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

Sarah Sullivan
February 27th, 2020 September 3rd, 2019 |
Read time: 14 minutes
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Find out how long you can carry short term health insurance in your state

When the Trump Administration lifted the federal 90-day 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
  • Massachusetts
  • New Jersey
  • New York

Due to enhanced regulations on short term plans, such as prohibiting medical underwriting or requiring STM to cover the essential health benefits, very few or no insurers offer short term plans in the following states:[4]

  • Colorado
  • Delaware
  • District of Columbia (D.C.)
  • Hawaii
  • Rhode Island
  • Vermont

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.[5]

In effect, that means that 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 request a short term health insurance quote to see your STM options.

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Remember, short term health insurance is not ACA-qualifying coverage, is not guaranteed issue so you’ll have to qualify to enroll in a policy, and includes coverage for few if any essential health benefits.

Initial Term + Maximum Duration Limits by State

Please note that duration limits cited below are current through July 1, 2019.

Alabama – defaults to federal rules

  • Initial term limit: 364 days
  • Maximum duration: 36 months[6]

Alaska – defaults to federal rules

  • Initial term limit: 364 days
  • Maximum duration: 36 months[7]

Arizona

  • Initial term limit: 185 days
  • Renewal duration: 180 days[8]

Arkansas – defaults to federal rules

  • Initial term limit: 364 days
  • Renewal duration: 36 months[9]

California – In late September 2018, California passed legislation (SB910) that banned the sale or renewal of short term plans effective January 1, 2019.[10]

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.[11]

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.[12]

  • Initial term limit: 6 months[13]
  • Maximum duration: 6 months, policies may not be renewed[14]

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: 90 days
  • Maximum duration: 90 days, policies may not be renewed[15]

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: 90 days
  • Maximum duration: 90 days, policies may not be renewed[16]

Florida – Defaults to federal rules for duration limits. However, there are new restrictions on pre-existing conditions exclusions for policies with terms longer than 6 months or that are renewable.[17]

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

Georgia – defaults to federal rules

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

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.
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.[20]

  • Initial term limit: 90 days[21]

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[22]
  • Maximum duration: 36 months under new “enhanced” short term medical plan designation[23]

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.)[24]

Indiana

  • Initial term limit: 180 days
  • Maximum duration: 180 days, policies may not be renewed[25]

Iowa – defaults to federal rules for term and duration limits

  • Initial term limit: 364 days
  • Maximum duration: 36 months[26]

Kansas

  • Initial term limit: 364 days
  • Maximum duration: 24 months, limited to one renewal[27]

Kentucky – defaults to federal rules

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

Louisiana – Note: State regulations restrict the exclusion of coverage for pre-existing conditions by insurers (Title 22, Section 1072). Short term health plans are not subject to these restrictions as long as they have terms of no more than 6 months. In effect, limiting short term health plan durations to 6 months or less.

  • Initial term limit: 6 months[29]

Maine

  • Initial term limit: 364 days
  • Maximum duration: 24 months[30]

Maryland

  • Initial term limit: 90 days
  • Maximum duration: 90 days, policies may not be renewed[31]

Massachusetts – Short term health insurance is not available in Massachusetts due to long-standing guaranteed-issue and community rating requirements.[32]

Michigan

  • Initial term limit: 185 days
  • Maximum duration: 185 days, policies may not be renewed[33]

Minnesota

  • Initial term limit: 185 days
  • Maximum duration: 185 days, policies may not be renewed[34]

Mississippi – defaults to federal rules

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

Missouri

  • Initial term limit: 6 months
  • Maximum duration: 36 months[36]

Montana – defaults to federal rules

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

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.[38]

  • Initial term limit: 364 days
  • Maximum duration: 36 months[39]

Nevada

  • Initial term limit: 185 days
  • Maximum duration: 185 days, policies may not be renewed[40]

New Hampshire

  • Initial term limit: 6 months
  • Maximum duration: 6 months, policies may not be renewed[41]

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)[42]

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: 90 days
  • Maximum duration: 90 days, policies may not be renewed[43]

New York – Short term plans may not be sold in New York.[44]

North Carolina – defaults to federal rules

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

North Dakota

  • Initial term limit: 185 days[46]
  • Maximum duration: 12 months, with the requirement that insurers offer one non-underwritten renewal to policyholders[47]

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.[48]

Oklahoma

  • Initial term limit: 6 months
  • Maximum duration: 6 months, policies may not be renewed[49]

Oregon

  • Initial term limit: 90 days
  • Maximum duration: 90 days, including policy renewals[50]

Pennsylvania – defaults to federal rules

  • Initial term limit: 364 days
  • Maximum duration: 36 months[51]

Rhode Island – Due to state regulations, no insurers offer short term health plans in Rhode Island.[52]

South Carolina

  • Initial term limit: 11 months
  • Maximum duration: no more than 33 months[53]

South Dakota

  • Initial term limit: 6 months
  • Maximum duration: 6 months, policies may not be renewed[54]

Tennessee – defaults to federal rules

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

Texas – defaults to federal rules

  • Initial term limit: 364 days
  • Maximum duration: 36 months[56]

Utah

  • Initial term limit: 363 days
  • Maximum duration: 363 days, policies may not be renewed[57]

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[58]

Virginia

  • Initial term limit: 6 months
  • Maximum duration: 6 months, policies may not be renewed[59]

Washington

  • Initial term limit: 90 days
  • Maximum duration: 90 days, policies may not be renewed[60]

West Virginia – defaults to federal rules

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

Wisconsin

  • Initial term limit: 364 days
  • Maximum duration: 18 consecutive months including the initial term + subsequent renewals[62]

Wyoming – defaults to federal rules

  • Initial term limit: 364 days
  • Maximum duration: 36 months[63]

Please note: the materials available at this website are for informational purposes only and not for the purpose of providing legal or tax advice. You should contact your attorney or tax professional to obtain advice with respect to any particular issue or problem.

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 major medical 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.[64]

However, unlike 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).

So they may be a good option if 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 as they include benefits for services like ambulance transport and emergency room care, hospitalization, and diagnostics.

Still not sure? Contact a licensed insurance agent at 888-855-6837 for help.

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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