Short Term Medical (STM) Insurance: An Introduction
Why should I purchase Short Term Medical Insurance?
STM insurance plans provide insurance coverage during life transitions. When you are between group insurance or individual major medical policies, STM insurance policies pay for covered medical expenses due to unexpected illnesses or injuries. Covered expenses include diagnostic physician visits, emergency room treatment, hospital stays, surgery, intensive care and more, but do not include maternity care or Out-Patient prescription drugs.
STM policies are not ACA plans
STM policies do not meet ACA standards. The ACA is a Federal law that requires all major medical plans to provide specific benefits and requires that most Americans have health plans that qualify as Minimum Essential Coverage (MEC). These rules do not apply to STM policies.
Short-term medical insurance is a limited duration medical expense policy and is non-renewable. The amount of benefits provided depends on the plan selected and the premium will vary with the amount of benefits selected. STM is not a replacement for the comprehensive health insurance required under the ACA. This coverage has a pre-existing condition limitation exclusion.
You are able to renew the Elite Network Plan for any amount of time after the initial coverage period. We send email, text, and phone call reminders to you 1 week & 1 day before the policy expiration.
Difference between Short Term & ACA Plans
The ACA-compliant medical plans are guaranteed issue, meaning you cannot be denied coverage based on your health history. STM plans are underwritten, which means you must answer a series of medical questions when applying for coverage. Based on your answers, you may be declined for coverage.
Affordable, Customization, & Convenient
STM insurance policies are affordable. While STM contains limitations when compared to traditional major medical plans, the premium is generally lower. While ACA plans can only vary premiums based on geography, age, tobacco use and number of people covered (single vs. family plan), short-term plans can vary rates due to any number of factors, including health conditions.
Select from various benefit levels which best meet your insurance and premium needs. You can also add other coverage such as dental insurance or a discount prescription drug program.
Coverage can begin as early as the day following acceptance of your online application. In addition, policy forms and ID cards as well as claims information are available online.
Minimal Essential Coverage
STM plans do not meet the Minimum Essential Coverage requirements under the ACA and may result in a tax penalty. STM plans are designed to provide temporary healthcare insurance during unexpected coverage gaps.
Benefits vary from ACA plans
Unlike the ACA plans, which are required to cover the 10 Essential Health Benefits (EHB), STM policies are not required to cover EHBs at the same benefit level as an ACA plan. Policies will vary in what they cover, so you should check your policy’s details carefully.
Source: IHC Group