In 2016, emergency room visit averaged at $1,917, almost one-third up (31 percent) from the four years prior. Combine this with the hike in prescription medicine costs and healthcare nowhere near dropping any time soon; it’s important for Texan consumers to know all of their options, short term health insurance Texas includes.
You may know about the Consolidated Omnibus Budget Reconciliation Act (COBRA) and the Affordable Care Act (ACA) health insurance options. But what about short term health insurance? What is it? Who is this for? Is this the right option for you?
So What Exactly Is Short Term Health Insurance?
Short term health insurance is a healthcare insurance plan that covers people during a gap or transition period. This could be after a divorce in between jobs or retired, under the age of 65 and unable to qualify for Medicare.
Also, recent college graduates and those having just turned 26. (After turning 26, consumers cannot be under their parents’ health insurance plan).
Know that these reasons are all ACA-compliant. Here’s a list of special enrollment qualifiers. It’s best to research to see if a more comprehensive plan or a short term plan is the best way to go for you if you qualify for both.
As of recently, in 2018, the period people can have short term medical insurance has increased to 364 days, with renewals of up to 36 months.
The Pros and Cons
The Biggest Pro: Year-Round Enrollment Window
The biggest pro is that unlike many other healthcare plans, short term health insurance is available all year round. Whereas ACA plans or Obama Care are only available during open enrollment and special enrollment.
So if for some reason, you were unable to get a comprehensive healthcare plan during open or special enrollment or your plan was canceled mid-year, you always have the option of applying for short term medical insurance.
This is great for people who are in good health and want a healthcare plan that covers them for a few months and pay for a percentage of emergency services, should they need it.
Another Pro: Normally Cheaper Than ACA Plans
Short term health coverage, for the most part, is cheaper than ACA plans and in most cases less than half the cost . And, there’s a reason why.
With monthly health Insurance premiums for a family a four over $2,000+a month , short term health insurance Texas can take huge financial pressure off the average family.
Con: It Usually Doesn’t Cover Mental Health, Substance Abuse Treatment, Prescriptions, and Maternity Care
According to The New York Times, a study revealed that 57% of short term medical insurance plans covered mental health, 38% substance abuse treatment, 29% prescription medicine, and none covered maternity care.
The article went on to highlight that some short term healthcare plans also may not cover sports injuries and preventative care (i.e., immunizations, etc.).
Think Twice If You Have a Pre-Existing Condition or High Medical Costs
That and, unlike ACA plans that cannot cap coverage, short term health insurance can, covering health costs between $250,000 up to $2 million, depending on the situation and specific plan.
If you expect or end up having high medical bills, short term health insurance Texas may not be the right choice for you. Or, know that there is a possibility you may be kicked off of the plan if you have high health costs.
Pro: Consumers Can Be Covered the Next Day
Instead of waiting weeks for your applications to be reviewed and processed, short term health insurance Texas consumers only have to wait around 24 hours before getting a response to their application. That means, if accepted, consumers can be covered the next day.
Who Is Short Term Health Insurance Texas Exactly For?
In a Consumer Reports article, according to KFF, in 2017, out of the roughly 27 million people in Texas, a little less than 5 million Texans had Medicaid, almost 3 million Medicare, 475,000 had coverage under the military or Veterans Administration, nearly 5 million uninsured, and roughly 1.67 million a policy directly purchased from an insurance company.
While short term health insurance can apply to all groups, it’s usually more of a short term option for the latter (1.67 million who purchase an insurance plan directly from an insurance company).
In some cases, like if you don’t have a pre-existing health condition, are healthy, only looking for coverage to cover emergency health situations (i.e., an ER visit), under 65, and Medicaid and COBRA options are too expensive, short term health insurance Texas may be right for you.
For other cases, like if you qualify for Medicare, your COBRA or Medicaid plan is cheaper, or you prefer the normally-higher level of coverage they offer, and or you have a pre-existing health condition, another health care plan may be better.
Generally , if you’re in good health, short term medical insurance may be an option; if you have some health problems or know you’ll need a high level of care this year (i.e., maternity care), there may be other better options to choose from that can best support your healthcare needs.
Where Do You Get Short Term Medical Insurance Texas?
According to healthinsurance.org, these insurers offer Texas health insurance short term:
- Companion Life
- Everest Prime
- Independence American Life
- National General
- Standard Life
- United Healthcare (Golden Rule)
You can get short term medical insurance Texas from any qualified, licensed healthcare broker who offers short term plans from one or more of these insurers.
Some Tips When Considering Texas Health Insurance
1. Shop Around
Talk to your current or former employer about COBRA benefits they offer and check out their COBRA plan’s prices and level of coverage.
If you’ve just turned 26 and have been on your parents’ employer healthcare plan, see if their employer offers COBRA plans. If they do, see what prices and coverage levels they offer.
If you qualify for Medicaid, do this as well. Also, research and get quotes from more-comprehensive health insurance plans too.
2. Read the Fine Print and Be on the Lookout for Loop Holes
Short term health insurance Texas plans aren’t under the ACA, which means they don’t have to follow the same level of regulation. Read the fine print of the plan and check to see if there are loopholes and coverage caps.
#3. Look Up the Broker’s License and the Health Insurance Company
Also, to prevent a healthcare scam, look up the broker’s license number in Texas’ Department of Insurance database to see if the license is up-to-date and accurate. Also, look up the healthcare company in the Better Business Bureau (BBB).
We also recommend reading the reviews of the health insurance company on the BBB and other reputable review sites.
#4. Research ACA Penalties
People who have short term health insurance no longer face the ACA Obama Care penalty fees/taxes . These were eliminated On Jan 1st when the Trump Tax reform bill was passed into law. For Further information and clarification , do your research and discuss this with a qualified Licensed Health Insurance broker and qualified health insurance expert.
#5. Remember Health Insurance Isn’t the Only Healthcare Option
A cheaper health insurance plan isn’t the only way to save on health costs:
- Talk to your doctor about prescribing a generic medicine than a brand-based medicine (both work, but brand-based is usually a lot more expensive)
- Use sites like GoodRX and WeRX to shop for discounted prescriptions (for individuals with or without health insurance)
- Consider Urgent Care instead of the ER, if it’s not an emergency since Urgent Care can be hundreds cheaper
Questions or Comments About Short Term Health Insurance Texas?
Any more health insurance tips to add? Question about short term health insurance Texas? Comment below.