If you need health insurance now, a short-term plan is one option available in Idaho. This coverage tends to work well for transitional periods, such when you’re between jobs, because it’s economical and can be quickly obtained.
What Is Short-Term Health Insurance?
Short-term health insurance is temporary coverage that lasts as little as one month. Plans are designed to help protect your finances from unexpected medical bills, the kind you incur due to injuries and unforeseen illnesses. Benefits typically include doctor office visits, urgent care, emergency services, hospitalization, and surgery.
Idaho Short-Term Health Insurance Rules
While there are federal guidelines for short-term health insurance, states can set their own limits and requirements.1 There are two types of short-term health insurance that Idaho allows insurers to sell: traditional and enhanced. Different rules apply to each type.
Idaho limits traditional short-term policies to 364 days and doesn’t allow for renewals.2 Enhanced short-term policies are also capped at 364 days; however, they are guaranteed renewable for a total coverage duration of up to 36 consecutive months.3
Enhanced short-term health insurance became available to Idahoans in 2020. It is not the same as ACA coverage and isn’t subsidy-eligible, but does offer broader benefits than traditional short-term health insurance. Additionally, Idaho’s enhanced short-term plans are a guaranteed issue, which means you can’t be denied coverage even if you have a preexisting health condition.4
Short-term plans are not subject to the Affordable Care Act (ACA), which means they differ from ACA plans in some important ways. That said, there are a few similarities between ACA plans and Idaho’s enhanced short-term plans. Understanding the basics when it comes to these three coverage types can help you determine which makes sense for your circumstances.
What You Need to Know
Short-term health insurance provides temporary coverage when you’re between individual major medical or job-based health plans.
Idaho allows traditional short-term policies 30 to 364 days, with no renewals. Enhanced short-term policies may be renewed for coverage up to 36 months.
There are no open enrollment periods for short-term plans; you can enroll any time.
Is Short-Term Health Insurance Right for Me?
You may find a short-term plan works well for you based on the following:
Short-term health plans tend to cost less than unsubsidized ACA plans. This makes them a budget-friendly option if you don’t qualify for premium tax credits and can’t otherwise afford coverage.
There isn’t an open enrollment period for short-term health insurance. You can apply for a policy any time of year — no special enrollment eligibility required. Coverage may begin as soon as the day after your application is approved.
Traditional short-term plans aren’t required to include all of the ACA’s essential health benefits (e.g., preventive care, maternity). As such, this coverage tends to work best if you’re in good health and need it primarily to help pay for unexpected medical care.
If you need more robust coverage, Idaho’s enhanced short-term plans do include all essential health benefits. Keep in mind that your health history will factor into your rate for an enhanced policy.
This temporary coverage is designed for transitional periods such as when you:
- Are between employer-based health 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.
There are three types of health insurance available in Idaho: ACA plans, enhanced short-term health insurance, and traditional short-term health insurance. These are all different in cost and level of coverage.
Why Wouldn’t a Traditional Short-Term Plan Be Right for Me?
Traditional short-term health insurance isn’t right for everyone. You may decide to enroll in an ACA plan or one of Idaho’s enhanced short-term plans due to:
If you qualify for premium tax credits and cost-sharing reductions, an ACA plan will provide you with the broadest benefits at the lowest cost. You can enroll through Idaho’s Health Insurance Exchange.
Neither traditional nor enhanced short-term plans are eligible for subsidies.
If you want access to all of the essential health benefits, have ongoing health concerns, or expect to become pregnant, you’ll need to enroll in an ACA plan or one of Idaho’s enhanced short-term plans to ensure you have enough coverage.
ACA plans and enhanced short-term health plans are guaranteed issue. That means you qualify for coverage regardless of your age, health status, and other factors. But it’s possible to be denied a traditional short-term policy for these reasons.
While ACA plans must cover preexisting conditions (e.g., diabetes), traditional short-term plans do not. Idaho’s enhanced short-term health insurance policies may impose a waiting period on preexisting conditions.
Still not sure which plan is right for you? Read more about different coverage options.
Why Wouldn’t One of Idaho’s Enhanced Plans Be Right for Me?
Idaho’s enhanced short-term health insurance can be an appealing option for those who want coverage that includes the essential health benefits, is guaranteed issue, and costs less than unsubsidized ACA plans. However, these factors can also factor in your decision:
You can generally expect to pay more for an enhanced short-term plan than you would for a traditional short-term plan. Again, this is partially due to the expanded benefits.
Coverage Period Limitations
Enhanced short-term plans may be renewed up to 36 months, at which point you’ll have to find new coverage. If you want a plan you can renew beyond three years, then you’ll need to enroll in an ACA plan.
Idaho law allows insurers that offer enhanced plans year-round to impose waiting periods on preexisting conditions.5 These exclusion periods aren’t allowed periods for enhanced short-term health insurance sold exclusively during the annual ACA open enrollment. Otherwise, if you have preexisting conditions that you need coverage for right away, only an ACA plan will provide it.
How Much Do Short-Term Plans Typically Cost in Idaho
Your short-term health insurance premium — the amount you pay for coverage — depends on a number of factors, including your age, sex, ZIP code and tobacco use. If you buy one of Idaho’s enhanced short-term plans, your rate can’t be determined by your sex but can be determined by your health history.
While finding an affordable premium is important, it’s not the only cost to consider. You’ll also need to pay attention to the following:
- Plan deductible — What you pay out of pocket before your benefits take effect. Idaho’s enhanced short-term health plans include separate Rx and maternity deductibles, in addition to the annual deductible.
- 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.
You’ll find that a lower monthly premium means higher cost-sharing and vice versa. Additionally, look for policy and out-of-pocket maximums — the respective caps on what your policy pays and what you must pay for covered healthcare.
Check All Costs
A lower premium doesn’t necessarily mean the best plan for you. Policies with low premiums can mean higher copays, coinsurance and deductibles. Look at all the costs when considering a plan.
How Can I Buy Idaho Short-Term Health Insurance
You can shop for short-term health insurance online or through licensed health insurance agents and brokers. There are no open enrollment periods or special enrollment requirements for short-term health insurance, which means you can buy it any time.
The application and enrollment process is quick and easy. You’ll need to answer a brief health questionnaire to determine your eligibility, which will be determined within seconds.
Some insurers that offer traditional or enhanced short-term plans in Idaho, as of late 2020, include Blue Cross of Idaho, SelectHealth, and National General Health Insurance. Short-term coverage isn’t sold through Idaho’s Health Insurance Exchange.
What If I Need Extra Coverage?
Once you find affordable health insurance, you may still be concerned about meeting your deductible. Supplemental health insurance can help.
Supplemental policies pay lump-sum benefits when you have a covered accident or are diagnosed with a covered critical illness. You can choose how to use these benefits, which may help pay for costs such as:
- Your health insurance deductible and coinsurance.
- Medical bills not covered by your primary health insurance.
- Living expenses such as childcare, transportation, and rent or mortgage.
You can buy supplemental plans online or through licensed health insurance agents and brokers. This coverage is not available on Idaho’s Health Insurance Exchange.
Is supplemental coverage right for you? Learn more about how it works.
As you can see, not all short-term plans are the same, especially in Idaho. You’ll want to gather a few quotes and compare coverage options. Look at factors such as premium and cost-sharing amounts, plan benefits and exclusions, network requirements (if any), and non-insurance benefits such as telemedicine and vision discount programs.
Before you buy, contact the insurer if you have questions or need additional information. You can also check out our buyer’s guide to shopping for health insurance.