Quick answer: short-term health insurance, officially called short-term, limited-duration insurance (STLDI), is temporary coverage that is exempt from most Affordable Care Act rules. It can deny applicants based on health, exclude pre-existing conditions, leave out benefits such as maternity care or prescription drugs and cap what it pays. A 2024 federal rule limited these plans to four months, but in August 2025 federal agencies said they would not prioritize enforcing that limit, so how long a policy can last now depends largely on your state.
Short-term health insurance is often advertised as a cheaper way to stay covered between jobs or while waiting for other coverage to start. Monthly premiums can be much lower than an ACA Marketplace plan. The lower price comes from what these plans leave out, and the gaps can be costly if you get sick or injured.
This guide explains how short-term plans work, what they typically exclude and how to compare them with other options. It is part of our complete health insurance guide.
This is general information, not medical, legal or insurance advice. Sources: U.S. Departments of Labor, Health and Human Services and the Treasury, final rules on short-term, limited-duration insurance (89 FR 23338, April 3, 2024) and joint statement of August 7, 2025; HealthCare.gov, short-term health insurance and special enrollment period pages; Iowa Insurance Division Bulletin 25-05 and Oklahoma Insurance Department bulletin (2025) on state duration rules. Rules vary by state and may change. Checked October 2026. Questions about this article: hello@proinsuranceinfo.com.
What Is Short-Term Health Insurance?
Short-term, limited-duration insurance is individual health coverage designed to fill a temporary gap. Under federal law, it is excluded from the definition of “individual health insurance coverage,” which means it is generally exempt from the individual market requirements of the Affordable Care Act and the Public Health Service Act.
In practice, this means short-term plans do not have to follow many rules that apply to Marketplace and other ACA-compliant plans, including:
- Covering pre-existing conditions
- Accepting all applicants regardless of health
- Covering the 10 essential health benefits
- Avoiding annual and lifetime dollar limits on essential benefits
- Limiting out-of-pocket costs to the ACA maximum
HealthCare.gov notes that short-term plans are not considered qualifying health coverage and may not cover services you need.
How Long Can a Short-Term Plan Last?
The allowed length of short-term plans has changed several times.
| Period | Federal duration rule |
|---|---|
| Before 2018 | Less than 3 months |
| 2018 rule | Initial term under 12 months, up to 36 months with renewals |
| 2024 rule (policies sold on or after September 1, 2024) | Initial term up to 3 months, maximum 4 months total including renewals |
| August 7, 2025 statement | Departments will not prioritize enforcing the 2024 definition, including its notice requirement, pending new rulemaking |
In the August 2025 statement, the Departments of Labor, Health and Human Services and the Treasury said they intend to issue new rules on the definition of short-term coverage. Until then, HHS said it would not treat a state as failing to enforce federal requirements if the state follows a similar approach or applies its own state-law definition.
Some states responded quickly. Iowa and Oklahoma, for example, issued 2025 bulletins allowing carriers to sell short-term plans with initial terms under 12 months and total durations up to 36 months under state law. Other states restrict or effectively prohibit these plans. Before buying, check your state insurance department’s website for current rules.
Common Exclusions and Limits
Short-term plans vary widely, so the policy documents matter more than the brochure. Common exclusions and limits include:
Pre-Existing Conditions
Many short-term policies exclude conditions you had before coverage started. Some use a “look-back” period, often several years, during which any symptoms, diagnosis or treatment can count. Claims related to those conditions may be denied, even after you are covered.
Medical Underwriting
Insurers can ask health questions and deny coverage or charge more based on your answers. A plan that accepts you may still review your medical history when you file a large claim, and inaccurate answers can lead to denied claims or rescission of the policy.
Benefits Often Not Covered
Depending on the plan, these may be excluded or limited:
- Maternity and newborn care
- Prescription drugs
- Mental health and substance use disorder treatment
- Preventive care, such as screenings and vaccines
- Pediatric dental and vision care
- Rehabilitation services
Dollar Caps
Short-term plans can cap benefits per illness, per year or for the life of the policy. A cap that seems high can be reached quickly after a hospital stay, surgery or cancer treatment.
