For Consumers

What you need to know about short-term medical plans

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 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 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, 172.79 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 the 10 essential health benefits (www.healthcare.gov) such as maternity care, mental health services or prescription drugs. 
  • Cover you only for a limited period of time (up to 3 months in any 12-month period).

Who sells short-term medical plans?

If you decide to buy one of these plans, you should only buy one from a Washington state licensed agent or an authorized company. Currently, LifeMap Assurance Company is approved to sell short-term medical plans in Washington state.