As a resident of West Virginia, you have many short-term health insurance plans to choose from. But what are short-term medical plans (also called temporary health insurance) and how do you know if it’s right for you? This guide will help you decide.
What You Need to Know:
In West Virginia, residents are allowed to buy a plan that lasts as little as 30 days up to 364 days.
Temporary coverage is best for people who are pretty healthy and need to fill a gap in coverage quickly.
If you qualify for a short-term plan, the process to enroll online is fast and efficient and coverage can start as soon as the next day.
What is Short-Term Health Insurance?
Short-term health insurance is temporary healthcare insurance meant to cover a gap in coverage. It’s not a permanent or even a long-term solution. But if you qualify, it can help you get covered right away until you have long-term coverage in place.
In West Virginia, short-term medical plans can offer coverage for as little as 30 days and up to a maximum of 364 days. This gives you the option to buy an extended amount of coverage and cancel at any time if a permanent solution becomes available. There’s no penalty for canceling before the end of your coverage.
Unlike some other states, beyond the 364-day maximum, there are no restrictions on any short-term health insurance policy you buy in West Virginia.
Is Short-Term Health Insurance Right for Me?
A recent survey found that nearly half of Americans support short-term health insurance. And for good reason. Here are some benefits of temporary coverage:
The plans are affordable. Whether you’re between jobs or uninsured due to another situation, these policies are budget-friendly. If you don’t qualify for help paying for a plan through the federal Health Insurance Marketplace (an Affordable Care Act/Obamacare plan, in other words), a short-term medical plan can be an economical alternative.
It’s easy to enroll. Temporary plans don’t have the rigorous enrollment process that Obamacare and private plans require. You simply provide information about yourself like your gender and age, answer a handful of medical questions and give your payment information, and you can be covered in 24 hours or less.
It’s a good choice for people who are relatively healthy. Short-term medical insurance is for unexpected accidents and illnesses. It isn’t meant to cover long-term health conditions like diabetes, cancer, mental health issues or pregnancy.
Short-term health insurance can be a good option for times when you’re in a transition. Here are some examples of situations when this kind of coverage can fill a specific need:
- You lost your job and with it your health insurance.
- You can’t afford COBRA insurance or don’t qualify for it.
- You’re in a new job and waiting for employer coverage to start.
- Your income doesn’t qualify you for a financial subsidy for an Affordable Care Act (ACA) plan and you can’t afford the ACA premiums.
- You’re turning 26 and aging off your parent’s insurance plan.
- You’re going to college and the school requires students to have health insurance.
- You’re retiring early but don’t yet qualify for Medicare.
- You’re outside the ACA Marketplace Open Enrollment Period but don’t qualify for a Special Enrollment Period.
- You need to insure children who aren’t eligible to be covered on your health policy.
Short-term health plans offer non-insurance discounts and benefits as well. The most popular of these is telemedicine (virtual/online appointments with a physician), offered either at a low cost or free of charge, depending on the plan you choose. This benefit can be handy if you don’t expect to use your insurance much or at all, but need a quick virtual visit for a medical issue or need a prescription filled.
When Would West Virginia Short-Term Health Insurance Not Be Right For Me?
One of the most important things to know about temporary coverage is that it doesn’t cover preexisting conditions. If you’ve been diagnosed with an illness or have been told by a doctor to seek additional testing for a potential condition, you would not qualify.
If you’re unsure about something your doctor told you or recommended to you and you opt to enroll in a short-term health plan anyway, there is a chance any medical bill could be attributed to your condition and not paid. So decide wisely.
If you tend to see the doctor regularly or require medication or other services to manage a chronic condition, or you’re planning on becoming pregnant, short-term medical coverage isn’t a good choice.
While some short-term plans have preventive exam coverage, the 10 “essential health benefits” mandated by the ACA aren’t covered by short-term insurance. For example, well-woman visits, free birth control and mental health benefits — all of which are required for every plan sold on the ACA federal Marketplace — are not included in short-term health policies.
