With short-term plans:
- You can be denied coverage if you have a pre-existing condition. This is a health problem you had before you secured health insurance.
- You’ll have a new plan each time you renew your coverage. Medical conditions that arose under your initial short-term plan may not be covered under your new plan.
- There may be no limit on out-of-pocket costs.
- There could be annual and lifetime benefit caps.
- There is no requirement to provide essential health benefits.
Here are some of the services (essential health benefits) that short-term plans may not offer that you can count on with UPMC Health Plan coverage:
- Maternity and newborn care
- Mental health treatment, including for substance use disorders
- Routine office visits
- Prescription drug coverage
- Preventive care
Short-term plans have much lower premiums than plans that comply with the Affordable Care Act (ACA) because they provide much less coverage. Depending on your income, you may qualify for a subsidy that makes an ACA-compliant plan more affordable.
You should also be aware that ACA Open Enrollment takes place between Nov. 1, 2022 and Jan. 15, 2023 for coverage in 2023. If you sign up for a short-term plan and decide you need more comprehensive coverage after Jan. 15, 2023, you may not be able to get an ACA-compliant plan until 2024. That means you may have a gap in care or be stuck with bills for medical care you received that’s not covered by your short-term plan.
Short-term plans can look like an affordable option, but if you end up needing care you may be in for an unpleasant surprise. The cost of the medical bills you incur for services the plan doesn’t cover may far exceed the premiums you would have paid for an ACA-compliant plan.
With UPMC Health Plan there are no lifetime limits on benefits, the coverage is extensive, and there is no denial of coverage or increased costs because of a pre-existing condition.