Frequently asked questions about
short-term health insurance in Ohio
Yes. There are at least nine insurers offering short-term health insurance in Ohio, including some that also offer ACA-compliant coverage through Ohio’s marketplace.
The Ohio Department of Insurance published Bulletin 2018-05 in October 2018, outlining rules for short-term health insurance in Ohio. The bulletin notes that while short-term plan duration can extend up to 364 days, the plans must be “one-time” policies in order to be exempt from many of the state’s rules for sickness and accident policies. The Department confirmed that “one-time” means that the plans cannot be renewable.
However, it is possible to apply for a new short-term policy after the first one ends.
Until October 2, 2018, federal regulations limited short-term health insurance plans to no more than three months in duration, and prohibited renewals. But new rules finalized by the Trump administration in 2018 allow for much longer short-term plans, unless a state imposes its own restrictions.
Bulletin 2018-05 clarifies that even non-renewable short-term health insurance in Ohio must comply with certain state requirements, including (but not limited to):
- Internal and external reviews
- Provider network details must be disclosed to the consumer
- Certain care must be covered, including mammograms, autism spectrum disorder treatment, and newborn care.
While Ohio statute does not technically define short-term health insurance plans, the policies essentially have to be non-renewable, as they would otherwise have to conform to all of the state’s rules that apply to regular individual major medical plans.
But as Anthem has clarified regarding their Enhanced Choice short-term plans, Ohio residents are allowed to apply for another short-term policy after the first one ends (but this would be a new application, as opposed to the continuation of an existing plan).
The Ohio Department of Insurance also published a consumer alert about short-term coverage in October 2018, cautioning residents to read the fine print on short-term plans and understand the out-of-pocket costs (such as the monthly premium, a deductible, or copayments/coinsurance) that they might have to pay in various scenarios.
As of 2022, there were at least nine insurers offering short-term health insurance in Ohio:
- Anthem Enhanced Choice (Anthem also offers ACA-compliant coverage)
- Companion Life
- Everest Insurance
- Medical Mutual (also offers ACA-compliant coverage)
- National General
- The North River Insurance Company
- Paramount/ProMedica (also offers ACA-compliant coverage)
- Standard Life
- UnitedHealthcare (Golden Rule)
Short-term health insurance in Ohio can be purchased by residents who meet the underwriting guidelines used by insurers. This generally means applicants under 65 years old (some insurers put the age limit at 64 years) who are in fairly good health.
Short-term healthcare insurance plans typically include blanket exclusions for pre-existing conditions. Accordingly, they typically do not provide adequate coverage for someone who needs ongoing treatment for a chronic condition.
If you need to enroll in health insurance coverage in the Buckeye State outside of the annual open enrollment period for major medical coverage, the first step should be to check your eligibility for a special enrollment period. If you’re eligible for one, you may be able to enroll in an ACA-compliant major medical plan, even outside of open enrollment.
A variety of qualifying life events will trigger a special enrollment period and allow you to buy a plan through the health insurance exchange in Ohio. These plans are purchased on a month-to-month basis, so you can enroll in one (with a premium subsidy if you’re eligible) even if you’re only going to need it for a few months before another policy takes effect.
Despite the limitations of short-term coverage (e.g., exclusion of pre-existing conditions, no coverage for outpatient prescription drugs, etc.), there are times when a short-term health insurance policy might be the least costly and most realistic option to use:
- 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 are newly employed and have a waiting period until you can be covered by your new employer’s health insurance plan; short-term insurance may provide a much more affordable (but less comprehensive) stopgap than COBRA or an ACA-compliant plan. (Note that if your transition period is fairly short, COBRA can be used as a “free” alternative if you don’t end up needing medical care. This is because you have 60 days to sign up for COBRA. If you do so, even at the very end of that window, your coverage gets backdated to the first day you would have otherwise been uninsured. If you don’t end up needing medical care during that period, you can simply not sign up for COBRA. But note that this is a time-limited opportunity, so it won’t work if your gap in coverage is going to be more than 60 days.)
- If you will soon be eligible for Medicare.
- If you’re not eligible for Medicaid or a premium subsidy in the exchange, an ACA-compliant plan might be unaffordable.
People not eligible for premium subsidies include:
- Ohioans who earn too much money to be subsidy-eligible. Through at least the end of 2022, there is no longer a set income cap for subsidy eligibility, thanks to the American Rescue Plan. But for people who earn more than 400% of the poverty level, subsidies aren’t available if the full-price cost of the benchmark plan would be less than 8.5% of your ACA-specific modified adjusted gross income.
- People ensnared by the ACA’s family glitch (note that the Biden administration is working on a fix for the family glitch that’s expected to be in place by 2023).