Short Term Health Insurance Coverage Duration Rules In Every State

Neither the Trump administration or Congress have been able to disassemble the Affordable Care Act (ACA) as it stands today, so states have stepped forward to protect or dismantle elements of the ACA on behalf of residents within state lines. One way they are doing this is expanding or limiting coverage durations on short term health insurance plans.

Many states have adopted the administration’s 2018 expansion of short term health insurance plans, a reversal of an Obama-era rule that limited the plans to just 90-days. In some states, you can now purchase short term medical plans for up to 364 days and remain continuously covered for up to 36 months. The administration’s plan was to give more consumers choice in the marketplace and allow those who couldn’t afford ACA plans to still have some type of healthcare coverage.

While short term health insurance plans do not meet the requirements of the ACA, coverage can be attractive to individuals and families looking for a budget-friendly solution for high health insurance prices. Many times short term health plans are purchased as a temporary solution for individuals who find themselves uninsured from job loss, experiencing a change in marital status, aging off a parent’s plan at 26 or retiring early and not wanting to pay the high price for COBRA coverage. Short term medical insurance fills a coverage gap when life takes a turn. Yet not all states embrace the opportunity for residents to have choices beyond the ACA.

States That Ban Short Term Health Plans

Some states have fully banned temporary medical plans from being sold, while others have imposed such restrictive state rules, no health insurers will offer the plans as a short term option. Here is a list of states that currently do not have short term health insurance coverage:

  • California
  • Colorado
  • Connecticut
  • Hawaii
  • Massachusetts
  • New Jersey
  • New York
  • Rhode Island
  • Vermont

For everyone else, here is a list of state coverage durations along with renewal limits for each. Note that in some states, the coverage duration law differs depending on the insurance company’s filing. If the company files for an individual plan, the maximum duration could be one length of time, and if the insurance company files a group association plan, the coverage duration could be a different length of time. This summary aims to cover both durations with “up to” language as a general rule. But you might notice different coverage options when shopping for short term health insurance based on the insurance company you are interested in.

Short Term Health Insurance Coverage Durations By State

Alabama – Up to 364 days of coverage with the ability to reapply for additional policies for up to 36 months.

Alaska – Up to 364 days of coverage with the ability to reapply for additional policies for up to 36 months.

Arizona – Up to 180 days of coverage, and reapplied is allowed for an additional 180 days. On August 27, 2019, coverage duration in the state of Arizona will increase up to 364 days, and thereafter, re-application or extensions of coverage for a total duration up to 36 months.

Arkansas – Up to 364 days of coverage with the ability to reapply for additional policies for up to 36 months.

California – The sale of short term health insurance plans are not allowed.

Colorado – Plans are limited to 180-days, but due to state-mandated benefit requirements, no insurance carrier is currently selling short term medical insurance.

Connecticut – Up to 180 days of coverage is allowed with no re-application, but insurers must cover the same ACA essential health benefits.

Delaware – Up to 90-days of coverage allowed with no re-application during any 364-day period.

District of Columbia – Up to 364 days of coverage with the ability to reapply for additional policies for up to 36 months.

Florida – Up to 364 days of coverage with the ability to reapply for additional policies for up to 36 months.

Georgia – Up to 364 days of coverage with the ability to reapply for additional policies for up to 36 months.

Hawaii – State law bans anyone from purchasing a short term health plan in Hawaii if they are eligible for an ACA plan, so no insurance carrier sells short term health insurance in the state.

Idaho – Up to 364 days of coverage with no re-application during the 365 day period the 180 day policy was purchased in. There must also be a 60 day wait if insured wants to purchase a second policy from the same insurance company.

Illinois – Up to 180 days of coverage with no re-application during the 365 day period the 180 day policy was purchased in. There must also be a 60 day wait if insured wants to purchase a second policy from the same insurance company.

Indiana – Up to 180 days of coverage with the ability to reapply for additional policies for up to 36 months.

Iowa – Up to 90 days of coverage with the ability to reapply for additional policies for up to 36 months.

Kansas – Up to 364 days of coverage with the ability to reapply for additional policies for up to 24 months.

Kentucky – Up to 364 days of coverage with the ability to reapply for additional policies for up to 36 months.

Louisiana – Up to 180 days of coverage with the ability to reapply for additional policies for up to 36 months.

Maine – Up to 364 days of coverage with the ability to reapply for additional policies for up to 24 months.

Maryland – Up to 90-days of coverage allowed with no re-application once the 90-day policy has expired.

Massachusetts – The sale of short term health insurance plans is not allowed.

Michigan – Up to 185 days of coverage with no re-application during a 365-day period once the 185-day policy has expired.

Minnesota – Up to 185 days of coverage. Reapplication is allowed but the time enrolled in a short term plan can’t exceed a total of 365 days during any 555-day period.

Mississippi – Up to 364 days of coverage with the ability to reapply for additional policies for up to 36 months.

Missouri – Up to 180 days of coverage with the ability to reapply for additional policies for up to 36 months.

Montana – Up to 364 days of coverage with the ability to reapply for additional policies for up to 36 months.

Nebraska – Up to 364 days of coverage with the ability to reapply for additional policies for up to 36 months.

Nevada – Up to 185 days of coverage with no re-application during that same calendar year once the 185-day policy has expired.

New Hampshire – Up to 180 days of coverage. Additional coverage for two six-month periods is allowed twice for up to 18-months of coverage.

New Jersey – The sale of short term health insurance plans are not allowed.

New Mexico – Up to 90 days of coverage with no re-application allowed. In addition, an individual cannot apply if they had short term health insurance coverage in the previous 12 months.

New York – The sale of short term health insurance plans are not allowed.

North Carolina – Up to 364 days of coverage with the ability to reapply for additional policies for up to 36 months.

North Dakota – Up to 185 days of coverage with the ability to reapply once during the 12 months of coverage.

Ohio – Up to 364 days of coverage with the ability to reapply for additional policies for up to 36 months.

Oklahoma – Up to 364 days of coverage and is not renewable.

Oregon – Up to 90 days of coverage is allowed. Then, there must be a 60-day break before an individual can enroll in a new short term health insurance plan.

Pennsylvania – Up to 364 days of coverage with the ability to reapply for additional policies for up to 36 months.

Rhode Island – The sale of short term health insurance plans are not allowed.

South Carolina – Up to 364 days of coverage with the ability to reapply for additional policies for up to 36 months.

South Dakota – Up to 185 days of coverage and is not renewable.

Tennessee – Up to 364 days of coverage with the ability to reapply for additional policies for up to 36 months.

Texas – Up to 364 days of coverage with the ability to reapply for additional policies for up to 36 months.

Utah –Up to 363 days of coverage with no renewal.

Vermont – The sale of short term health insurance plans are not allowed.

Virginia – Up to 364 days of coverage with the ability to reapply for additional policies for up to 36 months.

Washington – Up to 90-days of coverage allowed with no re-application once the policy has expired during a 12-month period.

West Virginia – Up to 364 days of coverage with the ability to reapply for additional policies for up to 36 months. There must be a 63 day break between policies if purchasing a group association plan.

Wisconsin – Up to 364 days of coverage with the ability to reapply for additional policies for up to 18 months of consecutive coverage. Then, the individual must take a 64-day break before re-apply again.

Wyoming – Up to 364 days of coverage with the ability to reapply for additional policies for up to 36 months.

 

Editor’s Note: State regulations are subject to change. This list is current as of June 19, 2019. Pivot Health’s short term health insurance plans are filed as either individual or group association, depending on the state. Coverage durations can vary based on individual or group association filings.