What are Short Term Limited Duration Plans? What do they cover?
The U.S. Department of Health and Human Services (DHHS) recent final rules on Short-Term Limited-Duration Insurance mean that some insurers may now offer products that don’t adhere to previous Affordable Care Act (ACA) requirements.
These short term plans 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 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 Administrative Code (NAC) limit short term plans to 185 days.
It is more important than ever for consumers to carefully compare health insurance options to make sure the plan they select won’t leave them high and dry if they have an unexpected medical event. Oftentimes, these Short Term Limited Durations Plans are marketed as comprehensive health insurance, but they are NOT comprehensive. While some people may find that short term 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 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 Short Term Limited Durations Plans may think they have coverage but with little benefit.
The following is a list of benefits that are NOT covered by short term 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