Top Questions on Texas Short Term Health Plans
We get calls daily with all sorts of reasons for needing temporary health insurance in Texas.
It usually involves missing windows for other coverage or needing a longer-term fix.
There have been big changes lately in the short term market which may or may not stay around depending on the White House residents and we'll look at that as well.
Let's walk through the top questions we get with short term health plans including both their pros, cons, and especially their uses!
First, our credentials:
This is what we'll cover:
- Quick intro to Texas short term health plans
- When does short term work well
- How long can I keep short term coverage for in Texas
- How quickly can short term plans start?
- What is the best carrier for short term plans in Texas
- How do I compare the short term plan options for my needs
- How does short term compare to Texas exchange plans
- Can I be declined for short term in Texas
- How do I quote and apply for short term
Let's get started. These are the common questions but reach out to us directly with your specific questions!
Quick intro to Texas short term health plans
We're lucky in Texas to still have short term plans available!
They fill a very specific need in the health care market for temporary gaps in coverage.
Generally speaking, short term plans:
- Have a fixed period of time they can be active
- Require underwriting - meaning approval is based on health
- Work well for more catastrophic health needs even though some plans are now richer by design
- Are priced well versus a bronze plan on-exchange IF we don't qualify for a subsidy
- Have different levels from hospital only to more comprehensive plans
- Work better if we're in good health as they have waiting periods for pre-existing conditions
Let's start to narrow down some of the questions we typically get.
When does short term work well
For the most part, short term Texas plans work well in these situations:
- Need coverage to start mid-month since most other plans begin 1st of a given month
- Need coverage till other plans (employer, etc.) kicks in
- Need coverage till Exchange open enrollment or special enrollment trigger starts
- In between jobs and Cobra is too expensive
Let's look at exactly what short term is!
How long can I keep short term coverage for in Texas
This recently changed.
We had a plan from UnitedHealth which could go for 360 days and be renewed 3 times. Almost 3 years!
The White House passed an executive order essentially capping the time that short term plans could be effective.
Max is 3 months plus a 1-month extension (why not just make it 4 months???).
Now, this can change of course depending on who is in the White House so reach out to us if you need longer-term needs and the Exchange plans don't make sense.
For now, it's shorter periods of time. Plan on 3 months worst case. We may be able to stack short term policies (re-apply and re-qualify) depending on health.
Let's get to the real draw for many people.
How quickly can short term plans start?
This is one key reason people HAVE to get short term.
If approved, it can start midnight after enrollment! No other plans will do this now since the 1st of the month is usually the EARLIEST we can get for most employer and individual family plans.
Short term is great in that we can get coverage... tomorrow. Of course, we can pick a later date as well but most people call up for "immediate" coverage.
Hello short term!
What is the best carrier for short term plans in Texas
In Texas, there's really one sheriff in short term town.
UnitedHealthCare or UnitedOne.
Not only are they a legit carrier with nationwide presence (Top 3 in the country) across all markets (individual, Medicare, Business) but they have the networks!
Your options for doctors and or hospitals are critical. Any health plan is only worth as much as its network.
In Texas, UnitedHealthCare uses their HMO network for the short term option which matches what we see on the individual family market generally now.
You can quote UnitedOne short term plans here:
One note...short term in Texas is listed under the Golden Rule brand but it's United as the underlying carrier.
That makes it much easier but then there's all the plans!
How do I compare the short term plan options for my needs
United HAD four different short term options in the Texas market with increasing benefits:
- Hospital and Surgical - catastrophic care for facility-based needs
- Tri-Term Value - adds in other benefits (office, etc.) after deductible is met; RX card
- Copay Select Max - adds in copays for office and RX; coinsurance up to max after deductible
- Plan 80 Max - you pay up to deductible then plan takes over for covered benefits
The Tri-Term is the longer term option which may or may not come back with every election!
For now, we have a range from basically hospital only (think major medical or catastrophic health plans).
The Copay Select adds in more day-to-day benefits for office visits and RX.
The Plan 80 Max is a richer benefit offering with a simple design (deductible and then lots of help).
They all have a defined Out of Pocket max which caps your exposure in case of really big bills (think hospital, etc.).
That's really why we're getting short term coverage—the "Big What If."
A family member had a blood clot last August out of nowhere (super healthy).
The bill was $500K! More importantly, if you can't show the hospital an insurance card, good luck with that.
We're happy to walk through the Short Term options but pricing will probably dictate which way you go.
How does short term compare to Texas exchange plans
There are subsidies available on-Exchange (ACA, Obamacare) based on income.
If you qualify for these subsidies AND you're able to enroll (open enrollment or special enrollment trigger), those are probably going to be the better move.
We have a whole review of Texas short term versus Obamacare.
The on exchange plans are more robust (mental health, RX, pregnancy, etc) and they don't time out the same way.
That being said, usually people opting for short term can't enroll on exchange (see missed Texas open enrollment) OR they just need a short period covered till other coverage starts and do not want to go through the full exchange process.
We're happy to walk through the pros and cons of either.
Finally, one key difference between the two.
Can I be declined for short term in Texas
Yes. We have to qualify based on health to be approved which is a key difference versus Exchange plans.
That being said, we see most people get approved but if you have something bigger going on or expected, that may be an issue.
There's no downside to applying and seeing what they come back with. We can then go from there to see how we might get exchange coverage.
Also, there is a waiting period for pre-existing conditions which means the plan will not pay out for issues you have going on now.
These plans are really designed for new accident/illness issues that can and do pop up all the time!
Finally...
How do I quote and apply for short term
We make this fast, free, and easy here:
We're happy to help with any questions but enrollment is all online and pretty easy (as far as insurance goes :) right through the quote tool.
There's zero cost for our assistance and these are the best rates available on the market!
Reach out with any questions: