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What Do Short-Term Healthcare Insurance Plans Cover

If you’re researching short-term healthcare insurance plans, you may wonder what you can expect to be covered. One benefit of temporary policies is that often they can be customized to meet your needs.

While each one is different, there are general guidelines for what is and isn’t covered. These aren’t hard-and-fast rules, but more of what’s typically offered so you can determine whether a temporary plan is right for you.

Will you be left paying the hospital bill should you need an emergency appendectomy? If you need a thyroid test, can you expect that to be covered as well? And what happens if your old tennis elbow injury flares up?

What might seem like a minor issue is actually a pertinent coverage question you should fully understand before enrolling in any healthcare plan.

While policies vary, most temporary healthcare insurance covers care and treatment due to an illness or injury—with some restrictions. Benefits are detailed before you sign up so you’ll want to review all documents carefully before making a decision.

A word of caution is in order. Preexisting health conditions are usually not covered by a temporary health plan.

If you have a medical condition such as diabetes, hypertension, pregnancy, or have had a heart attack or stroke in the past, this will likely affect your acceptance in a health plan. Unlike major medical coverage, your application for coverage may be declined for preexisting conditions under a temporary plan.

Before signing up, spend some time reviewing various plans’ benefits and exclusions. If you don’t understand a provision, ask your insurance plan representative for clarification before you enroll.

What’s Covered

As a general rule, covered expenses include doctor’s visits, diagnostic services such as laboratory work and x-rays, emergency services, surgery, and hospital stays. You can expect most short-term healthcare insurance plans to cover high-dollar expenses incurred should you fall suddenly ill or become injure–with certain limitations.

However, just because your doctor orders a test, it doesn’t mean that it’s automatically or fully covered. For instance, you may have blood drawn, and your primary care physician may opt to have additional tests run at the same time that may not be covered.

You might end up being responsible for a portion of a diagnostic procedure. Don’t assume your doctor’s office knows what’s covered by your specific short term health plan or which laboratories are in network.

Even if your medical plan covers injuries and illnesses, this doesn’t mean all illnesses and injuries are covered. And neither are all treatments, tests, services, and healthcare facilities. This is why it’s crucial to evaluate each plan and familiarize yourself with differences in healthcare coverage.

Just because you’re sick or hurt and need care doesn’t mean that the expenses of being treated will be covered.

What’s Not Covered

Most of us are more concerned about what a policy doesn’t cover. Again, while each company is different, you can expect that short-term healthcare insurance plans won’t cover preexisting conditions or injuries from participating in “extreme” sports or dangerous activities such as BASE jumping or hang gliding.

In other words, if you have temporary medical coverage, this may not be the best time to climb Mount Everest or learn kite-surfing. Avoiding dangerous situations or activities is usually better for your health in the long run, anyway.

Also, don’t expect your medical expenses to be covered for injuries as a result of racing vehicles such as a motorcycle, dirt-bike, boat, or aircraft. Or those from riding an all-terrain vehicle, snowmobile, or similar. Most sports-related injuries aren’t covered by temporary plans either

What If I’ve More Questions

It’s difficult to detail everything that short-term healthcare insurance plans will and won’t cover, especially since they’re not all the same. That’s why you should evaluate each temporary health plan’s benefits carefully. It’s tempting to assume that if one diagnostic test is covered, then all tests probably will be, but that’s not the case.

Moreover, don’t assume that any illness or injury that’s not specifically addressed in a plan’s benefits is covered. Make sure that you raise these questions before enrolling in a short-term plan—even if you feel it’s unlikely that you’ll need treatment.

Understanding the provisions of the short-term healthcare insurance plans you’re considering before you enroll will save you time, money, and frustration. Your insurance company representative can address specific questions if they’re not detailed in the description of coverage and benefits.

Last but not least, you might want to write down your needs, be clear regarding your expectations, and make sure that the healthcare plan you select meets your requirements.


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