Availability of short-term health insurance in New Hampshire

No. As of 2024, it appears that no insurers are offering short-term health insurance in New Hampshire.

There had been one as of 2022, but they no longer offered short-term plans as of 2023, and the New Hampshire Insurance Department confirmed that no other insurers had taken their place at that point.

In 2024, the New Hampshire Insurance Department noted that there were some approved filings in SERFF for short-term health insurance.¹ But only one was current (Golden Rule) and the carrier did not appear to be actively marketing short-term health insurance in the state.

Short-term health insurance in New Hampshire can’t exceed six months in duration, and cannot be renewed. Enrollees are allowed to apply for a new short-term plan that can take effect after the first plan ends, but it has to be a new, separate plan, with a new deductible and out-of-pocket exposure.²

A short-term plan also cannot be issued to anyone in New Hampshire who has had more than 540 days of short-term coverage in the past 24 months. So a person can’t have more than a year and a half of short-term coverage in a given two-year period.

This effectively prevents people from stringing together multiple short-term policies, back-to-back, in place of an ACA-compliant plan (essentially, you can have up to three short-term plans, and then you’d have to take a break from short-term coverage for at least a year before you could buy another short-term plan.

Here’s the wording of New Hampshire’s regulation:

“Nonrenewable, individual health insurance policies which provide medical, hospital, or major medical expense benefits for a specified term may be delivered or issued for delivery to any person in this state for purposes of providing short-term, interim coverage only and no such policy shall provide coverage for a specified term in excess of 6 months, nor shall any such policy be issued in this state to a person who was previously covered under short-term medical policies providing in total more than 540 days of coverage within the preceding 24-month period.”

The Trump administration’s relaxed rules for short-term plan duration were clear in stating that states may continue to impose tighter regulations than the new federal rules. So short-term plans in New Hampshire continue to have maximum terms of six months and are nonrenewable.

The Biden administration has finalized a rule change that will sharply limit short-term policies, capping total duration, including renewals, at four months, for policies issued or sold starting in September 2024. This will supersede more lenient state rules.

But as noted above, no insurers sell short-term health insurance plans in New Hampshire as of 2024.

As of 2022, the New Hampshire Insurance Department had just one insurer, Independence American Insurance Company, listed as offering short-term health plans in the state.

But Independence American stopped offering short-term health insurance at the end of 2022, and the insurance department confirmed in early 2023 that no insurers were offering short-term plans in the state.

That appears to still be the case as of 2024, as the only insurer that’s listed with a currently approved filing in New Hampshire SERFF does not appear to be actively marketing short-term coverage.¹

Short-term health insurance in New Hampshire is not available as of 2024, as there are no insurers offering these plans in the state.

If you’re in New Hampshire and need health insurance, your first step should be to see whether you’re eligible to enroll in an ACA-compliant major medical plan.

These plans can be obtained during open enrollment (November 1 through January 15) or during a special enrollment period. There are a variety of qualifying life events that will trigger a special enrollment period and allow you to buy a plan through the health insurance exchange/Marketplace in New Hampshire (HealthCare.gov).

ACA-compliant major medical plans are purchased on a month-to-month basis, so you can enroll in a plan even if you only need coverage for a few months before another policy takes effect.

And if your annual household income makes you eligible for a premium subsidy, you might find that an ACA-compliant plan is much less expensive than you expected (you can qualify for a premium subsidy that will be prorated for just the months you need coverage, as long as your total annual income makes you eligible for a subsidy).

The annual open enrollment period for ACA-compliant coverage runs from November 1 to January 15. You do not need a qualifying event to sign up during this window. And it’s worth noting that the American Rescue Plan’s premium subsidy enhancements will continue to be available through at least 2025, making ACA-compliant coverage more affordable than it was before 2021.

Although there are no short-term health plans available in New Hampshire as of 2024, the New Hampshire Insurance Department still has a comprehensive guide for consumers, outlining the questions people should ask themselves before opting for a short-term medical plan. This will be relevant if short-term health plans become available again in the state in the future.

If and when short-term plans become available in New Hampshire, there may be times when a short-term health plan might be the only realistic option, or the best option to meet your needs for a short while, such as:

• If you missed open enrollment for ACA-compliant coverage and do not have a qualifying event that would trigger a special enrollment period.
• If you’re newly employed and the coverage that your employer provides has a waiting period. In that case, a short-term term could cover you against unexpected medical costs while you wait for your new job-sponsored coverage to take effect (if you also have a qualifying event, you could enroll in an ACA-compliant plan through the New Hampshire Health Insurance Marketplace instead, and cancel it when your employer’s coverage takes effect).
• If you’ll soon be enrolled in Medicare, but need coverage until that point and don’t have access to an employer-sponsored plan or a qualifying event that would allow you to sign up for an ACA-compliant plan through the New Hampshire marketplace. Note that although Medicare covers pre-existing conditions regardless of coverage history, Medigap insurers can impose a pre-existing condition waiting period if the policy you had before enrolling in Medicare did not cover your pre-existing conditions.
• If you’re losing access to an employer’s plan mid-month, you can use a short-term policy to cover you for the rest of that month. But as of 2024, the Health Insurance Marketplace will allow you to enroll in a Marketplace plan effective the first of the month when your coverage will end (instead of the first of the following month, which was the only option prior to 2024).³ This would entail double coverage for the first part of the month, but would eliminate the need for a short-term bridge plan. (Note that if COBRA or state continuation is available, you can use that as a fall-back plan instead, since coverage would be retroactive to the date you lost your employer-sponsored coverage.)
• If you’re not eligible for Medicaid or a premium subsidy in the exchange, the monthly premiums for an ACA-compliant plan might be unaffordable.

Learn more about Medicaid in New Hampshire, which might be an option depending on your current monthly household income, and which would provide more robust coverage than a short-term health plan.

The Granite State has its own regulations and coverage requirements pertaining to short-term health insurance in New Hampshire. The state has also published guidance and information for consumers, highlighting the many ways that short-term healthcare insurance plans offer less robust protections than ACA-compliant plans.

Until October 2, 2018, federal regulations limited short-term plans to no more than three months in duration, and prohibited renewals. But the Trump administration changed the rules at that point, allowing much longer durations for short-term insurance. If states have their own restrictions, however, the state rules apply instead, and New Hampshire is an example of this.

The Biden administration’s stricter rules will supersede more lenient state rules. But as noted above, there are currently no insurers that offer short-term policies in New Hampshire, so the allowable durations are a moot point for the time being.