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Short Term Medical
Insurance & Bridge-to-
Medicare Plans
Our Short Term Medical insurance gives you an affordable and flexible plan to face those unpredictable moments in life with confidence.
These plans are designed to help bridge gaps in your health care coverage and can provide the financial protection you need from unexpected medical bills and other health care expenses, including:
- Doctor visits and some preventative care
- Emergency room and ambulance coverage
- Urgent Care benefits
- Rx discount card and some plans offering limited Rx coverage
- Deductibles from as low as $2500 up to $25,000
- Expansive PPO networks
- Coverage from 1 month to 3 years
It is important to remember that Short-Term Medical (STM) Insurance must be medically underwritten and they do usually not cover pre-existing conditions. Also, these plans are not compliant with the
and don’t require Minimum Essential Coverage (MEC) benefits like ACA plans do but for many people, and in many situations, the best Short-Term health insurance plan they can find may just be the right solution.
Because the STM plans aren’t required to have these additional benefits, the premiums are a fraction of the cost of most ACA plans (unless you qualify for a subsidy). Additionally, the individual mandate has been eliminated which means you will not be charged a tax/penalty for not enrolling in an ACA health plan.
Some of the basic essential health benefits (Minimum Essential Coverage) that are required in ACA plans that are not required for Short-Term Medical plans include things like Laboratory services, prescription drugs, mental health & substance use services, maternity/newborn care, pediatric services, rehab, ambulatory and preventative & wellness services. However, we are finding that more STM plans do include some of these services and even some plans are designed with copays and Rx.
In selecting a STM plan, you want to be sure that you choose a PPO network and be sure your primary care doctor is in the network. Most of these plans do include extensive PPO networks. Short-Term Medical plans are becoming more popular because they are not only more affordable but are flexible and you can add a “gap” policy as a kind of “rider” for sickness and accidents, which can cover the entire cost of the deductible.
Bridge-To-Medicare plans are simply those Short-Term Medical plans that offer coverage (up to 3 years) that bridges the gap to Medicare eligibility. For example if you are 62 years old, you can enroll in a 3-year plan that covers you until you reach age 65 and then can enroll in Medicare or if you’re 63 years old, you can enroll in a 2-year plan covering you until Medicare eligible. Also, the good news about these type of plans is that you are covered for pre-existing conditions after the first year and if you do develop a pre-existing condition in the first year or two, they are covered in subsequent years.
There is also an extraordinarily affordable “Bridge-To-Medicare” plan provided by a general lines insurance company that offers Bronze, Silver, Gold and Platinum plans with 1-month to 1-year contracts only. The caveat is that the client has had to have been declined by a STM company and not qualified to enroll in ACA (due to being outside the Open Enrollment period or not qualifying for a Special Election Period, like losing a job or moving). Of course, any pre-existing conditions you have would be excluded but these are good alternative plans that are super affordable, if you need catastrophic coverage for a short time period (up to 1 year).
As with any other type of insurance you seek, it is important to have proper and professional insurance planning performed by a local and trustworthy insurance consultant so you can make an informed decision about all the choices you have. Trust me, you don’t want to toss away hard-earned money by enrolling in a plan that will not be serving your needs.
WHO SHOULD CONSIDER SHORT TERM INSURANCE PLANS?
- Children rolling off their parent’s health insurance
- A college student or just out of school
- Anyone in-between jobs or just recently lost a job (but check ACA first for a subsidy)
- Those without health insurance who missed Open Enrollment and don’t qualify for a Special Enrollment
- Waiting for your ACA coverage to begin
- Waiting for benefits to begin at a new job
- Losing coverage after divorce (but check with ACA for a Special Enrollment)
- Under 65 and in good health
- Needing a temporary alternative to COBRA insurance
- Waiting for Medicare – ages 62 to 65 (1 month – 3 years out)
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