Short Term Health Insurance Initial Term and Maximum Duration Limits by State

Sarah Sullivan
September 1st, 2020 September 1st, 2020 |
Read time: 14 minutes
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When the Trump Administration lifted the federal 3-month short term health insurance duration limit beginning in October 2018,[1] it opened the door for states to have more flexible short term health insurance duration limits.

Many states already had existing statutes in place prior to the Obama-era federal rule. These states are generally reverting back to their previous regulations. Some states that previously did not regulate short term insurance duration began doing so, and some states that had regulations on the books are adding to them.[2]

Short term health insurance policies are banned in the following states:[3]

  • California
  • New Jersey
  • New York

Due to enhanced regulations on short term plans, such as prohibiting medical underwriting or requiring short term medical to cover the essential health benefits, very few or no insurers offer short term plans in the following states:

Short term health plans are not available during the annual open enrollment period in these states:

  • Maine[13]
  • Virginia (effective July 1, 2021)[14]
  • Washington[15]

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Short Term Medical Policies for up to 36 Months?

The short term medical rule reversal also makes it possible for carriers to extend short term policies up to a maximum duration of 36 months where state regulations allow, including policy renewal without medical underwriting.[16]

In effect, that means that in some states a person may obtain coverage under a short term plan for up to 36 consecutive months without needing to officially re-apply or go through the medical underwriting process.

So, what are the initial term limits and maximum duration limits on renewable policies for short term health insurance in your state?

Check the list below, or get a short term health insurance quote to see your short term medical options. You’ll get immediate results so you can compare costs and benefits and see if one meets your needs.

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Remember, short term health insurance is not ACA-qualifying coverage. It is not guaranteed issue so you may be denied coverage and it is not required to cover the essential health benefits in most states.

How Long Can You Stay on Short Term Health Insurance?

Please note that the duration limits cited below are current as of Aug 31, 2020.

Alabama – defaults to federal rules

  • Initial term limit: 364 days
  • Maximum duration: 36 months[17]

Alaska – defaults to federal rules

  • Initial term limit: 364 days
  • Maximum duration: 36 months[18]

Arizona

  • Initial term limit: 364 days
  • Renewal duration: 36 months[19]

Arkansas – defaults to federal rules

  • Initial term limit: 364 days
  • Renewal duration: 36 months[20]

California – In late September 2018, California passed legislation (SB910) that banned the sale or renewal of short term plans effective January 1, 2019.[21]

Colorado – In April 2019, Colorado significantly tightened their requirements for short term medical plans. As a result, no insurers currently offer plans in the state.[22]

Connecticut –Connecticut requires short term medical plans to cover essential health benefits. In addition, any renewable short term policy longer than six months cannot exclude pre-existing conditions.[23]

  • Initial term limit: 6 months
  • Maximum duration: 6 months, policies may not be renewed[24]

Delaware – Stricter regulations were implemented on December 1, 2018 to prohibit renewals and extensions, disallow successive back-to-back plans to be sold to the same policyholder, and disallow a new policy to be issued to the same applicant more than once in a year.

  • Initial term limit: 3 months
  • Maximum duration: 3 months, policies may not be renewed[25]

District of Columbia – Stricter regulations were implemented in January 2019. The regulations: permanently limit plans to 90 days, prevent renewals and require plans to cover pre-existing conditions for which treatment was sought in the previous 12 months.

  • Initial term limit: 3 months
  • Maximum duration: 3 months, policies may not be renewed[26]

Florida

  • Initial term limit: 364 days
  • Maximum duration: 36 months[27]

Georgia – defaults to federal rules

  • Initial term limit: 364 days
  • Maximum duration: 36 months[28]

Hawaii – Additional legislation was enacted July 2018 indicating that an insurer may not issue, renew or re-enroll an individual in a short term policy if that person was eligible to enroll in ACA-qualifying major medical insurance during an open enrollment period.[29]

Because essentially everyone is eligible to enroll in ACA-qualifying major medical insurance during the annual open enrollment period, the new restriction virtually eliminates short term plans in the state.

  • Initial term limit: 90 days[30]

Idaho – Legislation was passed in April, 2019 to extend Idaho’s short term medical plan initial term limits and maximum duration, as pre-ACA state laws had been more strict.

  • Initial term limit: 364 days[31]
  • Maximum duration: 36 months[32]

Illinois

  • Initial term limit: 180 days
  • Maximum duration: 180 days (new legislation makes it impossible to renew or obtain a new policy back-to-back.)[33]

Indiana

  • Initial term limit: 364 days
  • Maximum duration: 36 months[34]

Iowa

  • Initial term limit: 364 days
  • Maximum duration: 36 months[35]

Kansas

  • Initial term limit: 364 days
  • Maximum duration: 24 months, limited to one renewal[36]

Kentucky – defaults to federal rules

  • Initial term limit: 364 days
  • Maximum duration: 36 months[37]

Louisiana –Short term plans with a duration longer than six months may not exclude coverage for pre existing conditions after the first 12 months of coverage for which medical advice, diagnosis, care or treatment was sought during the 12 months immediately preceding the effective date of coverage.

