spouse’s group plan. Once a divorce is settled, the nonsubscribing spouse will no longer qualify as an eligible dependent and can’t remain on their former spouse’s policy.
While a Temporary Medical plan can be a good idea for some people, it might not be right for others. This is especially true for anyone who needs major medical coverage or has a preexisting condition.
1) People with a Preexisting Condition
Anyone with what may be considered a preexisting condition cannot receive a Temporary Medical plan. Preexisting conditions include heart attack, asthma, cancer and diabetes.*
2) People Needing Specialty Care
Many Temporary Medical plans provide no coverage for services related to pregnancy, childbirth, substance abuse, mental health, and preventative care.
3) People Who Need Consistent Treatment and/or Prescriptions
A Temporary Medical plan would not be a good option for those in need of ongoing treatment. Additionally, prescription drugs are often not covered, especially specialty drugs. A Short Term plan may offer a drug discount card, but the patient may have to pay the entire discounted price with no guarantee of reimbursement.
*The definition of preexisting condition varies by state, but in general, Short Term health insurance plans exclude coverage for conditions that existed, were diagnosed or treated within the previous 2 to 5 years, which includes, but is not limited to, cancer, diabetes and asthma. The conditions listed here do not constitute a complete list of preexisting conditions.
You may come to the conclusion that a Temporary Medical plan is a good choice for you, but may not know where to go from here. Don’t worry. Most people feel the same way. Fortunately, it’s a fairly simple process and is very similar to how you would acquire and use typical major medical insurance.
Here’s how it works…
1) You can apply for a Short Term insurance plan online through many carriers like Golden Rule Insurance Company. The application is typically fairly short. Applying is relatively simple.
2) Once your plan is effective, you pay monthly premiums in order to receive coverage for eligible medical expenses.
3) If you become sick or get hurt, you can go to the network doctor or hospital of your choice (as always, check to make sure it's in network for the most coverage and savings). Simply present your insurance card as you normally would.
4) Your healthcare provider will bill your Short Term insurance carrier, which pays its share of eligible medical expenses and then the healthcare provider will bill you for the remainder.
5) When you receive your bill from the doctor or hospital, you will be responsible for the deductible, just like any other medical insurance policy.
6) In addition to the deductible amount, you are also responsible for the coinsurance, which is a percentage of the remaining expense.
7) Once you’ve reached the out-of-pocket maximum, your insurance plan pays 100% of the remaining eligible covered medical expenses up to the “coverage-period maximum benefit.”
Not all Short Term plans are created equal, so it’s really important to read plan details before signing up. Try to find a reputable insurance company that’s been around a long time. Golden Rule Insurance Company, for example, an affiliate of UnitedHealthcare, is a well-respected name that has sold Temporary Medical plans for 30 years.
When picking a carrier, you’re going to want one that offers as much flexibility and as many options as possible. Among other things…
1) Look for a company that’s reputable, with a solid customer service and claims team.
2) Look for coverage you can customize to your needs and budgets.
3) Look for plans with a variety of premiums and deductibles.
4) Look for access to a large in-network group of doctors, healthcare professionals, hospitals, and other medical facilities.
5) Look for a plan that provides access to a network with your preferred doctors.
6) Look at the fine print to make sure you understand what the plan does and does not cover.
Quotes for plans you are directed to through TemporaryMedicalPlan.com are underwritten by Golden Rule Insurance Company, an affiliate of UnitedHealthcare.
This policy has exclusions, limitations, reduction of benefits, terms under which the policy may be continued in force or discontinued. For costs and complete details of the coverage, call [or write] your insurance agent or the company [whichever is applicable].