- 9 Important Differences between Short Term Health Insurance Plans and ACA Insurance Plans
- Updated: 10/31/2018
- Many people that select Short Term Health Insurance instead of Affordable Care Act Coverage make that Choice because of the Significant Premium Savings
9) Pre-existing Medical Conditions
- Short Term Health Insurance Plans exclude coverage for Pre-existing medical conditions. ACA Health Insurance Plans cover pre-existing medical conditions. If you have an expensive pre-existing medical condition, an ACA compliant plan may be better for you. If you have a low cost pre-existing medical condition, then you may need to decide if the extra cost of the ACA compliant plan is better for you.
8) Do you need a Referral to see a Specialist?
- Short Term Health Insurance from UnitedHealthcare's Golden Rule Insurance Company do not require a referral to see a specialist. You can select your own doctor.
For ACA plans, you need to read the details of the plan you are considering. Some plans require a referral from your primary care provider to see a specialist and some do not.
7) Provider Network Choices
- Short Term Health Insurance from UnitedHealthcare's Golden Rule Insurance Company use UnitedHealthcare Choice or Choice Plus networks. This is a nationwide network with providers throughout the country. The network has nearly 1,200,000 physicians and other health care professionals and about 6,500 hospitals and other medical facilities.
For ACA plans, you need to read the details of the plan you are considering. Some plans only have providers in your city or State. Others have providers nationwide.
6) Prescription Drugs
- Short Term Health Insurance offers a choice of coverage options. Some include prescriptions, and others do not. You can choose the coverage level that's right for you.
ACA plans include prescription drug coverage.
5) Preventive and Wellness care
- Short Term Health Insurance generally exclude Preventive and Wellness care.
ACA plans include preventive and wellness coverage.
4) How Comprehensive is the Coverage?
- Short Term Health Insurance is comprehensive coverage, but not as comprehensive as Affordable Care Act compliant plans. ACA plans include "minimum essential benefits", and short term plans do not include all of these benefits.
3) Length of Coverage
- Short Term Health Insurance is available for a maximum term of under one year. Different States allow different terms for the coverage. You can apply for a new plan if you need coverage for a longer time.
When you purchase an ACA plan, you remain eligible to keep that plan for the calendar year so long as you continue to pay your premium.
2) Choice of Effective Date of Coverage
- Short Term Health Insurance is available for an effective date as early as the day after you apply. Any day of the year can be your effective date.
ACA plans are available only during open enrollment, or a special enrollment period. If you miss your open enrollment dates you will not be able to apply again until the next open enrollment period.
1) Monthly Premium Payments
- Short Term Health Insurance generally costs less than ACA coverage. Since you can choose your plan design, deductible, and other benefit options, you can select a plan to meet your budget.
ACA plan premium payments depend on your income level. The same plan may be no monthly premium for some people and a high monthly premium for others. Your premium amount will depend on your income and subsidy level. People with no subsidy find the prices to be very high.
- Starting in 2019 there is NO TAX PENALTY. You can buy a Short Term Health Insurance Plan that is not Obamacare (ACA) Compliant and will NOT Pay a Tax Penalty