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Short-Term Plans

If you’re in the market for health insurance, you may have heard about short-term plans.

Short-term plans provide much less coverage and more limitations than plans that are compliant with the Affordable Care Act, such as those offered by UPMC Health Plan.

With short-term plans:

  • You can be denied coverage, or charged more, 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 the 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 substance use disorder
  • Routine office visits
  • Prescription drug coverage
  • Preventive care; many services are at no cost to member

Short-term plans have much lower premiums than the plans that are compliant with the Affordable Care Act 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 from November 1, to December 15 for coverage in 2019. If you sign up for a short-term plan and later decide you need more comprehensive coverage after December 15, you may not be able to get an ACA-compliant plan until 2020. 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.

Bottom line:

Short-term plans can look like an affordable option. But if you actually need care you may be in for an unpleasant surprise. The medical bills you incur for services the plan doesn’t cover may far exceed the premiums you pay for coverage that you can rely on.

With UPMC Health Plan you will receive no lifetime limits on benefits, rich coverage, and no denial of coverage or increased costs due to a pre-existing condition.