Short Term Limited Duration Plan Impact on The Individual Market

Jun 1, 2018
The U.S. Department of Health and Human Services (DHHS) released a final rule that will undermine high-quality, comprehensive insurance for adults, children, and especially for people with pre-existing conditions. The final rule on short-term limited duration plans (STLD) loosens requirements on insurance plans that can discriminate against people with pre-existing conditions, don’t have to cover essential benefits, don’t cover prescription drugs outside of the hospital setting, and otherwise, leave people unprotected from health and financial harms. Nevada Revised Statutes limit STLD plans 185 days.

It is more important than ever for consumers to carefully compare health insurance options to ensure the plan they select won’t leave them high and dry if they have an unexpected medical event. Oftentimes, these STLD plans are marketed as comprehensive health insurance, but they are NOT comprehensive. While some people may find that STLD plans offer lower premiums they offer far less coverage in return; which could mean higher costs in the end if a consumer gets sick or needs certain types of medical care. The rule from DHHS allows plans to deny coverage, or charge higher premiums because of pre-existing conditions, age, or gender. These plans may also drop consumers from their coverage if they are diagnosed with a medical condition after enrolling. Without the protections afforded in the Nevada Health Link Qualified Health Plans consumers who purchase STLD plans may think they have coverage but with little benefit. The following is a list of benefits that are NOT covered by STLD plans:

  • Maternity health care

  • Prescription drug coverage

  • Mental health care

  • Substance use disorder services

  • Preventative care – annual exams, check-ups, cancer screenings

  • Treatment for developmental delays

When choosing health insurance, always consult with a navigator, certified enrollment assister or licensed broker through Nevada Health Link. Use our in-person assistance tool to find a trained and certified individual in your area who can help you with the enrollment process one-on-one. If you miss open enrollment, you still have options. Certain qualifying life events (QLE) may make you eligible for a special enrollment period. QLE’s are life-changing events such as job loss, income change, marriage/divorce and birth/adoption of a child to name a few. 

Email us at for any additional questions you may have about Nevada health insurance plans and special enrollment period to see if you’re eligible today.