If you’re one of the 13.4% of Georgia residents without health insurance, you may be looking for affordable options that will cover you at least temporarily.1
Short-term health insurance is an alternative to Affordable Care Act (ACA; aka Obamacare) plans you can buy on the federal Health Insurance Marketplace. As the name suggests, it isn’t permanent insurance but a temporary option to give you “right now” coverage.
Applying for a short-term health plan is quick and easy and you can be covered just 24 hours after submitting your application. You have flexibility, too; Georgia residents can get coverage for as few as 30 days or up to nearly 36 months. Short-term plans give you the option, too, to pick your deductible and coinsurance and add a copayment option if you prefer.
In What Cases Would Short-Term Health Insurance Be Right For Me?
When deciding whether short-term health insurance fits your healthcare needs and budget, you’ll need to look at several factors. These are the benefits of a temporary plan:
Premiums for short-term health insurance are, on average, more affordable than those for an ACA plan,2 especially if you don’t qualify for a subsidy on the federal Marketplace. (Subsidies, also called premium tax credits, help pay your premiums if you qualify based on income.)3
If your only options are COBRA (officially known as the Consolidated Omnibus Budget Reconciliation Act ) from a previous job or an unsubsidized Obamacare plan, short-term insurance is an option to consider.4 But keep in that mind that your short-term policy could have a copayment for each doctor’s visit and other expenses; and office visits and hospitalizations may be covered only after you’ve met your annual deductible. So be sure to read the policy carefully so you’re clear on what’s covered and what’s not.5
Enrollment Is Simple
As mentioned above, signing up for a short-term plan is easy and can take less than five minutes to apply. The process includes two stages:
- Answer medical questions. This will determine if you’re a candidate for a short-term plan, which won’t cover any preexisting conditions. Insurance companies can disqualify applicants from coverage based on medical history.6
- If you do qualify, you’ll complete the application and submit your credit card or banking information for your first payment. Once you provide your financial information and accept the terms of the policy, your first month’s premium will be billed immediately no matter what day you want the insurance to begin. Future payments will most likely be on a different date once you are on a monthly billing cycle. (Be aware that medical costs paid by credit card can wind up costing you hundreds or thousands of dollars extra in interest fees, if you don’t pay off all your charges at the end of each month. A debit card, check or money order may be preferable.)7
It’s Good for Generally Healthy People
The reason short-term plans are affordable is that they don’t cover chronic conditions or long-term or ongoing treatment like pregnancy or mental health care. As noted above, this type of insurance also doesn’t accept people with preexisting conditions and insurers aren’t obligated to cover the “essential health benefits” that every ACA plan must include.8 If you have a preexisting condition or think you’ll need extensive care while you’re covered by this policy, short-term insurance is probably not the right choice for you.
Temporary coverage makes the most sense if you’re between jobs and need an immediate solution that provides healthcare in the event of an emergency. Here are the most common situations that lead people to consider a short-term plan:
- You lost your job.
- You left your job and you can’t afford COBRA coverage.
- You’ve been furloughed and are unsure when your insurance benefits will start up again.
- You just got married or divorced.
- You’re waiting for your group insurance at a new job to start.
- You can’t find other insurance you can afford.
- You need coverage and don’t qualify for Medicaid in Georgia.
- You’ve retired before Medicare will cover you and need insurance.
- You’re just starting a new business and need coverage.9
When Would Short-Term Health Insurance Not Be Right For Me?
First and foremost, temporary health insurance is meant for just that: brief situations when you can’t get permanent coverage. As mentioned above, it’s not a good option if you have a chronic condition such as diabetes, a heart condition or any disease or illness that requires you to see a doctor regularly and/or take medication.
Not only do these plans not cover those with preexisting conditions, but your out-of-pocket costs are likely to mount up quickly in these situations and you may be subject to a waiting period for coverage for some situations.. That’s why it’s essential to read the policy completely before you sign up, so you’re sure it will cover what you need.10
If you believe you’ll need more care than a short-term plan can provide, you might want to consider enrolling in an Obamacare plan through the federal Marketplace. Your household income may qualify you for a subsidy that will reduce your monthly premium while giving you all 10 essential health benefits, including preventive care, to help keep you healthy.
