Illinois Short Term Health Insurance


stm-comp


Short Term Health Plans

FREE Online Quote

A Short Term Medical Plan is temporary medical insurance that provides comprehensive protection against unexpected health care health care expenses. Policies can be purchases from 30 to 360 days. The application process is simple with only a few qualifying questions to answer and coverage can begin as early as the next day.

 

Starting April 1, 2017 short-term plans are limited up to a maximum of 90 days until 2018. You may purchase an additional policy up to an additional 90 days as long as you qualify.

Short Term Medical Insurance is perfect for individuals who are:
  • Recent college graduates
  • Between jobs or laid off
  • Waiting for employer-sponsored coverage
  • Losing dependent status
  • Looking for a lower-cost alternative to COBRA
  • Recently retired and not eligible for Medicare
  • On strike

unitedhealthone
FREE Online Quote

The United HealthOne short-term medical plans allow you to choose your doctors and hospitals and pays for all covered expenses once your deductible and coinsurance amounts have been met. First, you pay your deductible, next United HealthOne Health pays 80% or 70% of the next $5,000 or $10,000 depending on which plan benefits you choose (this is called your coinsurance).

Once your deductible and coinsurance are paid, United HealthOne pays 100% up to the policy limits of $1 or $1.5 Million.

The 80% and 70% are both available with the $2,500, $5,000, and $10,000 deductible options.

Benefit Short Term Medical Value Short Term Medical Plus Short Term Medical Copay Value Short Term Medical Plus Elite
Get Quote Get Quote Get Quote Get Quote
Length of Coverage 30 – 90 days
Up to 6 monthly payments
30 – 90 days
Up to 12 months payments
30- 90 days
Up to 6 monthly payments
30 – 90 days
Up to 12 monthly payments
Deductible
Amount you pay toward covered expenses before the plan pays benefits
$1,000, $1,500, $2,500, $5,000, or $10,000 $1,000, $1,500, $2,500, $5,000, or $10,000 $1,000, $1,500, $2,500, $5,000, or $10,000 $1,000, $1,500, $2,500, $5,000, or $10,000
Rate of Payment (Coinsurance)
Percentage of covered expenses we pay after the deductible
70% after deductible 80% or 70% after deductible 70% after deductible 80% or 70% after deductible
Out-of-Pocket Maximum
The amount of money an individual pays toward covered hospital and medical expenses. Does not include deductible
For the 80% option, the out-of-pocket maximum is $5,000 per individual.

For the 70% option, the out-of-pocket maximum is $10,000 per individual.

For the 80% option, the out-of-pocket maximum is $2,000 per individual.

For the 70% option, the out-of-pocket maximum is $5,000 per individual.

For both the 80% and 70% option, the out-of-pocket maximum is $10,000 per individual. For the 80% option, the out-of-pocket maximum is $2,000 per individual.
For the 70% option, the out-of-pocket maximum is $5,000 per individual.
Prescription Drugs Not Covered – Discount Card included that can save an average of 20-25% on your Rx drugs Covered at 70% or 80% after deductible. Option to add $20 Rx generic copay available Option to add $20 Rx generic copay or add Rx coverage that pays 70% after deductible. Preferred Price Card included (you pay for prescriptions at point of sale, at lowest price available, and submit claim to UHC for reimbursement Covered at 70% or 80% after deductible with Preferred Price Card included. Option to add $20 Rx generic copay available
Lifetime Benefit Maximum
The total maximum amount the plan pays
$1 million $1.5 million $1.5 million $1.5 million
  • Rate of payment (coinsurance) options: 80/20 or 70/30 – you pay 20% or 30% after the deductible.
  • Lifetime Maximum Benefit is the total benefit that can be paid out over the lifetime of the policy (effective dates of the policy). You may choose to increase your Lifetime Maximum Benefit by upgrading your policy at the time of enrollment/purchase.

National General Short Term

FREE Online Quote

National General’s Short Term Medical insurance gives you a plan to face those unpredictable moments in life with confidence. It provides the financial protection you need from unexpected medical bills and other health care expenses, including

  • Doctor visits and some preventive care
  • Emergency room and ambulance coverage
  • Urgent care benefits, and more

National General Health Insurance Feature Highlights

  • Coverage Period Maximum of $250,000 and $1,500,000
  • Deductible options of $1,000, $2,500, or $5,000
  • Coinsurance Percentage of In-Network plan 100/0, 80/20, 70/30, and 50/50
  • Doctor Office Visit and Urgent Care Co-pay of $50

Choose Your Provider

National General’s Short Term Medical insurance gives you access to the Aetna Open Choice PPO network, one of the largest networks in the country with no referral required.
Aetna PPO Provider Finder

Short Term Health Insurance and Network Breadth

While more than half of ACA plans lack out-of-network coverage,14 all short term insurance plans offered through AgileHealthInsurance have broad network coverage ensuring that an enrollee has access to quality health care providers. If an enrollee goes out of network and finds that the provider does not accept their short term insurance, in many cases, the enrollee can get reimbursed by submitting their claim to the insurance company. To be sure, enrollees should check with their insurance company first.