Waiting Periods
Some plans have waiting periods before certain benefits apply, such as cancer treatment or elective surgery.
Out-of-Pocket Costs
Deductibles and coinsurance on short-term plans may be high and are not subject to the ACA out-of-pocket maximum. Our guide to deductibles, copays, coinsurance and out-of-pocket maximums explains these terms.
Provider Networks and Doctors
Many short-term plans use a provider network and pay less, or nothing, for care outside it. Before you buy, check that your doctors, nearby hospitals and any specialists you see are in the health plan’s network, and ask whether the plan requires referrals or prior authorization. Online directories can be out of date, so it is worth calling the doctor’s office to confirm.
Emergencies and Surprise Bills
Coverage for emergencies varies widely. Some short-term plans cover emergency room visits but cap the payment or limit ambulance coverage. The federal No Surprises Act, which limits surprise out-of-network bills for emergency care, applies to group health plans and individual health insurance coverage. Short-term, limited-duration insurance is not considered individual health insurance coverage under federal law, so those protections generally do not apply. Read the emergency section of the policy closely.
Short-Term Plans vs ACA Marketplace Plans
| Feature | Short-term plan | ACA Marketplace plan |
|---|---|---|
| Pre-existing conditions | Often excluded | Must be covered |
| Health questions | Often required | Not allowed for eligibility or price |
| Essential health benefits | Not required | Required |
| Annual or lifetime limits | Allowed | Not allowed on essential benefits |
| Out-of-pocket maximum | Not required | Required |
| Premium tax credits | Not available | Available to eligible enrollees |
| Enrollment | Year-round in most states that allow them | Open enrollment or special enrollment period |
Marketplace plans with premium tax credits can cost less than people expect, depending on income and household size. Compare the metal levels explained in our guide to ACA bronze, silver, gold and platinum plans before assuming a short-term plan is cheaper overall.
When People Consider Short-Term Coverage
Some situations where people look at short-term plans:
- A short gap between jobs when new employer coverage starts soon.
- Missing open enrollment without a qualifying event for a special enrollment period.
- Waiting for Medicare to begin.
- Healthy individuals who want catastrophic protection for a brief period and can accept the exclusions.
Even in these cases, check other options first. A plan that looks affordable for a few healthy months can become expensive if an unexpected diagnosis, accident or pregnancy is excluded, and a new health condition may make it harder to buy another short-term policy when the first one ends. Thinking through the worst realistic case, not just the expected one, is the best way to judge whether the savings are worth the risk.
Insurance companies that sell short-term plans set their own terms within state law, so two plans with similar premiums can treat the same situations very differently. Compare the full policy documents, not just the price, and check whether your state limits or does not allow short-term plans.
Alternatives to Consider First
Special Enrollment Period
Losing job-based coverage, moving, getting married, having a baby and certain other life events can qualify you for a special enrollment period on the Marketplace, usually 60 days. Our guide to open enrollment and special enrollment periods explains the rules.
COBRA
If you leave a job with an employer plan, COBRA may let you keep the same coverage temporarily, though you usually pay the full premium plus an administrative fee. See how long health insurance lasts after termination for timing details.
Medicaid and CHIP
Depending on income and state, you or your children may qualify for Medicaid or the Children’s Health Insurance Program. Enrollment is open year-round.
A New Employer’s Plan
If you are starting a new job, ask when coverage begins. Federal law limits waiting periods for group health plans to 90 days. Our article on how health insurance works when switching jobs walks through the options.
Medicare
If you are turning 65 or already have Medicare, a short-term plan is generally not a substitute. Medicare has its own enrollment windows, starting with the Initial Enrollment Period around your 65th birthday, and delaying Part B without other qualifying coverage can lead to a late enrollment penalty. Check Medicare.gov before choosing any other health plan.
How to Read a Short-Term Policy
Marketing materials highlight low premiums. The policy documents tell you what is actually covered. Look for these sections:
- Definitions: how the policy defines “pre-existing condition,” “medically necessary” and “emergency.” Narrow definitions can limit what is paid.
