When it comes to health care coverage, options can bring peace of mind. That person who is in-between jobs, the early retiree who doesn’t qualify for Medicare just yet, or the family that simply needs to fill a gap in coverage – they all might benefit from a short-term health plan.
Simply put, short-term health coverage can provide a temporary or short-term solution for an individual’s or family’s insurance needs. Here are five things – equally straightforward – that you should know about the plans.
1. Short-term plans generally cost less but have fewer benefits.
A 2019 Foundation for Government Accountability study found that short-term health plans could cost 80% less than Affordable Care Act (ACA) “bronze” plans. But, those short-term plans don’t have to cover all the essential health benefits covered in an ACA-compliant plan.
“Some of the common downsides in the traditional short-term plans are exclusions for benefits and services people depend on,” says Josh Wiens, director of product development for Blue Cross and Blue Shield of Nebraska. “Most plans don’t cover prescription drugs, mental health benefits, maternity coverage or pre-existing conditions.”
2. Short-terms plans are flexible.
Short-term plans are available to most people for up to one year with the option to extend the plans twice. You can enroll in a short-term plan at any time during the year; there isn’t a standard open enrollment period. “If someone develops a need for coverage midway through the year, they can find short-term coverage available to them,” Wiens says.
3. Most traditional short-term plans are similar between Nebraska and Iowa.
Each state does, however, have their own requirements that must be followed to be approved short-term plans. In Nebraska, for example, short-term plans are limited to under 12 months and must include a comparison of their benefits versus an ACA-compliant plan so individuals understand the differences.
4. Blue Cross and Blue Shield of Nebraska is launching an affordable alternative to traditional short-term health plans called Armor Health.
Anyone in Nebraska who is under age 65 can apply for Armor Health beginning Nov. 1 (for a Jan. 1, 2020, effective date). These policies offer 12 months of coverage with no limit to the number of times policyholders can re-apply.
“It’s more than just short-term coverage, gap coverage or catastrophic coverage,” Wiens says. “Armor Health offers benefits and services that aren’t always covered in a traditional short-term insurance plan. Benefits such as preventative care are covered at 100%. Outpatient mental health benefits and prescription drug coverage are also included, which isn’t always the case with traditional short-term coverage.”
Pre-existing conditions are covered after 12 months of continuous Armor Health coverage. In addition, benefits such as primary care, specialist visits, urgent care and telehealth services are covered at affordable copays.
“This new product has a look and feel similar to how we administered individual policies prior to the ACA marketplace,” Wiens says.
5. Armor Health could be a good fit for a range of people, including those who:
- Are looking for affordable major medical coverage
- Aren’t receiving a subsidy on an ACA plan
- Are between jobs
- Have retired early and don’t yet qualify for Medicare
- Own a small business and are looking for coverage for four or fewer employees
- Need to fill a gap in coverage
“There’s also the continued concern with the increase of premiums,” Wiens says. “Armor Health is a great option for individuals who can’t afford the premiums of an ACA plan or who are currently uninsured because they don’t have good coverage options available to them today.”
This article originally appeared on Omaha.com