Do you need health insurance in Illinois? When a coverage gap exposes you to unexpected medical expenses, short-term medical insurance can help. It provides quick, economical coverage until you secure another major medical plan.
What You Need to Know
Short-term health insurance benefits help protect your finances from unforeseen medical bills.
In Illinois, short-term policies can last 30 to 180 days and cannot be renewed.
You can enroll in temporary coverage online, any time of year.
What is Short-Term Health Insurance?
Short-term health insurance is temporary coverage that helps with healthcare costs related to illness and injury. Benefits typically include office visits, urgent care, emergency services, hospitalization, and surgery.
Illinois state law allows short-term policies to last as few as 30 days and up to 180 days, without renewals.1 This differs from federal limits, which cap short-term policies at 364 days and renewals at 36 months.2
Short-term health insurance is not subject to the Affordable Care Act (ACA). Consequently, it differs from individual major medical insurance (i.e., ACA plans) in some important ways. Those differences mean short-term plans work well for some people and ACA plans work better for others.
Is a Short-Term Health Plan Right for Me?
To determine whether or not short-term health insurance is a good fit, consider the following:
Short-term plans usually cost less than unsubsidized ACA plans. If you don’t qualify for an ACA subsidy, this option could make sense.
You can buy short-term coverage year-round — there are no open or special enrollment periods. If you qualify, coverage begins as soon as the day after you apply.
Because short-term plans do not include all of the ACA essential health benefits, they tend to work best for healthy people who do not have ongoing healthcare needs.
Short-term health insurance may be an appropriate choice if you:
- Lose job-based coverage.
- Start a new job with a waiting period before workplace benefits begin.
- Turn 26 and age off a parent’s health plan.
- Move to a new ZIP code.
- Get divorced and lose coverage.
Ready to shop? Find a short-term plan right now.
Why Short-Term Health Insurance May Not Be Right for Me
Short-term plans don’t make sense for everyone. An ACA plan could better meet your needs due to the following factors:
If you qualify for income-based premium tax credits and cost-sharing reductions, then consider an ACA plan from Get Covered Illinois, the state’s partnership exchange with the federal government. This will provide you with the broadest benefits at the lowest cost.
If you have ongoing issues, you may need more coverage than a short-term plan offers. Only ACA plans include all of the essential health benefits, including preventive care and pregnancy.
Not everyone qualifies for short-term health insurance. Unlike ACA plans, short-term plans are not guaranteed issue, which means your application can be denied based on your health history.
If you have a preexisting health condition such as diabetes, you may not qualify for a short-term plan, or your policy may not cover healthcare related to your condition.
How Much Do Short-Term Plans Typically Cost in Illinois?
Your premium — the amount you pay for temporary health insurance — depends on factors such as your age, sex, ZIP code and tobacco use.
Make sure you choose a plan you can afford overall. In addition to premium, pay attention to the following:
- Plan 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.
You can generally expect plans with a lower premium to have higher cost-sharing requirements and vice versa.
The example below shows rates and cost-sharing for a single 28-year-old woman living in Chicago (60613). She needs coverage for 180 days, has no dependents, and doesn’t use tobacco.
|Plan C||$114.72||$2,000||$30 | $60**||30%|
** Office visit to primary care doctor | urgent care center visit
Source: Pivot Health Cost Calculator
What will you pay? Get a quick quote.
How to Buy Illinois Short-Term Health Insurance
You can buy short-term plans on a private marketplace such as Pivot Health, through a licensed health insurance agent, or directly from an insurer. You cannot buy them through Illinois’ health exchange.
What if I Need Extra Coverage?
Once you find coverage within your budget, you may still be concerned about paying for healthcare when you need it. Supplemental insurance can help.
Your supplemental policy pays lump-sum benefits directly to you when you have a covered accident or critical illness. You can use these benefits for:
- 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.
Returning to our example of a 28-year-old woman who lives in Chicago (60613), here are sample rates for supplemental health insurance in Illinois:
|Premium||Critical Illness Benefit||Accident Medical Expense Benefit||Accidental Death & Dismemberment Benefit||Hospital Benefit (Per day up to 10 days)|
Supplemental plans are available from private marketplaces, licensed health insurance agents, and insurance companies.
What’s the Best Health Insurance for Me?
Short-term health insurance isn’t one-size-fits-all. Gather a few quotes and compare coverage before you buy. If you have questions along the way, be sure to ask the insurer.
Ready to find your plan? Let’s get started.