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Obamacare open enrollment for 2016 ended Jan. 31, and open enrollment for 2017 won’t begin until Nov. 1, 2016, with new coverage beginning Jan. 1, 2017. What do you do if you need health insurance sooner? There may be situations in which you are not eligible for special enrollment or have to wait for the Obamacare coverage you buy during a special enrollment period to begin.
For those who are in between major medical plans and need coverage fast, temporary health insurance, commonly known as short term health or short term medical, can be a wise option.
It may be tempting go without health insurance. It is just a month or two, right? The Affordable Care Act allows individuals who are not otherwise exempt from the individual shared responsibility provision (i.e., mandate) to be uninsured for a single period up to three months each year. Beyond that, you could face a tax penalty (i.e., individual shared responsibility payment).
While it may seem unlikely you will need the benefits while briefly uninsured, going without health insurance can mean you will have to pay all of your medical expenses yourself.
A 2013 study found that $2,168 was the average cost of an emergency room visit for more than 8,000 patients nationwide. Of the top 10 reasons people visit the ER, kidney stones were most expensive and cost an average of $4,247 to treat and upper respiratory infections cost the least with an average of $1,101.
If you become injured or unexpectedly ill, are you prepared to pay for related medical care entirely out of pocket?
Life is unpredictable, even if you are in good health. Should situations you don’t expect to happen become reality, a short term health insurance plan can offer peace of mind that you have benefits to help pay for covered medical expenses until your ACA-compliant qualified health insurance plan takes effect.
Temporary health plans:
It is important to recognize that temporary health insurance plans are not ACA compliant and do not qualify as minimum essential coverage. They are intended for unforeseen circumstances and do not include essential health benefits or preventive care. If you go more than a single period of up to three months without qualified health insurance coverage and are not exempt, you may face a tax penalty. Short term health plans are not guaranteed issue and pre-existing exclusions apply, which means your health history can impact whether or not you qualify for coverage.
If you need a qualified health insurance plan to avoid a tax penalty or want access to comprehensive health insurance benefits, you may be eligible for a special enrollment period. Special enrollment periods are extended to those amid certain life events (i.e., moving, divorce, marriage, adopting or giving birth to children) and allow you to enroll in an ACA-compliant health insurance plan outside of open enrollment. During a special-enrollment period, qualified health insurance plans may be purchased through a state-based or federally facilitated health insurance exchange or in the private marketplace.
Open enrollment for 2017 health insurance plans begins Nov. 1, 2016, and runs through Jan. 31, 2017. To begin coverage Jan. 1, 2017, you must enroll in a qualified health insurance plan on or away from your state’s exchange by Dec. 15, 2016.
When you are in between health plans, contact your state-based or federally facilitated exchange or a health insurance producer, such as the licensed health insurance producers available by calling the number at the top of your screen, for assistance. These individuals can work with you to explore the best solutions for your situation.
This post was originally published on Nov. 3, 2014. It was last reviewed and updated July 28, 2016.
 Abrams, Lindsay. “How Much Does It Cost to Go to the ER?” The Atlantic. Feb. 28, 2014. http://www.theatlantic.com/health/archive/2013/02/how-much-does-it-cost-to-go-to-the-er/273599/
SHORT-TERM MEDICAL EXPENSE (STM)
THIS IS A SHORT TERM HEALTH BENEFIT PLAN THAT IS NOT INTENDED TO QUALIFY AS THE MINIMUM ESSENTIAL COVERAGE REQUIRED BY THE AFFORDABLE CARE ACT (ACA). UNLESS YOU PURCHASE A PLAN THAT PROVIDES MINIMUM ESSENTIAL COVERAGE IN ACCORDANCE WITH THE ACA, YOU MAY BE SUBJECT TO A FEDERAL TAX PENALTY. ALSO, THE TERMINATION OR LOSS OF THIS POLICY DOES NOT ENTITLE YOU TO A SPECIAL ENROLLMENT PERIOD TO PURCHASE A HEALTH BENEFIT PLAN THAT QUALIFIES AS MINIMUM ESSENTIAL COVERAGE OUTSIDE OF AN OPEN ENROLLMENT PERIOD. THIS POLICY INCLUDES A PRE-EXISTING CONDITION EXCLUSION PROVISION.
About The IHC Group
Independence Holding Company (NYSE: IHC) is a holding company that is principally engaged in underwriting, administering and/or distributing group and individual disability, specialty and supplemental health, pet, and life insurance through its subsidiaries since 1980. The IHC Group (including through its 92% ownership of American Independence Corp. (NASDAQ: AMIC)) owns three insurance companies (Standard Security Life Insurance Company of New York, Madison National Life Insurance Company, Inc. and Independence American Insurance Company), a majority of Ebix Health Administration Exchange, Inc., a fully insured third party administrator, and IHC Specialty Benefits, Inc., which is a technology-driven insurance sales and marketing company that creates value for insurance producers, carriers and consumers (both individuals and small businesses) through a suite of proprietary tools and products (including ACA plans and small group medical stop-loss). All products are placed with highly rated carriers.
About IHC Specialty Benefits, Inc.
IHC Specialty Benefits, Inc., doing business as Health eDeals Insurance Solutions is a full-service marketing and distribution company that focuses on small employer, individual and consumer products. Health eDeals markets products via general agents online, telebrokerage, advisor centers, private label and directly to consumers. For more information about Health eDeals visit http://www.HealtheDeals.com.