Important: Short-term medical plans are currently not available for sale in Washington state. If you or someone you know is being offered a short-term medical plan, contact our office.
If you need temporary insurance during a gap in health insurance coverage, short-term medical plans may suit your needs. However, you should be aware there are significant differences between short-term medical plans and standard health insurance.
What are short-term medical plans?
Short-term medical plans provide temporary catastrophic coverage, such as if you’re in a car accident or suffer a heart attack. They only provide coverage for a limited amount of time if for some reason you’re unable to enroll in a health insurance plan. These plans tend to be cheaper than health insurance, but the coverage comes with limitations.
What you need to know before you buy a short-term medical plan
Short-term medical plans do not meet the definition of an individual or group health insurance plan under the federal Affordable Care Act (ACA) or Washington state law. This means short-term medical plans are exempt from a number of coverage mandates that ACA-approved health insurance plans must provide to plan enrollees.
Before you consider buying one of these plans, it's important to understand how they are different than other health coverage options (PDF, 213.63 KB).
Here's what short-term medical plans can do:
- Deny your application for coverage or charge you higher premiums based on your medical history, including pre-existing conditions.
- Base your premium on your age, gender and other factors.
- Exclude benefits for certain types of illnesses and treatments.
- Cap the dollar amount on benefits the company pays.
- Apply dollar caps and higher deductibles on coverage.
- Drop all of the 10 essential health benefits (www.healthcare.gov) except they must cover mental health services and prescriptions for mental health treatment. Per RCW 48.44.341 (leg.wa.gov), short term medical plans issued or renewed on or after Jan. 1, 2021, must cover mental health treatment.
- Cover you only for a limited period of time (up to 3 months in any 12-month period).
Who sells short-term medical plans?
Short-term medical plans are currently not available in Washington state.