Short Term Medical Insurance
Alternatives to Major Medical Plans or ACA Plans
THE IHC/Independence Brokerage Group
What is Short Term Medical (STM) Insurance ?
Short Term Medical Plans may be thought of as micro-healthcare plans that are customizable to your needs. They are about 40% to 60% lower on premiums than Obamacare/ACA major medical plans. You can sign up for a plan any time of the year, and the coverage begins the next day.
Plans available in Florida and Texas
There are two categories of plans available, Connect STM and Connect Plus. Plans in both categories are available for durations of:
- 364 days
- 6 months or less
- More than 364 days, and
- Get coverage until January 1st of the next year.
- Get coverage until January 1st of next-to-next year.
Types of Policies
There are three types of policies:
- Connect STM: Has no coverage for pre-existing conditions.
- Connect Plus: Has $25,000 coverage for pre-existing conditions.
- Connect STM Extend: Has longer duration of coverage. Has no coverage for pre-existing conditions.
Features of all policies
- Deductible: For all policies, deductible available is $2,500, $5,000, and 10,000.
- Coinsurance: For all policies, coinsurance available is: 50%, 70%, and 80%. The plan will pick up this percentage.
- OV suffix signifies that there is no prescription drugs coverage available.
- Rx suffix signifies that there is prescription drugs coverage available. The maximum benefit available for Rx is $2,500.
- Maximum Out-of-Pocket: All policies have maximum out-of-pocket expense ceiling.
- Maximum Benefit: All policies have $2,000,000 as maximum benefit for the duration of the policy.
- Exclusions and Limitations: For all policies, exclusions and limitations apply.
Other integrated products
All Short-Term Medical insurance products are integrated with add-on products listed below:
- Hospital Insurance
- Accident and Critical Illness Insurance
- Dental Insurance:
- Health Discount Program Gap Health Insurance
- Vision and Hearing
Generally, short-term medical insurance is applicable to the following groups of people:
- Individuals who are risk averse to being medically uninsured.
- Individuals transitioning between jobs.
- Those seeking an affordable option to COBRA
- Employees waiting for employer’s group medical coverage to begin as job benefit.
- Self-employed individuals who find ACA medical plans to be expensive.
- Those who are waiting to enroll in an ACA compliant major medical plan during its open enrollment period between Nov 01 to Dec 15.
- Those needing immediate coverage while shopping and applying for permanent coverage.
- College students or recent graduates.
- Individuals no longer eligible on parents’ plan.
- On strike, laid off, or terminating employees.
- Part-time or temporary workers.
- Individuals not yet eligible for Medicare coverage.
- New residents of the United States.
Things to know before I sign up for it.
Medical Qualifying Questions
- Individuals between ages of 18 to below 65.
- Child between ages of 2 to 18.
- Family comprising of you, your spouse, and your dependent child(ren).
Your dependent child is defined as follows:
- Who is below 19 years of age, (includes just born)
- Who is at least 19 years of age but less than 25 years enrolled and attending as full time student at an accredited college, university, vocational or technical school,
- Who is not pregnant at the time of application,
- Who is not member of armed forces,
- Who is not medically disqualified due to certain medical conditions or critical diseases.
The applicant must be able to respond ‘Yes’ to following:
- I have lived in the U.S, for 12 consecutive months.
- I am not an active member of armed forces,
- I am not covered by any government sponsored health insurance plan, or any other group or individual medical health insurance on proposed effective date of the new STM policy,
- I am not pregnant, am not an expectant parent, in process of adopting a child, or undergoing fertility treatment.
- I am below 300 pounds for male, below 250 pounds for female.
- I am not medically disqualified due to certain medical conditions or critical diseases.
Optimization of Medical Insurance
To optimize health coverage, it is significant to understand how your finances will be bear with the outflow of your cash out-of-pocket in emergencies and hospitalization. Hospitalization is very fearful for its inevitable recourse and heavy expenses. It must be covered by in-network providers of insurance company providing coverage. To compare the mainstream major medical plan, the PPACA, with Short Term Medical plans, which are available for as long as 36 month, it is significant to delve into the Cost vs. Benefit of Risk Management analysis when combined with Hospital Supplemental insurance plans. To cover financial risks over and above what Short Term Medical insurance can provide, it is significant to consider adding following coverages:
Supplemental Medical Plans: These plans are indemnities designed as financial protections to pay you fixed coverage benefits upon defined occurrences to reduce your out-of-pocket costs of deductible, coinsurance, and other expenses related to your hospitalization, surgery, health emergencies and help you pay for other incidentals. You can buy these plans standalone (a-la-carte) or preferably with your main medical health insurance plan (either Short Term Medical or a Major Medical plan). The plans are offered by The IHC Group and are a part of your sign-up process for Short Term Medical plan as add-ons. Following supplemental plans are offered in Florida only as part of sign up process for Short Term Medical, or standalone purchase.
Here is an example showing effect of adding a supplemental medical plan to the basic ACA or Short Term Medical plan that pays $1,000 per day of hospitalization.
Medical Ancillaries: In broad general terms, ancillary medical services refer to a wide range of healthcare services in support of the work of physicians, surgeons, and an array of medical services. Typically, ancillary medical services fall in categories of diagnostic services, medical equipment, therapeutic services, custodial services, and other such services. Following optional plans are offered as part sign up process for Short Term Medical, or standalone purchase.
These plans come with nationwide network of healthcare providers who offer you discounted medical costs and out-of-pocket expenses. It is significant to use providers in the networks so as to get discounted services and processing of your medical claims the Insurance. Reach out to following network of providers to search for providers. Since participation in networks in dynamic, do call to check and verify for appointments.
- MultiPlan: has a number of networks within.
- FirstHealth and Cofinity: are national PPO Networks
- Doctor: Search by specialties.
- Dentemax: This is PPO network of dental care providers.
- Ancillary Care: This is network of about 33,000 ancillary providers . They provide diagnostic services, medical equipment, therapeutic services, and some other medical services
From these networks of available providers, search for the providers that you would select to go to, call their office, and verify to make sure they are in the PPO network associated with The IHC Group, and they would honor the policy plans. If you need help, ask question to servicer, Loomis, through membership portal.
Insurance terms to know and understand
I want to sign up. How should I go about?
I just signed up. Now What?
I’m a policy holder. I need help!
Follow the instructions in the email.
Third party, Loomis Company, provides customer service.
Read more customer service information
- Customer Service: select Option 3 for members at 866-473-6615
- Online Member Portal: http://www.loomisco.com/healthxgateway/member
- Policy Documents Requests: IHCDocuments@loomisco.com
- Bill inquiries: 866-473-6615 Fax: 610-374-6986
To prevent high medical expenses, get covered today!
Call us at 407-792-6060 or leave message below.
We’ll get back to you within 24 hours.