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Humana Short-Term Plans

A host of different policies make healthcare coverage affordable with Humana. The company also participates in the Affordable Care Act (ACA) marketplace exchanges, popularly known as “Obamacare,” so consumers can choose either major medical plans or more budget-friendly Humana short-term plans.

How Humana Short-term Plans Work

Generally, Humana short-term plans are less expensive than ACA-compliant health plans because they don’t offer the same level of coverage. These temporary plans are intended for people who don’t want or cannot afford major medical insurance or have a situation in which a temporary form of limited coverage makes sense.

These temporary plans do have a few restrictions, however. If you’re healthy and need medical coverage due to a job change or other life circumstance, you may want to consider a short-term health plan.

One important factor to keep in mind when evaluating these plans is that there is a possibility that you might be rejected because there’s no government rule that requires the insurer to accept you as a member.

Another factor to consider is that short-term plans don’t cover preexisting conditions—any health issues or other conditions that exist at the time of application. If you’re currently receiving treatment for an injury or illness such as diabetes or hypertension or you’ve been diagnosed with a health condition in the past, these won’t be covered and you’ll probably be rejected for a short-term plan.

It’s important that you review plan conditions and exclusions carefully when evaluating short-term plans and before applying for enrollment. After a short-term plan expires, members are required to reapply to receive further benefits.

Members should be aware that if they’re accepted for an additional term under Humana short-term plans, any deductible and other amounts will renew. Basically, the policy will begin… again.

This also applies as to whether you have preexisting conditions at the time of renewal that may have been covered under the previous term. Your medical condition that was covered initially may be deemed to be preexisting, which may restrict your ability to reapply.

Short-term Healthcare

Humana short-term plans offer various benefits.

SB 50/10000

A short-term plan with a duration of three months, SB 50/10000 lets you cancel coverage each month or extend the policy after the end of the term. This isn’t a “preferred provider organization” (PPO) or an “exclusive provider organization” (EPO) so out-of-network providers are covered.

SB 50/10000 is an indemnity plan, meaning that members have much more freedom in the choice of doctors and hospitals, but they’re responsible for coordinating billing and reimbursement. This plan isn’t eligible for a Health Savings Account (HSA).

Once Humana members meet the $10,000 deductible, coinsurance kicks in, and the company pays half of covered medical expenses, with plan enrollees covering the other 50 percent. The coinsurance ends once members meet a limit of $20,000 for out-of-pocket services for the term of the policy. The company pays up to a maximum of $2 million for covered medical expenses.

A visit to the doctor or a specialist will cost members a 50-percent coinsurance once the deductible has been met. Outpatient lab or X-ray, outpatient surgery, and hospitalization are also 50-percent coinsurance after the deductible has been paid.

Prescriptions for covered inpatient injuries or illness have a 50-percent coinsurance after the deductible for both brand-name and generic medications. Outpatient prescriptions aren’t covered, but a discount is available.

This Humana short-term plan doesn’t have a separate deductible for prescriptions, and mail-order prescription service isn’t available. There is no coverage for medical services outside of the country.

There is no charge for periodic obstetric or gynecological (ob/gyn) exams. Not covered are well-baby care or periodic health checkups. Due to the very low premiums, this plan doesn’t cover chiropractic or mental health services.

Before You Enroll

Humana advises that applicants shouldn’t cancel any existing health insurance coverage or decline Consolidated Omnibus Budget Reconciliation Act (COBRA) benefits until they receive an approval letter and insurance policy (also known as an insurance contract or certificate). When evaluating a plan, make sure you understand and agree with the terms of the policy.

Humana short-term plans include several options for six months of coverage under EPO and PPO plans. Many Humana healthcare plans don’t cover chiropractic or mental health services.

Deductibles, limits, coinsurance, and prescription plans vary for these policies. In addition, there are additional restrictions for maternity care and well-baby care. You should pay special attention to the effective date, premium amount, waiting period, benefits, limitations, exclusions, and riders. Premiums are subject to change based on the optional benefits you choose (if any) and other factors such as rate changes that take effect before the start date of the policy.

Consumers interested in Humana short-term plans should refer to plan documentation for more detailed information.

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