Life doesn’t always line up with your health plan. Leaving a job, retiring early or aging off your parent’s health plan can leave you without health insurance. And sometimes, you need a solution that lasts longer than a few months.
That’s where extended short term health insurance can help. If you need temporary health insurance for more than a year, it may be an option worth considering. Here are some of the ways this coverage differs from ACA plans available on the Health Insurance Marketplace, “standard” short term health insurance plans and more.
What is extended short term health insurance?
Extended short term health insurance is a type of short term, limited duration insurance available in select states, with coverage for nearly three years. If you are approved for healthcare coverage after you apply, these plans have three consecutive terms that reach the plan’s maximum length.1
Extended short term health insurance plans may cover doctor visits, prescription drugs and hospital stays. Some plans may also cover preventive care and certain pre-existing conditions after a waiting period.
Extended short term health insurance offers flexible coverage for nearly three years for life’s in-between moments. Explore plans online.
Extended short term health insurance vs. short term health insurance: What’s the difference?
Both options provide temporary health insurance, so what sets them apart? One important difference is how long the coverage lasts.
Short term health insurance plans can provide coverage for nearly 12 months, depending on the state. Extended short term health insurance plans can last nearly three years.
With short term health insurance plans, you can get healthcare coverage as early as the next day after you apply in many cases. Extended short term health insurance plans usually begin within five days of your application, if you qualify.1
How are extended short term health insurance plans different from ACA Marketplace plans?
It's important to note that short term health insurance plans are not a substitute for ACA coverage. When comparing extended short term health insurance to Affordable Care Act (ACA) Marketplace plans, the differences include the length of coverage, what’s covered, when you can apply and whether medical underwriting is required.
Medical underwriting is when insurance companies review your health history to determine eligibility and coverage terms.2
Short term health insurance and extended short term health insurance plans do not meet all federal requirements to qualify as “minimum essential coverage,” and the plans do not include all the essential health benefits like ACA Marketplace plans.
| | ACA Marketplace plans3 | Extended short term health insurance plans1 |
| How long does coverage last? | Coverage runs from January 1 or February 1 to December 31.4 | Coverage can last nearly three years and can begin any time of year. |
| What does it cover? | ACA Marketplace plans must cover the 10 essential health benefits. | Extended short term health insurance plans provide coverage only for what is outlined in the policy or certificate. They may include coverage for hospital stays, emergency services, doctor visits, diagnostic tests, prescription drugs and preventive care (a waiting period may apply). |
| When can you enroll or apply? | You can usually enroll during the annual ACA Open Enrollment Period, which typically runs from November 1 through January 15. | You can apply for extended short term health insurance at any time. |
| Is medical underwriting required? | No | Yes, so you can be denied coverage. |
Who can benefit from extended short term health insurance?
You may want to consider an extended short term health insurance plan if you are:
Between jobs. Extended short term health insurance can help provide you with medical coverage until you can find a new job with benefits.
Retiring early. If you have a few years before Medicare eligibility, extended short term health coverage may help bridge the gap between major medical policies for a limited period of time.
Turning 26. Aging off a parent’s health insurance plan may leave you looking for coverage of your own. An extended short term health insurance plan can give you more time to find a long-term solution.
Past the ACA Open Enrollment Period. If you missed the annual ACA Open Enrollment Period and don’t qualify for a Special Enrollment Period, extended short term health insurance could fill a gap between major medical policies for a limited period of time until you can enroll in an ACA Marketplace plan.
Self-employed. If you work for yourself and don’t have access to employer-sponsored coverage, extended short term health insurance could be valuable when there is a gap between major medical insurance policies. This may give you time to consider other options.
Need coverage for a gap between major medical policies for a limited period of time? Explore whether short term or extended short term health insurance plans are a fit for your needs.
Who might not benefit from extended short term health insurance?
Extended short term health insurance can be a helpful temporary health insurance option, but it isn’t a fit for everyone.
