Short Term Health Care Exclusions Guide

Short-term medical insurance has excellent uses for individuals who need a health care plan, but don’t plan on keeping it forever. A short-term insurance plan is useful if you are between jobs, waiting for a new plan to start, or seeking an alternative to a COBRA plan. However, these types of policies come with exclusions and other conditions that make it not suitable for everyone.

If you are in the market for a short-term health care plan, be mindful of these common exclusions and conditions.

Pre-existing Conditions

Short-term health insurance plans don’t cover pre-existing medical conditions. The plan itself determines the precise definition of a pre-existing condition. In general, a pre-existing condition includes a health problem for which you were diagnosed or treated for in the preceding five years. Also, if you have a health condition for which you haven’t sought treatment or diagnosis, where a reasonable or prudent person would have, it may also be considered a pre-existing condition.

Maternity Care

If you are pregnant or planning on becoming pregnant, a short-term plan may not be the best option for you. Most short-term plans don’t include maternity care. Still, short-term plans differ, so it is best to read the policy carefully if you have questions about specific coverages.

Coverage is Not Guaranteed

While Affordable Care Act health plans are guaranteed issue – meaning they are available regardless of your medical history, short-term plans are not. When you are seeking coverage under a short-term plan, you will be asked about your medical conditions and medical history. The company will review your application and decide whether to issue a policy.

Short-Term Plans Do Not Renew

Short-term coverage plans don’t automatically renew like traditional health insurance plans. After the expiration of the short-term policy, you must apply for a new policy.

For individuals who have developed health conditions while insured by a short-term plan, applying for another short-term plan is problematic. The condition will likely not be covered if the policy is issued at all.

However, if a health condition keeps you from purchasing another short- term plan, you can apply for an ACA plan during the Open Enrollment Period.

To learn more about short-term medical insurance exclusions that may affect you, contact the professionals at at (855) 401-8383 Our licensed insurance experts will be happy to answer any questions you have.