It’s important to decide what type of care you need to stay healthy: comprehensive coverage or more economical coverage for life’s “what if” situations. Temporary coverage is best for people in the latter situation.
How Much Does Short-Term Health Insurance Cost in West Virginia?
As an example, a 35-year-old woman living in Charleston, West Virginia, would pay a monthly premium of $70 for the lowest priced short-term plan, and up to $419 per month for a plan with the highest level of benefits. As you can see, there’s a wide range in the cost of premiums depending on the plan you choose.
West Virginians have a total of 79 plans to choose from. But before you begin to shop, take a little time to understand a few short-term health insurance terms to help build your plan:”
Premium: The monthly cost of your health insurance is the premium. Your premium is determined by your ZIP code, age, gender, the benefits you choose and the length of the policy. When you apply for and enroll in a short-term health insurance plan, you pay the first month’s premium right away, even if the start date is in the future. Your second insurance premium will be withdrawn from your account during your second month of coverage.
Deductible: The deductible is the annual amount you pay toward medical bills before the insurance company is responsible for contributing. Deductibles can range from $1,000 to $20,000. The higher your deductible, the lower your monthly premium. The reverse is true as well: The higher your premium, the lower your deductible. You can choose which makes the most sense for your budget.
Coinsurance: Once you’ve met your deductible, the insurance company will begin to pay the majority of your medical bills. However, you’re typically still responsible for a percentage of the costs. This split between you and your insurer is called coinsurance. Based on the coverage you choose, you can pay zero coinsurance up to 30%.
Copayment (copay): Some short-term health plans offer the option of copays for doctor’s office visits or prescription drugs. A copay is a flat rate you pay for a service or drug outside of the deductible. It’s important to note that if you have a copay plan and see a doctor, the copay only applies to the office visit and not to additional services like X-rays or lab tests.
Total Out-of-Pocket Maximum (or Limit): This is the total amount you’re ultimately responsible for before your insurance company begins to pay 100%. Plans differ, so make sure you understand what’s considered the “maximum.” For example, the out-of-pocket maximum for some short-term plans is a combination of the deductible and coinsurance, whereas other plans consider the annual deductible alone the only amount you need to meet before you hit your total limit.
Total Maximum Coverage: There are set limits as to what your insurance company is responsible for. If you have a policy for $500,000 in total coverage and your medical bills go over that amount, you’re responsible for 100% of all additional charges that exceed $500,000.
How Do I Buy Short-Term Medical Insurance in West Virginia?
Once you’ve analyzed multiple plans and determined what short-term insurance policy is right for you, it’s usually a quick process to get enrolled online:
- Enter the required demographic information (age, gender, etc.) to get quotes.
- Review plans. Compare deductible amounts, coinsurance and copay options, as well as the benefits and what’s not covered. (You can compare plan features side-by-side on most sites.)
- Read the plan brochure to confirm you’ve made the choice that’s right for you.
- Decide on your policy start date.
- Answer the qualifying medical questions honestly.
- If you’re approved (you’ll get an immediate answer), complete your personal and credit card or banking information to enroll in the plan.
Short-term health insurance companies that advertise plans in West Virginia include:
- Companion Life Insurance Company
- Everest Reinsurance Company
- Independent American Insurance Company
- National General Accident & Health
What If I Need Extra Coverage?
Residents of the Mountain State also have access to supplemental insurance coverage to help pay unexpected medical bills for accidents and critical illnesses up-front.
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. Supplemental insurance plans can take the stress off of having to pay a high deductible.
This type of plan pays a flat cash amount for qualifying accidents and sickness, giving you extra protection from some medical bills. An accidental death policy is also included.
If you decide short-term health insurance is the right option until you can get permanent coverage, here’s some final advice as you move ahead:
- Compare exclusions and benefits, not just price, for any policy you’re considering.
- Be sure you understand all the 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 West Virginia only allows a maximum of 364 days of short-term coverage, so start planning for how you’ll get permanent coverage when your policy ends.