Short-term health plans in West Virginia
- West Virginia defers to federal rules for the maximum duration of short-term health plans.
- Short-term health plans can have initial terms of up to 364 days, and total duration, including renewals, of up to 36 months.
- Opioid Reduction Act’s insurance provisions do apply to short-term health insurance in West Virginia.
- At least seven insurers offer short-term plans in West Virginia.
West Virginia’s short-term health insurance regulations
Insurers that offer short-term health insurance in West Virginia are required to file rates and plans with the West Virginia Office of the Insurance Commissioner. The state passed legislation (SB273) in 2018 designed to reduce opioid utilization, and the Office of the Insurance Commissioner confirmed that the insurance-related provisions of that bill do apply to short-term plans.
Short-term plans duration in West Virginia
West Virginia does not have regulations pertaining to the maximum duration for short-term health insurance plans, so the state defaults to the federal rules for short-term plan duration.
Until October 2, 2018, federal rules limited short-term plans to three months and renewals were not permitted. But the Trump Administration implemented new short-term insurance rules at that point, allowing the plans to have initial durations of up to 364 days. Renewals are permitted as long as the total duration of the coverage doesn’t exceed 36 months.
But renewability is optional for insurers, and insurers can choose to offer plans with shorter terms. Some of the insurers that offer short-term health insurance in West Virginia cap their terms at six months and don’t allow for any renewals.
- Aspen Insurance
- Companion Life
- Everest Reinsurance
- Golden Rule (UnitedHealthcare)
- Independence American Insurance Company
- National General
- Standard Life
Who can get short-term health insurance in West Virginia
Short-term health insurance plans in West Virginia 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.
Since short-term health insurance plans typically include 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 West Virginia, first determine if you’re eligible for a special enrollment period that would allow enrollment 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 West Virginia. ACA 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 only keep it for a few months before another policy takes effect.
When should I consider short-term health insurance in West Virginia?
- You missed open enrollment for ACA-compliant individual market coverage and do not have a qualifying event that would trigger a special enrollment period.
- You’re not eligible for Medicaid or a premium subsidy in the exchange, the monthly premiums for ACA-compliant plans might be too costly.
People ineligible for premium subsidies include:
- Those earning more than 400% of the poverty level. (For 2021 coverage, that is $51,040 for a single person. If your ACA-specific modified adjusted gross income is somewhat above the subsidy-eligibility, there are steps you can take to reduce it).
- People trapped in the ACA’s family glitch.
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.