Will a Short-Term Insurance Plan Cover My Prescription? Probably Not.
But that lower price means that these new plans will offer a lot less coverage than what other existing plans offer, including those mandated by the Affordable Care Act (ACA).
Here’s a look at the upsides and downsides of these short-term plans.
What they cover
Don’t expect these short-term plans to cover everything that other insurance does. There’s a long list of exceptions, starting with prescription drugs. A Kaiser Family Foundation study found that only 29% of short-term plans will help pay for prescription medications. People on these plans will have to find other ways to reduce the cost of their medications, such as using the discounts and coupons on GoodRx.
“Only 29% of short-term plans cover prescription medications.”
These plans also often don’t cover maternity care, mental health care, preventive care, treatment for sports injuries, many surgeries, and other commonly used benefits.
The plans vary from state to state, so be sure to read the fine print about coverage and exceptions before you sign up.
What they cost
One advantage of the short-term plans is that they’re much cheaper than ACA coverage—at least at first. Rates vary by location, but in Chicago, for example, while a bronze level ACA plan costs about $300 per month, rates for short-term plans start at just $55 per month.
But watch out: many of these plans have hefty cost-sharing built into their design. So, that $55 plan could still stick you with up to $22,500 in out-of-pocket expenses before any coverage kicks in. And they typically cap the coverage at between $250,000 and $2 million. That means, if something really bad happens, these plans might not cover all costs incurred.
Who can get them
Here’s a big catch: these short-term plans aren’t available to just anyone. For the most part, they won’t accept people with pre-existing conditions (and who doesn’t have some sort of pre-existing condition these days?). So if you have a medical history, you could be denied coverage.
How to fill in the gaps
If you are thinking of getting a short-term plan, be sure to check its coverage—including exceptions and limits—and shop around. And know that you’ll have to fill in coverage gaps for things like prescription drugs on your own. This is where GoodRx can help—our discounts often mean prices that are equal or even lower than insurance prices.
So if you do need a prescription filled when you’re on a short-term plan, be sure to check prices and get the best possible discount coupon you can find.
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