Bridge the Gap Until Open Enrollment

Have you lost health insurance through your job?   Is COBRA too expensive?  Do you not have health insurance and want it now?

Unless you experience a “qualifying life event”, you cannot enroll in a major medical plan until the next open enrollment, beginning November 15th for coverage starting January 1, 2015.  Even if you have a qualifying life event after losing coverage, the soonest coverage will start is on the 1st of the month after loss of coverage.

This can put many people in a dilemma…  If you have lost health coverage from a job, you may have a 30 day gap in coverage, unless you pay for COBRA, which can very expensive and is not subsidized by the government.  If you are in-between jobs, your new employer’s plan will typically have a waiting period of 30 to 90 days before coverage begins.   And if you previously did not have coverage and want it now, you’ll have to wait until January 1st to get it.

An affordable solution is short-term medical insurance.  Short-term medical plans are designed specifically for people that need “temporary coverage” until open enrollment or until their major medical coverage kicks in.  At half the cost of major medical plan, short-term plans “bridge the gap” between periods of time when you are not covered by a major medical plan or when COBRA is too expensive.

A short-term plan does not meet the requirements of the Affordable Care Act, so you need to look at the potential tax penalty if you go without major medical coverage for more than three consecutive months.   However, because short-term plans are roughly 30% to 50% the cost of major medical insurance, it may make financial sense.

Unlike major medical plans which are “guaranteed-issue” and cover all pre-existing conditions, you may not qualify for a short-term plan if you have serious health conditions and they do not cover pre-existing conditions.  Short-term plans are month-t0-month medical plans that you can keep up to a maximum of 6 months.  You can re-apply after 6 months, but if you have developed a serious medical condition you can be declined coverage.  Short-term plans do not have all of the benefits of a major medical plan like free preventive care and some plans may not include coverage for prescriptions.  Benefits do vary from carrier to carrier, so you want to make sure to get the plan that is best suited for your situation.

The way a short-term health plan works is you first must meet a deductible.  The higher the deductible, the lower the monthly premium.  After you meet the deductible, you can choose a plan that will pay either 50%,  80% or 100% of medical costs (called co-insurance).  The higher the co-insurance (the amount the insurance company pays), the higher the premium.  Short-term plans provide up to $2 million in coverage, which can be enough coverage until you are able to enroll in a major medical plan at the next open enrollment.

For more information on short-term medical plans and to get quotes, go to or call us at 1-800-788-2197.


AUTHOR - Ali Nagy