Short-term health plans in New Hampshire
- Short-term health insurance in New Hampshire is limited to six months and cannot be renewed.
- Consumers can’t buy a short-term plan if they’ve had more than 540 days of short-term coverage in the past 24 months.
- At least one insurer offers short-term health insurance in New Hampshire, and another was approved as of mid-2021.
New Hampshire’s short-term health insurance regulations
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.
Short-term plans duration in New Hampshire
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.
A short-term plan also cannot be issued to anyone 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 are 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.
Which insurers offer short-term plans in New Hampshire?
As of mid-2021, the New Hampshire Insurance Department had just one insurer, Independence American Insurance Company, listed as offering short-term health plans in the state.
But SERFF filing data (filing number AMMS-132655853) indicate that Golden Rule (part of UnitedHealthcare) received approval for new short-term health plans from the New Hampshire Insurance Department in mid-2021. As of September 2021, it appeared that those plans were not yet for sale, as Golden Rule’s New Hampshire products were still limited to dental plans. But if and when the company starts to market their short-term plans in New Hampshire, there should be products available from both Independence American and Golden Rule.
Who can buy short-term health insurance in New Hampshire?
Short-term health insurance in New Hampshire can be purchased by residents who can meet the underwriting guidelines that insurers use. In general, this means being under 65 years old and in fairly good health.
Short-term health medical insurance plans typically include blanket exclusions for pre-existing conditions, so these types of plans are not adequate for someone in the Granite State who needs medical care for ongoing or pre-existing conditions.
And short-term health plans do not have to cover the essential health benefits (prescription drugs, maternity care, and mental health care are the most commonly excluded) and can impose caps on the maximum amount they’ll spend on your medical costs.
If you’re in New Hampshire and need health insurance, your first step should be to see whether you’re eligible for a special enrollment period that would allow you to enroll in an ACA-compliant major medical plan. 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 in New Hampshire (HealthCare.gov).
These 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 even less expensive than a short-term plan (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 falls within the eligible range).
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 for 2022, making ACA-compliant coverage more affordable than it’s been in prior years.
When should I consider short-term health insurance in New Hampshire?
The New Hampshire Insurance Department has a comprehensive guide for consumers, outlining the questions people should ask themselves before opting for a short-term medical plan.
But 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 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 prior to enrolling in Medicare did not cover your pre-existing conditions.
- If you’re losing access to an employer’s plan mid-month. In this case, you’ll qualify for a special enrollment period to buy a plan in the marketplace, but it won’t take effect until the start of the next month. A short-term plan could be used to cover you for the gap you’d otherwise have (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. This includes people caught by the ACA’s family glitch. This happens when a person is employed by a company that provides affordable coverage for employees, but the costs to add family members are mostly or fully payroll deducted, making the total family premium unaffordable — and the family is also ineligible for premium subsidies in the marketplace.
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.
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 healthinsurance.org. Her state health exchange updates are regularly cited by media who cover health reform and by other health insurance experts.