  • Initial term limit: 364 days
  • Maximum duration: 36 months as long as the policy includes pre existing conditions coverage after the first 12 months[38]

Maine – Beginning Jan. 2020, due to added consumer protection restrictions which permit only in-person sales of short term policies, no carriers currently offer policies in the state.[39]

  • Initial term limit: Up to Dec. 31 of the policy issue year – Maine prohibits the sale of short term policies during the annual open enrollment period (Nov-Dec)
  • Maximum duration: 24 months[40]

Maryland

  • Initial term limit: 3 months
  • Maximum duration: 3 months, policies may not be renewed[41]

Massachusetts – Short term health insurance is not available in Massachusetts due to long-standing guaranteed-issue and community rating requirements.[42]

Michigan

  • Initial term limit: 185 days
  • Maximum duration: 185 days, policies may not be renewed[43]

Minnesota

  • Initial term limit: 185 days
  • Maximum duration: 185 days, policies may not be renewed[44]

Mississippi – defaults to federal rules

  • Initial term limit: 364 days
  • Maximum duration: 36 months[45]

Missouri

  • Initial term limit: 6 months
  • Maximum duration: 36 months (coverage subject to applicable state mandates)[46]

Montana – defaults to federal rules

  • Initial term limit: 364 days
  • Maximum duration: 36 months[47]

Nebraska – Follows federal guidelines for term and duration limits, even though Nebraska has prior state laws regarding durations. However, the state has imposed other requirements for short term plans.[48]

  • Initial term limit: 364 days
  • Maximum duration: 36 months[49]

Nevada

  • Initial term limit: 185 days
  • Maximum duration: 185 days, policies may not be renewed[50]

New Hampshire

  • Initial term limit: 6 months
  • Maximum duration: 6 months, policies may not be renewed[51]

New Jersey – Short term health plans are unable to be sold in New Jersey due to long-standing regulations (New Jersey statute 17B:27A – 3).[52]

New Mexico – Legislation that was passed in April 2019 limits new short term plans to a maximum duration of no more than 90 days and they must be non-renewable. These requirements go into effect beginning in 2020.

  • Initial duration limit: 3 months
  • Maximum duration: 3 months, policies may not be renewed[53]

New York – Short term plans may not be sold in New York.[54]

North Carolina – defaults to federal rules

  • Initial term limit: 364 days
  • Maximum duration: 36 months[55]

North Dakota

  • Initial term limit: 185 days[56]
  • Maximum duration: 12 months, with the requirement that insurers offer one non-underwritten renewal to policyholders[57]

Ohio

  • Initial term limit: 364 days
  • Maximum duration: 364 days, must be a “one-time” limited duration policy of less than 12 months to be excepted from certain state requirements applicable to “sickness and accident” policies.[58]

Oklahoma – defaults to federal rules

  • Initial term limit: 364 days
  • Maximum duration: 36 months[59]

Oregon

  • Initial term limit: 3 months
  • Maximum duration: 3 months, including policy renewals[60]

Pennsylvania – defaults to federal rules

  • Initial term limit: 364 days
  • Maximum duration: 36 months[61]

Rhode Island – Due to state regulations, no insurers offer short term health plans in Rhode Island.[62]

South Carolina

  • Initial term limit: 11 months
  • Maximum duration: no more than 33 months[63]

South Dakota

  • Initial term limit: 364 days
  • Maximum duration: 364 days[64]

Tennessee – defaults to federal rules

  • Initial term limit: 364 days
  • Maximum duration: 36 months[65]

Texas

  • Initial term limit: 364 days
  • Maximum duration: 36 months[66]

Utah

  • Initial term limit: 364 days
  • Maximum duration: 36 months[67]

Vermont – Requires short term policies cover pre-existing conditions, which may make it difficult or impossible to find policies to enroll in since typically short term policies require medical underwriting and do not cover pre-existing conditions.

  • Initial term limit: 90 days
  • Maximum duration: 90 days, policies may not be renewed[68]

Virginia – Currently, short term plans are available with initial term limits of 364 days and 36-month max duration.[69] However, beginning July 2021:

  • Initial term limit: 3 months
  • Maximum duration: 6 months[70]

Washington

  • Initial term limit: 3 months
  • Maximum duration: 3 months, policies may not be renewed[71]

West Virginia – defaults to federal rules

  • Initial term limit: 364 days
  • Maximum duration: 36 months[72]

Wisconsin

  • Initial term limit: 364 days
  • Maximum duration: 18 consecutive months including the initial term + subsequent renewals[73]

Wyoming – defaults to federal rules

  • Initial term limit: 364 days
  • Maximum duration: 36 months[74]

Should You Get a Short Term Health Policy?

You’ve validated that short term health insurance is available in your state – should you apply?

Short term health insurance isn’t right for everyone. It is not ACA-qualifying health coverage and most policies do not include coverage for things like preventive care, prescription drugs, pregnancy, and pre existing conditions.

In fact, a 2018 analysis by Kaiser Family Foundation (KFF) found that of 24 distinct short term medical policies marketed in 45 states:

  • 43% did not cover mental health services
  • 62% did not cover substance abuse treatment
  • 71% did not cover outpatient prescription drugs
  • 100% did not cover maternity care[75]

However, unlike qualifying major medical plans, short term plans are not subject to the annual open enrollment period, meaning you can apply and enroll anytime if you qualify (except in states that limit the sale of short term plans during the annual open enrollment period).

Short term health plans may be a good option if you qualify and you’re between jobs or if you missed open enrollment and don’t qualify for a special enrollment period.

Short term health plans will provide some level of coverage in the event of an accident or critical illness after you’ve met your out of pocket costs. Policies typically include benefits for services like ambulance transport and emergency room care, hospitalization, and diagnostics.

Still not sure about short term medical insurance? Contact a licensed insurance agent at 888-855-6837 for individual help or learn more about short term plans by checking out our article series.

Need Supplemental or Short Term Insurance?

Apply in 3 Easy Steps

  • Get a quote within seconds
  • Compare multiple plans
  • Finish application online

Originally Published On November 5th, 2018
Independence American Insurance Company and/or Madison National Life Insurance Company, Inc. may underwrite the products referenced on this website. Legal Disclaimers.

Footnotes