The Palmetto State offers a variety of options for short-term health insurance. This article will help you explore these options and also determine if temporary medical insurance is right for you.
What Is Short-Term Health Insurance?
Short-term medical insurance (also called temporary health insurance) is designed to cover you if you’re in between policies. It’s not meant to be a permanent solution.
Residents of South Carolina can purchase a maximum of 330 days of short-term coverage per policy, up to 33 months. If you’re unsure when you’ll have permanent insurance, consider enrolling for the maximum amount of time and cancel whenever you need to. There’s no penalty for canceling early.
Short-term health plans don’t need to follow the federal government requirements that all plans offered under the Affordable Care Act (ACA) do. But it will provide some medical and hospital coverage if you have an unexpected accident or illness.
Short-term medical plans also include non-insurance healthcare benefits like telemedicine (virtual visits with a provider, such as by phone or internet), eye exams and prescription eyeglasses. Many times these services are free or offered at a discount, which can help you keep healthcare costs down.
What You Need to Know:
South Carolina residents can buy a short-term policy for up to 330 days of coverage. The total amount of uninterrupted temporary coverage allowed in the state is 33 months.
Temporary medical insurance can be a good choice to bridge a gap in coverage if you’ve lost your job, can’t afford COBRA, are getting divorced or find yourself in other common situations.
A number of insurance companies offer these policies in South Carolina, but if you have a preexisting medical condition, you won’t qualify.
Is Short-Term Health Insurance Right for Me?
Temporary medical plans can be a good fit if you need health insurance right now. They are affordable, it’s easy to enroll and they make sense for a number of situations. Here are three important things to know about short-term policies:
The plans are budget-friendly. One attractive feature of short-term health insurance is its affordability. The monthly cost (called a premium) is lower because the insurance only covers any future medical expenses you might need, not any current, ongoing medical treatment or medications. By paying only for the unexpected, you can save a lot.
Enrollment is easy. You can apply online for coverage in five minutes or less once you’ve compared plans and made your decision. All you need to provide to get a quote is demographic information like your age, ZIP code, gender and how long you need coverage for. Once you determine which plan you want to apply for, you’ll answer a handful of medical questions to find out if you qualify. If you do, you can complete the application with your contact information and form of payment.
You need to be healthy. As mentioned above, short-term health insurance requires that you not have any ongoing (preexisting) medical conditions.
Short-term medical coverage may make sense if you find yourself in any of the following situations:
- You’ve lost your job and with it your health insurance.
- You can’t afford COBRA insurance.
- You don’t qualify for a financial subsidy,which lowers the cost of an ACA (also known as Obamacare) plan.
- You’re turning 26 and aging off your parent’s health plan.
- You’re in an employer waiting period before your permanent coverage begins.
- You’re retiring early and don’t yet qualify for Medicare.
- You’re going to college and the school requires proof of health insurance.
- You’re losing your health coverage because of divorce.
- You missed the Open Enrollment Period but don’t qualify for a Special Enrollment Period.
When Would Short-Term Health Insurance Not Be Right for Me?
If you have a diagnosed medical condition or a doctor has told you to get further testing for a possible condition, you won’t qualify for short-term insurance. Be sure to answer the medical questions on the application truthfully; you’ll find out immediately whether you qualify or not.
Short-term health plans generally exclude coverage for most of the ACA’s “essential health benefits,” which include pregnancy, maternity and newborn care, most prescription drugs, preventive services, lab services and mental health services.1 Temporary plans also have dollar limits on the coverage they provide. If you see your doctor(s) often and/or need medications, an ACA plan might make better sense and ensure you have access to the medical care you need.
If you don’t qualify for a short-term health plan, check with the federal Health Insurance Marketplace to see if your income qualifies you for a financial subsidy that will lower the cost of your monthly premium. You can also see if you qualify for South Carolina Medicaid through the state’s Healthy Connections portal.
How Much Do Short-Term Health Insurance Plans Cost in South Carolina?
As with any kind of health insurance, there’s a range in what you can spend, depending on the company you choose and the benefits you want. A 28-year-old woman living in Charleston, for example, can buy a short-term healthcare policy starting at $79 a month with a $20,000 deductible; or she could opt for a top-tier plan for $194 a month with a $5,000 deductible and choose her providers from within or outside a network.2
Let’s look at the different kinds of costs associated with every health insurance policy:.
Premium: The monthly cost of health insurance is called the premium. The first month’s premium is paid when you apply and are approved, even if your insurance policy doesn’t start right away. Payment for the following months starts on month two and runs until the policy expires or you cancel it.
Deductible: This is the amount you must pay out-of-pocket for your medical expenses before the health insurance company starts to contribute. In South Carolina, you have a choice of deductibles ranging from $5,000 to $20,000. The higher the deductible, the lower your monthly premium. Likewise, the lower the deductible, the higher your premium.
Coinsurance: Once you’ve met your deductible, the insurance carrier begins paying the majority of your medical expenses. However, you are still required to pay a portion of the costs. This is known as “coinsurance” and in South Carolina coinsurance ranges from nothing to 30% or more of total expenses, depending on the coinsurance level you choose when you buy your policy.
Copayment: Some short-term health insurance plans have copayments (aka “copays”) for doctor’s office visits, emergency room visits and prescription drugs. Copays are not payable toward your deductible and if your doctor orders additional tests like X-rays or lab work, those services aren’t covered under the copayment.
Total Out-of-Pocket Maximum (or Limit): This is the total amount you’re ultimately responsible for before your insurance company pays 100% of covered medical costs. Limits differ, so make sure you understand what’s considered the “maximum” for your policy.
Total Maximum Coverage: There are set limits as to what your insurance company is responsible for. If you have a policy for $1,000,000 in total coverage and your medical bills go over that amount, you’re responsible for all additional charges that exceed $1,000,000.
How Do I Buy Short-Term Health Insurance in South Carolina?
Once you’ve compared plans and determined which policy is right for you, getting enrolled online is a straightforward process:
- Enter the required information about yourself to get a quote(s).
- Review your plan options. Compare deductible amounts, coinsurance and copay options, as well as the benefits. (You can compare plan features side-by-side on most sites.)
- Read the plan brochure to see what’s not covered under exclusions and limitations.
- Decide on your policy start date.
- Answer the qualifying medical questions.
- If you’re approved, complete your contact and credit card or banking information to enroll in the plan.
You can enroll online at a marketplace like Pivot Health, directly with a carrier or ask a licensed agent for help.
What If I Need Extra Coverage?
Residents in South Carolina also have access to supplemental insurance coverage to help pay unexpected medical bills for accidents and illnesses.
These plans start at $29.95 a month for individuals seeking $2,500 in coverage and cap out at $99.95 for families who can get $5,000 in policy coverage.3 Supplemental plans pay a flat cash amount for qualifying accidents and sickness, giving you extra protection from some medical bills. An accidental death policy is also included. Consider a supplemental plan if you want extra protection but can’t afford a low-deductible policy.
If you decide short-term health insurance is the right option to bridge a gap in coverage until you can get permanent coverage, here’s some final advice:
- Compare both benefits and exclusions/limitations. Don’t solely focus on price.
- Be sure you understand all the out-of-pocket costs involved, not just the monthly premium. This includes copayments, deductibles and coinsurance.
- If you’re accepted, consider applying for supplemental insurance for extra protection if you think you need it.
- Remember that you can cancel a policy at any time if you get permanent coverage sooner than you expected.