Filling the Coverage Gap for New Marketplace Plans

Short Term Medical Insurance

SHORT TERM MEDICAL

Short term health insurance for temporary gaps in coverage.

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Please note, our Short Term Medical insurance is intended for temporary gaps in health insurance.  It is not compliant with the federal Affordable Care Act and does not cover expenses related to pre-existing conditions.

Understanding the Waiting Period

If you’re planning to enroll in a Marketplace plan during this year’s Open Enrollment Period, you need to understand that you may face a waiting period, or a gap in coverage, between the termination of your 2016 plan and the start of your 2017 plan. Whether you’ll have a coverage gap and how long it will last depends on the date you enroll in your new plan.

The current Open Enrollment Period for a 2017 ACA health insurance plan is November 1, 2016, through January 31, 2017.

  • If you enroll between the 1st and 15th day of the month, your coverage starts the first day of the following month. For example, if you enroll on December 1, 2016, your coverage starts on January 1, 2017.
  • If you enroll between the 16th and last day of the month, your coverage starts the first day of the second following month. For example, if you enroll on December 16, 2016, your coverage starts on February 1, 2017.

The last day to ensure that your health coverage starts on January 1, 2017, was extended to December 19, 2016. If you are enrolling after this date, you may face a waiting period before your new plan begins.  You will need to determine how to remain insured during this gap in coverage.

Short Term Medical Can Bridge the Gap

Short-term medical insurance is limited-duration health insurance designed to cover you during a temporary period in which you would otherwise be uninsured. If you will experience a waiting period before your ACA-compliant coverage takes effect, you can purchase a short-term policy to bridge the gap.

Short-term coverage can be as short as one month, and you can tailor the length of your policy to your specific waiting period. For example, if you enroll in your ACA plan on January 1, 2016, then it will not take effect until February 1, 2016. A short-term policy can provide you with coverage for unexpected ailments during the 31-day gap until your long-term plan begins.

These types of policies exist outside the scope of the Affordable Care Act and do not count as minimum essential coverage. They offer coverage of less than 3 months for costs resulting from unexpected injury or illness, such as emergency room visits, hospitalizations, outpatient surgery, and lab/X-ray fees.

A plan like Short Term Medical, underwritten by HCC Life Insurance Company, also offers:

  • a fast enrollment process
  • low copay at urgent care centers
  • a 10-day free-look period
  • no application fee
  • no out-of-network penalties

In most states, Short Term Medical can go into effect the day after it is purchased. Note that some states have a 72-hour waiting period between the purchase date and the date the policy goes into effect for illness. (Coverage for accidental injuries that occur after the policy is effective is not subject to the waiting period.)

Don’t risk going uninsured during a waiting period. Get a Short Term Medical plan to supplement your ACA-compliant policy and bridge any temporary coverage gaps.

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Short Term Medical (STM) plans provide temporary, short-term coverage of less than 3 months.  STM plans do NOT provide “minimum essential coverage” as defined in the Affordable Care Act ("ACA" also known as "Obamacare").  STM plans also do not cover pre-existing conditions, cannot be renewed, and are not guaranteed issue.

Please review the policy for additional exclusions and limitations. By purchasing an STM, you may still be subject to the ACA tax penalty for not maintaining minimum essential coverage. You should consult your tax advisor to determine if the ACA tax penalty applies to your specific situation.

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