What’s the Average Cost of Short-Term Health Insurance in Georgia?
As an example, a 35-year-old woman living in Atlanta could pay a premium anywhere from around $100 to $723 or more a month for a policy.11 Multiple factors affect the price you’ll pay for coverage, including:
- Your age.
- Your gender.
- The medical deductible for the plan you choose.
- Coinsurance for the plan you choose.
- Total coverage maximum for the plan you choose.12
When you combine all of these factors, you can better understand how pricing is calculated.
Insurance companies will price your plan based on how you structure it. Typically, you can choose your deductible, coinsurance and how much coverage you want. That will determine your monthly premium price. As mentioned above, your first month’s premium is paid immediately, and subsequent monthly premiums are deducted according to the administrator’s billing cycle.
Let’s look at some common short-term health insurance terms that can help you figure out the true cost of any plan you’re considering:
This is the monthly cost for your medical insurance plan. You pay for your first month of coverage immediately, no matter what you set as your future effective date. The payment date for the following months could be billed differently based on the time of the month you enroll.13
This is the total you have to pay out-of-pocket during the coverage period before the insurance carrier is responsible for contributing its portion toward your medical claims.14
Once you’ve met your deductible, the insurance company starts sharing most of your medical costs with you. They can pick up 70% or more of your medical bills, depending on the coinsurance percentage you choose; you’re responsible for paying the remaining amount. At least one insurer in Georgia offers 100% coinsurance.15
Some short-term health plans require you to pay this flat-rate cost at each doctor’s visit and for some prescription drugs. For medications, you may have to meet a deductible first before copayments begin.16
All short-term medical plans have an out-of-pocket maximum, which means you won’t have to pay more than a specified amount for in-network medical services while insured under the policy. (Note: Some short-term plans have coinsurance out-of-pocket maximums and some just have a general out-of-pocket maximum. Coinsurance out-of-pocket maximums mean you have to pay your deductible first and then share payment responsibilities with your insurance company up to the maximum amount. General maximums allow you to pay your deductible and then stop paying once you’ve hit the maximum. For example, if you have a $5,000 deductible and a $10,000 coinsurance maximum, you are responsible for paying up to $15,000 of your medical bills before the insurance company is responsible for paying 100%. If you have a general out-of-pocket maximum of $10,000, you only pay your $5,000 deductible and $5,000 in coinsurance and no more. After that, the insurance company is responsible for paying any additional medical claims. This max does not include whatever you spend on premiums and some other expenses.)17
Total Coverage Maximum
This is the total amount of expenses an insurance company will guarantee to pay during your policy period. Maximum limits can start at $100,000 and run up to $1 million or more.18
It’s important to remember that if you purchase multiple policies at once, all of these factors restart each time a new policy term begins. Georgia offers up to 364 days of coverage with the ability to reapply for additional policies for up to 36 months. So keep in mind that your coverage period begins again with each subsequent policy.
How Can I Buy a Short-Term Insurance Plan?
Temporary insurance can be purchased online from website aggregators, through a licensed insurance agent or by purchasing from a company directly like Pivot Health.
As mentioned above, you’ll need to answer some medical questions to see if you qualify, and if so, you’ll move on to apply and submit payment information.
Making the Best Decision For Your Health
Now that you have more information on picking the right short-term health insurance plan for your health and budget as a Georgia resident, you can make a more confident choice. Here are four key questions to consider:
- How much can you afford to pay in a premium each month?
- If an unexpected illness or emergency strikes, will you have enough savings to cover the deductible?
- Once you meet your deductible, do you have enough to cover the coinsurance percentage, or will you need 100% coinsurance paid by your insurance company?
- Do you anticipate seeing a doctor never, seldom or often while insured? Do you take any expensive medications? This will help you decide whether you need to budget for a copay for office visits and/or prescription drugs.