Short Term Health Insurance In Pennsylvania

In 2017, President Trump requested that the Department of Health and Human Service (HHS) develop new regulations regarding short-term health insurance. HHS then proposed changes that would allow short-term policies to remain in effect for up to 364 days. If the proposed changes become final, then more people nationwide would have access to temporary plans lasting nearly a year. The regulations give states the right to create their own rules regarding short-term policies. Currently, Pennsylvania has not passed any laws or regulations that will override federal regulations.

Short term health insurance is designed to fill a gap in coverage. You may be changing jobs and there is a waiting period before your new insurance takes effect or you may have just graduated college but have not found a job in your field yet. Prior to 2017, short term health insurance policies could be in effect for up to just under one year, but the Obama administration imposed a 90-day limit on temporary policies in an effort to encourage people to sign up for major medical insurance instead.

Some health insurance companies worked around the three-month limitation by selling four 90-day policies bundled together. One policy took effect the day after the other expired, giving you almost one year of coverage. Because pre-existing conditions are not covered under short-term policies, this prevented people from being denied if an illness occurred during one policy since you only had to deal with medical underwriting at the start of the bundled contract.

It’s important to understand, however, that if you purchased four 90-day policies and developed an illness during one of the early policy periods, treatment for that illness may not have been covered when the next policy took effect. In addition, short term policies do not meet the requirements of the Affordable Care Act (ACA) and if that’s your only health insurance, you could face a tax penalty at the end of the year. This tax penalty will be zeroed out starting in 2019.

Some plans have an extensive period where illnesses and injuries can be considered pre-existing. Insurers might also include any illness or injury that caused symptoms that a “reasonable person” would have sought treatment to correct. There are also limits on what treatments are covered and when. For example, a policy may require a 30-day waiting period before cancer treatment can begin. One study from the Kaiser Family Foundation found that of the 21 short term policies available in Philadelphia, 57 percent covered mental health services, 33 percent covered substance abuse treatments, 33 percent covered prescription drugs and none covered maternity care.

There are concerns that expanding short-term coverage will create uncertainty in the insurance marketplace. Some experts believe that if individuals have the opportunity to purchase less costly coverage with reduced coverage, it will remove a large number of healthy people from the insurance marketplace, leaving more people purchasing ACA-compliant plans who already have costly medical conditions.

Carriers Offering Short-Term Policies in Pennsylvania

Companion Life Insurance Company

Golden Rule Insurance Company (UnitedHealthcare)

Independence American Insurance Company

LifeShield National Insurance Company

National General Accident & Health