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Understanding Short-Term Limited Duration Health Insurance

Issue Brief
  1. For example, a newly hired employee who must complete a probationary period before becoming eligible for group health benefits might seek coverage through a short term policy during the probationary period.

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  2. The Health Insurance Portability and Accountability Act of 1996 (HIPAA).

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  3. See, for example, Time Magazine, “The Health Care Crisis Hits Home,” March 5, 2009, available at http://www.pnhp.org/news/2009/march/the_healthcare_cris.php

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  4. Short-term policies commonly exclude coverage for pre-existing conditions, often defined as conditions (1) for which medical advice, diagnosis, care or treatment was recommended or received preceding the date the covered person became insured under the policy, or (2) that was not diagnosed but manifested symptoms that would have caused an ordinarily prudent layperson to seek medical advice, diagnosis, care or treatment.

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  5. National Association of Insurance Commissioners, Accident and Health Policy Experience Report for 2016, available at http://www.naic.org/prod_serv/AHP-LR-17.pdf

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  6. The Commonwealth Fund. State Regulation of Coverage Options Outside of the Affordable Care Act: Limiting the Risk to the Individual Market. March 29, 2018. Available at http://www.commonwealthfund.org/publications/fund-reports/2018/mar/state-regulation-coverage-options-outside-aca

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  7. ParityTrack. Parity Implementation National Survey. Accessed April 17, 2018. Available at https://www.paritytrack.org/parity-reports/state-reports/

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  8. Modern Healthcare, “How Stakeholders in the Short-Term Medical Market are Gearing up to Attract More Customers”, April 19, 2018. Available at http://www.modernhealthcare.com/article/20180419/TRANSFORMATION04/180419913/how-stakeholders-in-the-short-term-medical-market-are-gearing-up-to

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  9. The IHC Group Interim Coverage Plus plan brochure: https://www.healthedeals.com/Media/Default/Anthem/Brochure_Interim_Coverage_Plus_0418.pdf

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  10. See, for example, https://www.agilehealthinsurance.com/health-insurance-learning-center/term-insurance-costs-less-for-26-year-olds-with-penalty-and-subsidies

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  11. Wall Street Journal, “Sales of Short-Term Policies Surge,” April 10, 2016.  Available at https://www.wsj.com/articles/sales-of-short-term-health-policies-surge-1460328539

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  12. See, for example, brochure for one currently-marketed short-term policy explaining the length of coverage, “Current federal regulations limit short term medical plans to 90 days under one certificate of insurance. However, [we offer] you the convenient opportunity to apply for up to four back-to-back certificates at one time. You do not have to qualify again for the three additional certificates, and you can cancel at any time.”  https://www.pivothealth.com/_assets/pdf/Pivot_Health-Short_term_medical_brochure-20161027.pdf

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  13. Association for Community Affiliated Plans. Effects of Short-Term Limited Duration Plans on the ACA-Compliant Individual Market. April 12, 2018. Available at https://www.communityplans.net/policy/effects-of-short-term-limited-duration-plans-on-the-aca-compliant-individual-market/

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Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in Menlo Park, California.