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Short-term health insurance in Florida

Florida does not limit the duration of short-term plans, and no longer limits pre-existing condition exclusions on plans that last more than six months

Florida’s short-term health insurance regulations

Until October 2, 2018, federal regulations limited short-term health insurance plans to no more than three months in duration, and prohibited renewals. The Trump Administration is now allowing for much longer short-term plans unless a state imposes its own restrictions.

Short-term health insurance in Florida does not limit the duration of plans beyond the federal rules, but prior to June 2019, the state had a statute that limited pre-existing condition exclusions on plans with terms of longer than six months. Florida Statute 627.6045 states that health plans cannot exclude pre-existing conditions for more than 24 months, and cannot look back more than 24 months to determine whether an applicant has pre-existing conditions. The law also says that a person who has prior continuous coverage (that’s at least as robust as the new coverage) during the 24 previous months is not subject to pre-existing condition exclusions. But prior to June 2019, it specifically exempted nonrenewable short-term plans with terms of no more than six months.

So if a short-term plan was nonrenewable and lasted no more than six months, the insurer could set its own rules regarding pre-existing conditions. But if the plan was renewable and/or had a term of more than six months, the insurer could only look at up to 24 months of medical history to determine whether pre-existing condition exclusions will apply, and could not impose pre-existing condition exclusions at all if the person had continuous creditable coverage during that time.

But in June 2019, Florida enacted S.322, which eliminated the requirement that the health plan be nonrenewable and last less than six months in order to be exempt from Florida’s pre-existing condition rules. The statute now simply says that it doesn’t apply to short-term health insurance in Florida as long as the plan discloses to the applicant that the policy will not cover pre-existing conditions and will not count as qualifying previous coverage if and when the person applies for a new policy under Florida’s pre-existing condition protection rules.

Even before Florida relaxed its rules for short-term plans, the majority of the short-term insurers in Florida were offering plans with initial terms in excess of six months. At least six other insurers were offering plans with initial terms of up to 12 months in late 2018, and some were allowing total duration, including renewals, of up to three years. A closer look at plan brochures for some of those insurers indicated that pre-existing condition lookback periods of up to five years were being used, so it was unclear how well insurers were complying with Florida’s rules regarding pre-existing conditions and longer short-term plans.

As of mid-2020, there are a variety of plans available in Florida with total durations of up to 36 months (including renewals). But Florida Blue confirmed that their short-term medical insurance policies are only available with terms of up to six months.

Short-term plans duration in Florida

There are no state-specific limitations on the allowable duration of short-term health insurance in Florida, so the state defaults to the federal regulations. Florida does not consider short-term health plans to be individual health insurance, which is the same as the federal approach. (This is why short-term plans are exempt from ACA regulation.)

Because Florida does not limit short-term plans, the Trump Administration’s new regulations apply in the state. Insurers can offer short-term plans with initial terms up to 364 days and the option to renew for a total duration of up to 36 months.

Insurers are allowed to cap their short-term plans at shorter durations, however, and prohibit renewal if they choose to do so.

Which insurers offer short-term plans in Florida

As of mid-2020, there were at least seven insurers offering short-term health insurance in Florida:

  • Aspen Insurance
  • Companion Life
  • Everest Reinsurance
  • Florida Blue
  • Independence American Insurance Company
  • National General
  • UnitedHealthcare (Golden Rule)

A health insurance agent or broker can help you compare the available options for short-term health insurance in Florida and decide which plan will be the best fit for you. Some things you’ll want to consider are the allowable plan durations (some insurers cap their plans at shorter durations than the maximum the state allows), whether the insurer offers guaranteed renewability, the specific health benefits the plan will provide, and the coverage limitations of the policy. For example, most short-term health insurance plans do not cover prescription drugs, but some do, so you’ll want to carefully read the details of the plan you’re considering.

You’ll also want to make sure you’re clear on whether the plan imposes specific dollar limits on services such as inpatient care, surgery, etc. (in addition to the plan’s overall benefit maximum). This is particularly important because some websites that sell short-term health insurance also sell fixed indemnity health plans and often present both options together, despite the fact that they are different types of coverage. Understanding your potential out-of-pocket costs before you enroll in the plan will help to prevent unwelcome surprises later on.

Who can get short-term health insurance in Florida

Short-term health insurance plans in Florida can be purchased by those who can meet the underwriting guidelines used by insurers. In general, this means being a resident of the Sunshine State under 65 years old (some insurers put the age limit at 64 years) and in fairly good health.

Short-term health insurance plans usually come with blanket exclusions for pre-existing conditions,  they are not adequate for someone who is in need of medical care and seeking a policy that will cover those needs.

If you’re in need of health insurance coverage in Florida, first determine whether you’re eligible to enroll in an ACA-compliant major medical plan (ie, an Obamacare plan). These plans are available during the annual open enrollment period that runs from November 1 to December 15. And they’re also available at other times of the year if you experience a qualifying life event that triggers a special enrollment period.

ACA-compliant plans can be purchased through the health insurance exchange in Florida, or directly from an insurance company, although premium subsidies are only available if you enroll through the exchange. If you do end up qualifying for premium subsidies (most exchange enrollees do), you may be surprised at how affordable the monthly premiums are after the subsidy is applied.

ACA-compliant policies are purchased on a month-to-month basis, so you can enroll in one even if you’re only going to need it for a few months before another policy takes effect. So for example, if you’ll soon be covered by an employer’s plan or Medicare, you can still enroll in an ACA-compliant plan during open enrollment or a special enrollment period, and then cancel the coverage when your new plan takes effect.

When should I consider short-term health insurance in Florida?

Whether you live in Miami or in the suburbs outside Tampa, there may be times when short-term health insurance is your only realistic option for coverage, such as:

  • You missed open enrollment for ACA-compliant individual market coverage (ie, Obamacare) or your employer’s healthcare plan, and do not have a qualifying event that would trigger a special enrollment period.
  • You’re newly employed but the business has a waiting period of up to three months before you can enroll in your employer’s healthcare plan.
  • You’ll soon be enrolled in Medicare, but have no other health insurance options in the meantime.
  • You’ve already enrolled in an ACA-complaint plan but have to wait up to several weeks before the insurance coverage takes effect.
  • You’re not eligible for Medicaid or a premium subsidy in the exchange, the monthly premiums for an ACA-compliant plan might simply be too costly.

People who are ineligible for premium subsidies include:

  • Those who earn more than 400% of the poverty level (for 2021 coverage, that amounts to $51,040 for a single person; if your ACA-specific modified adjusted gross income is just a little above the subsidy-eligible threshold, there are steps you can take to reduce it).
  • People caught by the ACA’s family glitch.
  • People who cannot enroll in a plan through the exchange because they are not lawfully present in the US (lawfully present immigrants can enroll through the exchange and can receive premium subsidies, but people who are not lawfully present cannot do either).

Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for Her state health exchange updates are regularly cited by media who cover health reform and by other health insurance experts.

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