What is Short Term Medical (STM) Insurance ?
Think of it as micro-healthcare plans thatare customizable to your needs. They are about 40% to 60% lower on premiums than Obamacare / ACA major medical plans. You can sign up for it any time of the year.
Plans are available for 90 days, 180 days, and 364 days.
All plans are month-to-month allowing flexible terms. These plans are not renewable (unlike Major Medical Plans), however, you can buy new plan as much as 60 days earlier to keep continuity.
Things to know before I sign up for it.
Is my situation suitable for Short Term Medical Insurance?
On Short Term Medical plans there is a large choice for selecting deductible, coinsurance, and length of coverage. Your selection determines preparation for financial risk due to unexpected medical situation you may run into. 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.
Am I eligible for Short Term Medical Insurance?
Short Term Medical insurance is available to primary applicant for:
- 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.
Can I take a quick look to compare these plans?
There are 5 different plans that can be compared for Short Term Medical. A comparison of plans and benefits for Short Term Medical can be seen here. A downloadable format for plans comparison is also available here.
Are there any disqualifying conditions to purchase this plan?
Please review this one page document to learn more about medical qualifying questions.
Are there Federal tax penalties for not having an ACA plan?
Effective Jan 01, 2019 individual mandate to pay tax penalty for not buying major medical plan was repealed from ACA; this occurred in September 2018. This has been a big relief to people who did not fall into low-income bracket to buy a subsidized major medical plan and for those who found premiums were getting out of their reach.
As a tax filer (individual or family) prior to Dec 31, 2018 if you did not have qualified health insurance coverage (such as a major medical ACA plan), you had two choices:
- Qualify and obtain an exemption either on hardship basis, non-hardship basis, or you are covered by a plan that qualifies as minimum essential coverage; or
- Pay a fee through your tax return based on number of months, termed as Individual Shared Responsibility Payment. For years 2016-2018, the flat fee was $695 per adult, $347.50 per child under 18, or 2.5% of your income above filing threshold, whichever is higher with family maximum of $2,085.
Because there were penalties involved, tax filers also received a 1095 form (A, B or C – depending on where you got your health coverage from) to prove that you had an ACA compliant insurance.
There are no more Federal tax penalties for not having ACA compliant health insurance effective starting in the Year 2019. Please note, Short Term Medical insurance is not ACA compliant health insurance.
Can I renew my Short Term Medical insurance once it expires?
STM plans are not auto-renewable. The next coverage period is not in continuation of the previous period; it will be the new plan with a new deductible, coinsurance, and pre-existing condition limitations. You can buy the next plan as much as 60 days in advance to ensure continuity of coverage
What are the supplemental medical product plans to add on to Short Term Medical insurance?
While signing up for Short Term Medical plan, you may consider to add supplemental indemnities plans to offset out-of-pocket expenses. The supplemental indemnities plans available are:
- Hospital & Surgery: Pays fixed benefits for covered hospital stay and surgical procedures.
- Care Access Plan: There are three levels of indemnity plans covering: hospital stay, surgical benefits, critical illness benefits, and optional health maintenance.
- Metal Gap2: There are five levels of indemnity plans to covering: accident medical expense, accidental death and dismemberment, critical illness, inpatient surgery, outpatient surgery, hospital admission benefit, and hospital confinement benefit.
What are the ancillary medical plans ?
These are add-ons to your main health insurance plan to make your health care plan comprehensive. The ancillary plans available are:
- Pharmacy / Rx Pay Card: This is fixed copay discount plan for prescription medications. Highly recommended that at the minimum, add this choice to your Short Term Medical plan.
- Dental Plan: There are three levels of dental plans available, PPO and indemnities.
- Telemedicine: Buy access to phone consultations with board certified physicians and get prescription medication ordered.
- Cancer, Heart Attack and Stroke: This indemnities plan covers financial risks associated with occurrence of these critical diseases
How do I find doctors, medical facilities, and ancillary providers who will accept this insurance?
What are some insurance terms that I should understand?
Office Visit Copay: What you pay upfront at the reception of doctor’s office when you present your IHC Short Term Medical insurance card. Please make sure the doctor’s office accepts it and bills to insurance company.
- Individual: The selected deductible maximum is an amount must be paid by the covered person before coinsurance benefit begin. The deductible applies per covered person, per covered period. To be risk averse, select the least deductible amount on your plan choices, though the premium will be higher.
- Family: When three covered persons in a family each satisfy their deductible, the deductibles for any remaining covered family members are considered satisfied for the remainder of the coverage period.
Coinsurance and Out-of-Pocket Maximum:
- After the deductible maximum amount has been met, you pay the selected coinsurance percentage of covered expenses until the out-of-pocket maximum that you selected has been reached.
- The out-of-pocket maximum amount is specific to expenses applied to the coinsurance percentage. It does not include covered expenses applied to the deductible, precertification penalty amounts, or expenses not covered under the policy.
- Once the deductible and Out-of-Pocket maximum amount has been satisfied, additional covered expenses within the coverage period are paid to by insurance at 100 percent, not to exceed the covered period maximum benefit amount. Benefits specific maximums may also apply.
I want to signup. How should I go about it?
Enter your information and browse plans
Customize from different Deductibles, Co-insurance, Maximum Out-of-Pocket, and Maximum Limit of Plan
The choices impact premium for of the plan. The lower your deductible, lower your out-of-pocket costs, and higher the co-insurance; more is the premium and lesser is your financial risk.
Add supplemental and ancillary insurance plan(s)
We recommend you get a Rx Pay Card. You may choose to add Dental, Care Access, Hospital & Surgical Indemnity, and Telemedicine.
Complete and submit application.
I just signed up. Now What?
To get a plastic Membership ID card, request in membership portal. Otherwise print ID card from online site
Go over the policy and understand its scope, benefits, and limitations.
Browse over network of doctors and select one to go to.
Do make an appointment with your selected doctor and make use of copay only free visit.
I’m a policy holder. I need help!
Follow the instructions in the email.
Customer service is provided by third party, Loomis Company
Read more customer service information
- Customer Service: select Option 3 for members at 866-473-6615
- Onllne Member Portal: http://www.loomisco.com/healthxgateway/member
- Policy Documents Requests: IHCDocuments@loomisco.com
- Bill inquiries: 1-856-892-4301; Fax: 610-374-6986
To prevent high medical expenses, get covered today!
Resource Library. Read more about each plan.
Short Term Medical Plans
Ancillary Medical Plans
Plan availability varies by State. Shop Plans to see what’s currently available for you.
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