- Schedule of benefits: the deductible, coinsurance, copays and any per-service limits, such as a cap per hospital day or per office visit.
- Exclusions and limitations: the list of services and conditions that are not covered. Read this section in full.
- Maximum benefit: the total amount the plan will pay per illness, per policy period or overall.
- Renewal and termination: whether you can renew, whether renewal requires new health questions and when the insurer can cancel the policy.
- Claims and appeals: how to file a claim and how to dispute a denial.
If any of these sections are missing or unclear, ask for the full policy before you buy.
If You Already Have a Short-Term Plan
People who already have short-term coverage can take a few steps to protect themselves:
- Mark the end date on your calendar, along with the next Marketplace open enrollment period.
- Watch for qualifying life events, such as a new job, a move or a change in household size, that may open a special enrollment period.
- Keep copies of your application, policy and all correspondence.
- Get pre-approval for planned procedures when the plan offers it, and ask in writing whether a service is covered.
- Appeal denials. If a claim is denied, ask for the reason in writing and follow the plan’s appeal process. You can also contact your state insurance department for help.
Questions to Ask Before Buying
If you are considering a short-term plan, ask the insurer or agent these questions and get answers in writing:
- How long does the plan last, and can it be renewed? Does renewal require new health questions?
- How does the plan define a pre-existing condition, and what is the look-back period?
- Which benefits are excluded or limited? Are prescriptions, mental health care and maternity care covered?
- What are the deductible, coinsurance and any benefit caps?
- Is there a provider network, and what happens if I see an out-of-network doctor?
- Can the insurer review my medical history after a claim, and could the policy be rescinded?
- Is the plan approved in my state, and is the company licensed by my state insurance department?
Red Flags
- Pressure to buy immediately or “lock in” a rate.
- Websites that look like government sites or imply a plan is an ACA plan.
- Vague answers about exclusions or caps.
- Policies sold by unlicensed companies or associations you have not heard of.
- Claims that a plan covers “everything.”
You can check whether an insurer or agent is licensed through your state insurance department.
Taxes and Coverage
Short-term plans are not eligible for premium tax credits. There is no longer a federal tax penalty for going without minimum essential coverage, though a few states, including California, Massachusetts, New Jersey, Rhode Island and the District of Columbia, have their own coverage requirements. In those places, short-term coverage generally does not satisfy the requirement.
Real-World Example
Consider a healthy 30-year-old who leaves a job in March and starts a new job with benefits in June. Options might include COBRA for about three months, a Marketplace plan through a special enrollment period, or a short-term plan. If this person is injured and needs surgery during the gap, the ACA plan or COBRA would cover it under standard rules, subject to deductibles and out-of-pocket limits. A short-term plan might cover it too, but only up to its caps, and only if the injury is not linked to a pre-existing condition. Comparing total possible costs, not just premiums, gives a clearer picture.
Frequently Asked Questions
Does short-term health insurance cover pre-existing conditions?
Usually not. Short-term plans are exempt from the ACA rule requiring coverage of pre-existing conditions, and many exclude them.
How long can short-term health insurance last in 2026?
It depends on your state. A 2024 federal rule set a four-month maximum, but federal agencies said in August 2025 they would not prioritize enforcing it, and some states now allow plans of up to 36 months.
Can I get a subsidy for a short-term plan?
No. Premium tax credits apply only to Marketplace plans.
Is short-term health insurance the same as a Marketplace plan?
No. Short-term plans are not ACA-compliant and can deny coverage, exclude benefits and cap payouts.
When is short-term insurance a reasonable choice?
It may fill a brief gap for healthy people who cannot get other coverage, but check special enrollment, COBRA, Medicaid and employer options first.
The Bottom Line
Short-term health insurance can cost less upfront, but it is a limited product with real gaps. It may exclude pre-existing conditions, essential benefits and high-cost care, and its length now depends largely on state rules. Before buying, compare it with a Marketplace plan, COBRA and Medicaid, read the policy carefully and confirm the insurer is licensed in your state.