You may want to consider other coverage options if you:
- Need immediate coverage for a pre-existing condition.
- Expect to need ongoing medical treatment or frequent care.
- Qualify for an ACA premium tax credit that could help lower your monthly premium.
- Want health insurance that covers all of the ACA essential health benefits.
- Prefer guaranteed acceptance without medical underwriting.
5 questions to ask before applying for extended short term health insurance
Extended short term health insurance can work well for some people, but it’s not a fit for everyone. Before applying, ask yourself these questions.
1. How long will my health insurance gap be?
A short term health insurance plan may work for a brief coverage gap between major medical policies for a limited period of time. If you need coverage for more than a year, extended short term health insurance may be an option.
Keep in mind that this coverage is temporary. Think about what your next coverage option will be when the plan ends.
2. What does the plan cover?
Not all health insurance plans cover the same services.
Extended short term health insurance plans may cover doctor visits, urgent care, hospital care and prescription drugs.1 Benefits vary by plan.
Before applying, review the plan’s benefits, limits and exclusions carefully.
3. Will this plan fit my health needs?
If you have a pre-existing condition, extended short term health insurance may not be a fit for you. These plans use medical underwriting to determine eligibility.
Some extended short term health insurance plans may cover certain pre-existing conditions after a waiting period.1 Be sure to read the plan details carefully so you understand what is and isn’t covered.
4. How much could I pay for care?
Don’t focus only on the monthly premium. Be sure to also check the deductible, which is the amount you pay before the health insurance plan begins paying for covered services.5 You may also have copays and coinsurance.
Think about how often you use healthcare coverage and how much you could comfortably pay out of pocket.
5. Can I see the doctors I want?
Check whether your doctors and hospitals are in the plan’s network.
If you want to keep seeing a specific doctor, confirm that they accept the plan before applying.
Extended short term health insurance can offer flexibility during a temporary gap between major medical policies for a limited period of time, but it works as a bridge rather than a long-term solution. Weighing your health needs, budget and the plan’s limits ahead of time can help you decide if it’s a fit for your needs.
Have questions about extended short term health insurance? Call 1-844-211-7730 to speak to a licensed insurance agent, or browse plans online.
Frequently asked questions
What is extended short term health insurance?
Extended short term health insurance is a type of short term, limited-duration health coverage available in select states. These plans can last nearly three years, and you can apply at any time.
Does extended short term health insurance cover pre-existing conditions?
Not right away. Most plans require a waiting period before they begin covering eligible pre-existing conditions.1
What are the biggest differences between extended short term health insurance and ACA Marketplace plans?
ACA Marketplace plans guarantee coverage and immediately cover pre-existing conditions.3 Most extended short term health insurance plans require medical underwriting and may not cover eligible pre-existing conditions until after a waiting period.1
Extended short term health insurance plans also do not meet all federal requirements to qualify as “minimum essential coverage,” and the plans do not include all the essential health benefits like ACA Marketplace plans do.
What happens when my extended short term health insurance plan ends?
If you want to keep health insurance coverage, you’ll need to apply for another plan. The end of an extended short term health insurance plan does not qualify you for an ACA Special Enrollment Period. You would generally need to wait for the annual ACA Open Enrollment Period to enroll in an ACA Marketplace plan. However, you can apply for another short term or extended short term health insurance plan at any time.
Is extended short term health insurance a good option before Medicare eligibility?
Extended short term health insurance is available to adults ages 19 to 63, and coverage ends at age 65. If you retire at age 62 or 63, extended short term healthcare coverage may help bridge the gap between major medical policies for a limited period of time until you’re eligible for Medicare.
For informational purposes only. This information is compiled by UnitedHealthcare, and/or one of its affiliates, and does not diagnose problems or recommend specific treatment. Services and medical technologies referenced herein may not be covered under your plan. Please consult directly with your primary care physician if you need medical advice.
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