Short-Term Health Insurance: What Covers You and What Doesn't

What short-term health insurance actually covers

Short-term health insurance is a temporary policy that typically lasts from a few weeks to a few months — usually no longer than three months at a time, though you can sometimes renew it. It covers doctor visits, emergency room care, hospital stays, and some prescription medications, much like a standard health plan. The catch is what it usually does not cover: preventive care visits (like annual checkups), mental health treatment, maternity care, or ongoing treatment for pre-existing conditions.

These plans exist to bridge gaps — between jobs, while waiting for employer coverage to start, or during a life transition. They are not designed to be permanent coverage, and they cost less than a full-year plan because they cover less and for a shorter time. The monthly premium is lower, but your out-of-pocket costs (deductibles, copays, coinsurance) can be higher than a standard plan.

Key Takeaways

• Short-term plans cover emergency and urgent care but typically exclude preventive visits, mental health services, maternity care, and pre-existing conditions.
• These plans last from weeks to months and cost less monthly than standard health insurance, but you pay more out of pocket when you use care.
• You can buy short-term coverage directly from insurers or through brokers; you do not go through your state's health insurance marketplace.
• Short-term plans do not count as coverage under federal law, so you may owe a tax penalty if you have no other coverage for part of the year.
• If you have a pre-existing condition or need ongoing treatment, short-term insurance will likely not cover it, and you should explore marketplace plans instead.

When short-term coverage makes sense

Short-term plans work best when you know the gap is temporary and you are unlikely to need major medical care during that time. Common situations include: starting a new job that has a waiting period before health coverage begins (often 30 to 90 days), leaving a job and waiting for COBRA or marketplace coverage to start, graduating from school and losing student health coverage, or aging out of a parent's plan.

They also make sense if you are between plans and want to avoid a lapse in coverage, even if you do not expect to use much care. An emergency room visit without any insurance can cost thousands of dollars; a short-term plan, even with a high deductible, limits that risk.

Short-term plans do not make sense if you have a chronic condition (diabetes, asthma, heart disease) that needs regular treatment, if you take prescription medications daily, or if you might need mental health care or therapy. These plans will not cover those things, and you will pay the full cost out of pocket.

How to find and compare short-term plans

You buy short-term coverage directly from insurance companies or through health insurance brokers — not through your state's health insurance marketplace (Healthcare.gov or your state's equivalent). Major insurers that offer short-term plans include Cigna, Aetna, UnitedHealthcare, and Anthem, though availability varies by state.

When you compare plans, look at three numbers: the monthly premium (what you pay every month), the deductible (what you pay before the plan starts covering costs), and the maximum out-of-pocket limit (the most you will pay in a year). A plan with a lower premium often has a higher deductible, so the cheapest monthly cost is not always the cheapest overall.

You will also see the plan's coverage limits — the maximum amount the plan will pay for a specific service or in total. Some short-term plans cap what they will pay for a hospital stay or emergency room visit. Read the plan documents carefully, because these limits are where short-term plans differ most from standard coverage.

What happens with pre-existing conditions

Short-term plans can legally exclude coverage for any condition you had before the policy started. This is called a pre-existing condition exclusion. If you have diabetes, high blood pressure, depression, or any other diagnosed condition, the plan may refuse to cover treatment for that condition for the entire time you hold the policy.

Some plans have a waiting period instead — they will cover the condition, but only after you have held the plan for a certain number of days (often 30 to 90 days). Either way, you need to read the specific plan's rules before you buy it. If you have any ongoing health needs, call the insurer directly and ask whether that specific condition is covered.

If you have a pre-existing condition and need coverage that includes it, a marketplace plan (through Healthcare.gov or your state's exchange) is a better choice. Marketplace plans cannot exclude pre-existing conditions, though they may cost more per month than a short-term plan.

The tax penalty and coverage gaps

Under federal law, you are supposed to have health coverage for every month of the year, or you may owe a tax penalty when you file your taxes. Short-term plans do not count as coverage under this rule in most states. If you have a short-term plan for three months and no other coverage for the other nine months, you may owe a penalty for those nine months.

The penalty amount varies by state and your income, and not all states enforce it. Some states have eliminated the penalty entirely. You can check your state's rules on the Kaiser Family Foundation website or by calling your state's health insurance marketplace.

If you are in a coverage gap, a short-term plan is still worth buying because it protects you from a catastrophic medical bill. But understand that it does not eliminate the tax penalty for the months you do not have coverage.

How long you can keep short-term coverage

Federal rules limit how long you can stay on short-term plans. As of 2024, a single short-term policy can last up to three months, and you can renew it, but the total time you can stay on short-term coverage is limited. The exact limit depends on when you first bought the plan and your state's rules — some states have stricter limits than federal law.

This matters because short-term plans are meant to be temporary. If your gap lasts longer than a few months, you will need to move to a different type of coverage: a marketplace plan, COBRA (if you left a job), Medicaid (if you may have access to), or an employer plan.

Before you buy a short-term plan, think about how long you actually need coverage. If the gap is longer than three months, a marketplace plan might be a better choice, even if the monthly cost is higher.

Short-term plans versus marketplace plans

The main differences come down to cost, coverage, and flexibility. Short-term plans have lower monthly premiums but higher out-of-pocket costs and many exclusions. Marketplace plans cost more per month but cover more services and cannot exclude pre-existing conditions. Marketplace plans also may have access to you for tax credits if your income is low enough, which can lower your monthly cost significantly.

If your gap is very short (a few weeks) and you are young and healthy, a short-term plan might save you money. If your gap is longer than three months, or if you have any health conditions or take regular medications, a marketplace plan is usually the better choice. You can also use both: buy a short-term plan to cover the immediate gap, then switch to a marketplace plan when you are ready for longer-term coverage.

Frequently Asked Questions

Can I use a short-term plan if I have diabetes or another chronic condition?

Most short-term plans exclude pre-existing conditions, which means they will not cover treatment for diabetes, high blood pressure, asthma, or any other condition you had before the policy started. Some plans have a waiting period instead of a full exclusion. You need to read the specific plan's rules or call the insurer to ask. If you need coverage for a chronic condition, a marketplace plan is a better choice.

What if I need mental health care or therapy?

Most short-term plans do not cover mental health treatment, therapy, or psychiatric medications. If you need mental health care during your coverage gap, a marketplace plan or Medicaid (if you may have access to) will cover it. Some community health centers also offer low-cost mental health services regardless of insurance status.

Do short-term plans cover pregnancy and childbirth?

No. Short-term plans typically exclude maternity care, pregnancy-related visits, and childbirth. If you are pregnant or planning to become pregnant, you need a marketplace plan or Medicaid. Medicaid covers pregnancy and childbirth for people who may have access to based on income.

Can I switch from a short-term plan to a marketplace plan mid-year?

Yes, but only if you have a may have access to life event — like losing your job, moving to a new state, or having a baby. If you do not have a may have access to event, you can only buy a marketplace plan during the annual open enrollment period (usually November through January). If your short-term plan is ending and you need longer coverage, check whether you may have access to for a special enrollment period.

Will a short-term plan cover an emergency room visit?

Yes, emergency room care is one of the main things short-term plans cover. However, you will pay your deductible first, then coinsurance (a percentage of the cost). Some short-term plans also have a cap on how much they will pay for an emergency visit. Read your plan documents to see what your out-of-pocket costs will be.