Questions? Call Us: 1-855-821-0869

1 2 3

Your Information

You can apply for yourself and anyone who lives with you.

ZIP Code

Gender

Male

Female

Date of Birth

Tobacco User

No

Yes

Covering anyone else?

Select from the options below to include coverage for your dependents.

Add Spouse

Gender

Male

Female

Date of Birth

Add Child

Child 1

Gender

Male

Female

Date of Birth

Add Second Child

Child 2

Gender

Male

Female

Date of Birth

Add Third Child

Child 3

Gender

Male

Female

Date of Birth

Add Fourth Child

Child 4

Gender

Male

Female

Date of Birth

All fields require a valid entry.

Need help? Call 1-800-200-9416

1 2 3

Contact

Enter your contact details to save your progress and access your quotes.

First Name

Last Name

Phone Number

Email Address

All fields require a valid entry.

Questions? Call Us: 1-855-821-0869

© 2023 ShortTermHealthInsurance.com

Terms & Conditions
Privacy Policy
California Consumer Policy

ShortTermHealthInsurance.com, a website owned by Health Network Group, LLC, markets products underwritten by National Health Insurance Company, Integon National Insurance Company and Integon Indemnity Corporation. Health Network Group National Health Insurance Company, Integon National Insurance Company and Integon Indemnity Corporation are all related companies under National General Holdings Corp.

This coverage is not required to comply with federal market requirements for health insurance, principally those contained in the Affordable Care Act. Be sure to check your policy carefully to make sure you are aware of any exclusions or limitations regarding coverage of preexisting conditions or health benefits (such as hospitalization, emergency services, maternity care, preventive care, prescription drugs, and mental health and substance use disorder services). If this coverage expires or you lose eligibility for this coverage, you might have to wait until an open enrollment period to get other health insurance coverage.

Also, this coverage is not “minimum essential coverage”. If you don’t have minimum essential coverage for any month in 2023 and you live in an state that has an individual mandate that you have health coverage that meets the minimum essential coverage, you may have to make a payment when you file your tax return unless you qualify for an exemption from the state’s requirement that you have health coverage for that month.

This Website is not associated with Healthcare.gov. ShortTermHealthInsurance.com is not a licensed agent or broker and cannot write insurance policies. ShortTermHealthInsurance.com connects consumers to industry trusted carriers to complete the enrollment process.

Short term plans are medically underwritten. This coverage is not required to comply with certain federal market requirements for health insurance, principally those contained in the Affordable Care Act. Be sure to check your policy/certificate carefully to make sure you are aware of any exclusions or limitations regarding coverage of preexisting conditions or health benefits (such as hospitalization, emergency services, maternity care, preventive care, prescription drugs, and mental health and substance use disorder services). Your policy/certificate might also have lifetime and/or annual dollar limits on health benefits. If this coverage expires or you lose eligibility for this coverage, you might have to wait until an open enrollment period to get other health insurance coverage. This is not Minimum Essential coverage as defined in the Affordable Care Act and may not cover all Essential Health Benefits in your state. Some Short Term plans are available as association group insurance only to members of FACT, an independent association. Additional membership fees may be required.

Supplemental insurance product not available in the State of Washington.