Top 5 Questions to Ask About Short Term Medical Insurance

Kelli Vorndran
Top 5 Questions to Ask About Short Term Medical Insurance

You're in a period of transition — job loss, aging out of your parents' policy, and so on — and you're considering the purchase of short-term medical (STM) insurance. You know STM is for the gaps when you're between long-term coverage alternatives, but you still need more information. Here are the top 5 questions to ask an STM insurance representative:

  1. How soon can I enroll? One of the great advantages of STM is that it's easy to get a policy. Because the underwriting process is automated, all it takes is filling out a simple form, which is accessible online and easy to submit. You can usually get approved for an affordable policy within 24 hours.

  2. Can I renew the policy when it's over? No, STM policies are neither renewable nor extendable. However, you may be able to apply for a new policy. Some insurers limit the number of policies allowed within a specified period, such as a year. In certain states, a waiting period also applies before an applicant can obtain another policy.

  3. Does my STM policy meet the Affordable Care Act's (ACA) Ten Essential Requirements? No. The ACA requires that all long-term policies provide:
    1. Preventive care and wellness
    2. Outpatient care
    3. Maternity and newborn care
    4. Prescription drug coverage
    5. Emergency room services
    6. Lab testing
    7. Pediatric care
    8. Hospitalization
    9. Services and equipment for injuries and chronic conditions
    10. Treatment for mental and behavioral health concerns

    Short-term policies offer basic coverage to help you through gaps in your long-term coverage. They aren't as comprehensive as ACA-approved plans. Talk to your representative about your budget and the plan that will work for you.

  4. What is covered by my STM policy? Short-term medical insurance is designed to protect you and your family from the risk of unexpected health issues while you're in transition. Urgent care procedures like lab/x-ray, emergency room visits, outpatient surgery, and hospitalization visits are covered, as any one of these could be needed unexpectedly during gap periods.Coverage for medical exams, pre-existing conditions, and other wellness issues is not provided.

  5. If I need to see a doctor, can I choose? Depending on how your coverage is structured, and what your insurer will cover, you may be able to choose. Some STM policies offered by certain insurers aren't part of a managed care organization like an HMO or PPO, which would give you the freedom to select your physician or hospital. However, while your STM policy may offer discounts at select providers, opting to go with coverage that allows this freedom of choice could also come with a price. Discuss your alternatives with your representative.

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