Understanding short-term health plans

Short-term health plans

In the past few years, federal regulations regarding short-term health insurance policies have allowed an expansion of that type of plan. The biggest change: increasing the length of coverage allowed under these plans from three months to 364 days.

Short-term health plans are often geared toward those who find themselves without health coverage for a number of reasons. Health insurance can help individuals and families avoid major financial loss should an accident or illness happen. A short-term plan can help bridge the gap so you don’t have to go without coverage.

Final numbers are not yet available, but the Department of Health and Human Services (HHS) estimates that the new rules would result in 600,000 people signing up for short-term plans in 2019 who either had individual marketplace plans or no coverage at all. By 2028, HHS projects a total increase of customers with short-term insurance to 1.4 million people.

Who should buy a short-term health plan?

These types of plans are ideal for people who are:

  • In between Open Enrollment Periods and can’t get coverage
  • Looking for an alternative to standard individual health plans
  • Not qualified for subsidies under the Affordable Care Act (ACA) and can’t afford a health plan through the Federally Facilitated Marketplace
  • Recent college graduates
  • Newly employed and waiting for health benefits to begin
  • Part-time or temporary employees who don’t have benefits
  • Between jobs and looking for an affordable alternative to COBRA
  • Recently retired and waiting for Medicare eligibility

How does short-term coverage work?

One benefit of a short-term health plan is that you can choose the coverage period.

For example, with a WPS Short-Term Health Plan, coverage can range from 30 to 364 days. You can apply for a new plan when the initial one ends, but the combined coverage period may not be more than 18 months. And, coverage can begin right away—as in, tomorrow if you choose.

Answers to frequently asked questions about WPS Short-Term Health Plan

Are my pre-existing conditions covered?

No, the short-term plan will not cover pre-existing conditions. Additionally, if you purchase a subsequent policy, the health plan might not provide coverage for pre-existing conditions.

When does my coverage take effect?
Coverage begins the day after the online application is submitted or the postmark date of the paper application and as late as 60 days from the date you sign your application. Coverage will not be in effect unless a full month’s premium has been collected.

What providers can I see?

The WPS Short-Term Health Plan uses the WPS Statewide Network. This network includes more than 15,000 health care providers, a wide range of clinics and specialty care centers, and 138 hospitals throughout Wisconsin, as well as parts of Illinois, Iowa, and Minnesota. If you receive care outside of the WPS Statewide Network, benefits may be reduced, claims will be subject to a maximum allowable charge, and the provider may bill you for charges above the maximum allowable fees.

Do I have coverage outside of Wisconsin?

Yes, this plan offers out-of-network benefits at a higher out-of-pocket cost.

What happens if I move out of Wisconsin?
If you move outside of Wisconsin after the policy is in effect, you can retain the policy for the duration of the policy term. Once the policy term expires, you will no longer be eligible for another term.

What are my payment options?

You can pay your premium by credit card, automatic bank withdrawal, or check. There are no fees applied to any payment options. We accept Visa, Mastercard, and Discover. There is a 2% discount applied when paying through automatic withdrawal.

Questions?

If you want to learn more about WPS Short-Term Health Plan—including plan options, a summary of covered and noncovered services, and network options—visit our website or contact one of our sales associates at 800-332-6421.

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