If you’re uninsured in Delaware, you might consider applying for short-term medical insurance. Short-term plans provide coverage for as little as one month, and can be an economical option when you’re between major medical policies.
What is Short-Term Health Insurance?
Short-term medical insurance is temporary health insurance. It’s designed to help pay for unexpected medical care during coverage gaps, such as when you’re between jobs or waiting for new benefits to begin. Plans typically cover doctor office visits, urgent care, emergency services, and hospitalization and surgery.
The Affordable Care Act (ACA) doesn’t apply to short-term health insurance. As such, short-term plans differ from ACA plans in some important ways. Understanding these differences will help you determine which coverage makes the most sense for you.
What to know about Delaware Short-Term Plans
Delaware limits short-term policies to three months and doesn’t allow renewals.1 This differs significantly from federal guidelines, which cap short-term policies at 364 days and allow renewals up to 36 months.2
Additionally, if you’re buying short-term health insurance to replace your existing accident or sickness insurance, Delaware requires insurers to provide an outline of coverage that describes benefits and exclusions, among other details.3 They must also provide you with a notice to sign, acknowledging your intent to replace your existing coverage.
What You Need to Know
Short-term health insurance provides temporary coverage when you’re between individual major medical or job-based health insurance plans.
Delaware allows short-term policies from 30 to 90 days and prohibits renewals.
You can apply for short-term coverage any time and start your policy as soon as the next day.
Is Short-Term Health Insurance Right for Me?
You may decide temporary coverage is a good fit based on the following:
Short-term plans typically cost less than unsubsidized ACA plans. They can be a budget-friendly solution if you don’t qualify for subsidies and can’t otherwise afford coverage.
There are no restrictions on when you can enroll in short-term health insurance. Your coverage may begin as soon as the day after you are approved.
A temporary health plan works best if you are in good health and don’t have ongoing medical concerns. Because short-term benefits center on injury and unforeseen illness, plans don’t include all of the essential health benefits.
Short-term health insurance is designed for transitional periods such as when you:
- Are between job-based health insurance plans.
- Start a new job with a benefits waiting period.
- Turn 26 and age off your parent’s health plan.
- Move to a new ZIP code and lose coverage.
- Lose coverage due to divorce.
Ready to learn more? Explore your short-term plan options.
Why Wouldn’t a Short-Term Plan Be Right for Me?
Short-term health insurance isn’t right for everyone. You may decide to enroll in an ACA plan instead based on the following:
If you qualify for premium tax credits and cost-sharing reductions, an ACA plan will provide the broadest benefits at the lowest cost. You can enroll for an ACA plan through Delaware’s Health Insurance Marketplace.
You’ll want to enroll in an ACA plan if you need access to all of the essential health benefits, have ongoing health concerns, or expect to become pregnant. In these circumstances, a short-term plan may not provide enough coverage.
Unlike ACA policies, short-term policies are not guaranteed issue. That means your short-term application can be denied based on your health history.
Unlike ACA plans, short-term plans won’t typically cover preexisting conditions such as autoimmune diseases or diabetes. If you have a preexisting condition, it may be excluded from your short-term policy.
Still not sure if short-term coverage is right for you? Get answers to frequently asked questions.
If you’re under regular medical care for a chronic condition, short-term health insurance probably won’t provide the coverage you need. But if you need health insurance for “just in case” scenarios, it can be a good fit.
How Much Do Short-Term Plans Typically Cost in Delaware?
Your age, sex, ZIP code and tobacco use will determine your short-term health insurance premium — the amount you pay for coverage.
Be sure to choose a plan you can not only afford to have, but also afford to use. As you narrow your options, look at cost-sharing requirements such as:
- Deductible — What you pay out of pocket before your benefits take effect.
- Copayment — A fixed amount you pay for covered services, often at the point of service (e.g., doctor’s office, urgent care).
- Coinsurance — The percentage you pay for covered medical expenses once you meet your deductible.
Other figures to consider include policy and out-of-pocket maximums — the respective caps on what your policy pays and what you pay for covered healthcare.
The example below shows rates and cost-sharing for a 35-year-old female living in Wilmington (19806). She doesn’t use tobacco, has no dependents, and needs coverage for 90 days.
Source: Pivot Health Cost Calculator
As you can see, although Plan A has the lowest premium, it also has a significantly higher deductible than Plan B and Plan C.
A Word of Advice
The cost of short-term health insurance isn’t just about your monthly premium; also take into account what you will pay if and when you actually need to use services.
How Can I Buy Delaware Short-Term Health Insurance?
You can buy short-term coverage online at PivotHealth.com or through licensed health insurance agents and brokers.
Delaware’s Health Insurance Marketplace does not include short-term plans.
Start shopping! Begin your search with Pivot Health.
What if I Need Extra Coverage?
Once you find affordable coverage, out-of-pocket costs may still be a concern. Supplemental health insurance can help.
Supplemental policies pay lump-sum benefits if you have an accident or are diagnosed with a covered critical illness. You can use these benefits for costs such as:
- Your health insurance deductible and coinsurance.
- Medical bills not covered by your primary health insurance.
- Living expenses such as rent or mortgage, childcare and transportation.
You can buy supplemental coverage online or through licensed health insurance agents and brokers. Premiums usually average a dollar or two per day.
The example below shows rates for a 35-year-old female living in Wilmington (19806):
|Premium||Critical Illness Benefit||Accident Medical Expense Benefit||Accidental Death & Dismemberment Benefit||Hospital Benefit (Per day up to 10 days)|
How does supplemental health insurance work? Here’s a quick overview.
What’s the Best Short-Term Plan for Me?
There are many short-term coverage options available. To find one that’s right for you, start by gathering a few quotes. Then, narrow your options based on premium and cost-sharing amounts, benefits and exclusions, network restrictions (if any), and non-insurance benefits such as telemedicine and vision discounts. Ask questions if you need help along the way.
There are dozens of Delaware short-term plans available. Get an instant quote.