Short Term Medical (STM) Insurance provides health insurance for individuals and families in times of transition. STM insurance covers the need for temporary medical coverage. It is an alternative to Obamacare plans whenever those plans are either unavailable (i.e. outside of Annual Enrollment Period) or unaffordable.
When you may need STM Plans?
Use Short Term Medical (STM) Insurance if:
- You are the newly hired in waiting period (before health insurance benefits begin)
- You’ve lost the job coverage, or you are between the jobs
- You are a student or graduate without coverage under your parent’s plan
- You are retired and waiting for Medicare eligibility
- You have just returned from active military duty
Short Term Medical Insurance Benefits
Short Term Medical Plans are not limited medical or mini-med plans. They are truly Major Medical Plans covering the following expenses (but not limited to):
- Inpatient Covered Expenses (Room and Board, Intensive care or Specialized care unit, Operating and Recovery Rooms, Doctors’ Visits, Prescription Drugs)
- Emergency Room, Outpatient hospital or Ambulatory center
- Physician Services for treatment and diagnostics
- Outpatient Expenses (X-ray, Laboratory test and analysis, Mammogram, Pap Smear, PSA Screening)
- Prescription Drugs
STM Plan Selections
Most STM plans are available for the coverage period from 1 to 11 months. If you need to extend the coverage beyond this time (normally up to 3 years), you will need to apply for a new application; there is no extension of your current plan.
Many insurance companies have their own network. You may visit ANY doctor or specialist but there are substantial savings for staying within the network.
The deductible choices (per person) are typically from $1,000 to $10,000. The deductible must be paid before the coinsurance benefits begin.
Office Visit Copay
Some plans allow office visit copay that are not subject of deductible – typically $50 per visit. The number of allowable copays depends on the lengths of coverage. Any office visits above the allowable number are subject to deductible and coinsurance.
Coinsurance percentage and Out-of-pocket
After the deductible has been met, the STM plan pays the selected coinsurance percentage of covered charges. The typical coinsurance percentages are 80%, 70% and 50%. The insured person will be responsible for the remainder 20%, 30% or 50% until the selected Out-of-pocket amount has been reached. The range of Out-of-pocket is typically between $2,000 and $10,000; it does not include the deductible. One the Out-of-pocket has been reached, the insurance company pays 100% of covered charges up to the maximum benefit (typically $1-$2 million).
Short Term Health Plans do not cover preexisting conditions (defined as conditions within 3-5 years before coverage has begun). They also have a list of limitations and exclusions that you should become familiar with.
If you’ve filed a claim under existing policy your policy may NOT be renewed, but another policy may be suggested.
STM Plan Cost
STM insurance plans are NOT Affordable Care Act compliant. In other words, their benefits are more limited and not being Guaranteed Issue Plans, they use preexisting conditions as a screening mechanism. Therefore, they are much more affordable in comparison with fully priced Obamacare plans (i.e. without subsidies).
Let Liberty Medicare help you choose a Short Term Health Insurance Plan
Liberty Medicare is here to help you during every stage of selecting and enrolling in the best and most suitable Short Term Health Plan for you.
As an independent insurance agency, we will provide you the benefits of objectivity in reviewing multiple plans. We’ll help you to understand the insurance industry jargon and ‘fine print’.
If you are considering buying a Short Term Health Insurance Plan, let us guide you. All our services are offered to you at no cost. To see real quotes from insurance providers, fill out our Individual Health Quote form or give us a call at 877-657-7477.