Short Term insurance plan premiums are also significantly less expensive than unsubsidized premiums for health plans sold on the exchanges. Compared to the average costs for 2016 Obamacare bronze plans for individuals aged 30, 40, and 50, short term insurance plans are 25 percent less expensive. Savings are greater for younger individuals without pre-existing conditions. For healthy males, aged 30, a short term insurance premium is 54.93% less expensive than an Obamacare Bronze plan.15

It should be noted that unlike ACA plans, short term insurance plans do not cover medical conditions that existed prior to enrollment.

Blue Cross BlueShield of Illinois
FREE Online Quote

BCBSIL SelectTemp PPO Plans were discontinued January 1, 2016

The Blue Cross and Blue Shield of Illinois SelecTEMP PPO Plan is an affordable short-term health insurance plan that provides individuals and families essential protection against unexpected accidents or illness. This plan utilizes the Blue Cross Blue Shield PPO network of doctors and hospitals and provides coverage from 1 month – 11 months.

SelecTEMP PPO is your temporary health insurance solution if you are:

  • Experiencing a gap in employer coverage or can’t afford COBRA.
  • Waiting for employer coverage to begin.
  • Between jobs or laid off
  • Losing dependent status
  • Looking for a lower-cost alternative to COBRA
  • Recently graduated and still seeking your dream job.
  • Age 64 and about to retire, but not yet eligible for Medicare.

SelecTEMP PPO covers many of the most costly health care services, including:

  • Inpatient and outpatient medical, surgical and hospital services.
  • Diagnostic services.
  • Emergency care
  • Office visits
  • Prescription drug coverage
  • Physical, occupation and speech therapy

SelectTemp PPO – Summary of Coverage

In-Network
Out-of-Network
Length of Coverage 1 – 11 months Get Quote
Deductible (individual)
Amount you pay toward covered expenses before the plan pays benefits.The family deductible is 2 times the individual deductible.
$500
$1,000
$1,500
$2,000
$2,500
$5,000
$1,000
$2,000
$3,000
$4,000
$5,000
$10,000
Rate of Payment (Coinsurance)
Percentage of covered expenses BCBS pays after the deductible
80% 60%
Out-of-Pocket Maximum
The amount of money an individual pays toward covered hospital and medical expenses. Does not include deductible
$1,000

($2,000 for 2 or more individuals)

$2,000

($4,000 for 2 or more individuals)

Lifetime Benefit Maximum
The total maximum amount the plan pays
$1.5 million $1.5 million

Short Term Medical vs. COBRA

A short term health plan is an excellent alternative to expensive COBRA premiums for most healthy individuals. Individuals who will need (or soon need) medical care for an existing chronic medical condition should elect COBRA since short term medical insurance does not cover pre-existing conditions. The table below illustrates the major differences between short term health insurance and COBRA.

Short-term medical insurance vs. COBRA

Short Term Medical COBRA Insurance
Type of Coverage Major medical coverage, including inpatient & outpatient care Same as previous benefits
Significant exclusions Pre-existing conditions, wellness benefits All previous exclusions
Choice of doctors Free to choose any doctor or hosptial If previous coverage was PPO or HMO, choice limited to in-network providers
Price Up to 70% less expensive than COBRA coverage, depending on insured’s age, city of residence, and cost of COBRA Up to 102% of total price of employer’s plan. The 2016 median price in Illinois for single coverage is $536/month

What Short Term Medical Plans Cover

Short Term Medical Insurance plans allow you to choose any doctor or hospital and do not limit you to in-network providers. Once your deductible and coinsurance amounts have been met, the insurance company pays for all covered medical, hospital, and surgical surgical expenses. his includes physician services, prescriptions, X-ray, laboratory services, inpatient hospital stays, inpatient and outpatient hospital surgeries, anesthesia services, skilled nursing facility care and rehabilitation up to a lifetime maximum of $2 million.

Prescription Coverage

Prescriptions are covered under Assurant short term medical plans, but there is no copayments. When you present your STM prescription card, which is part of your ID card, at a participating pharmacy, you will receive a negotiated discounted and then will be subject to deductible and coinsurance amounts. Below are some real-life savings examples of some commonly used prescriptions with the Short Term Medical prescription drug card.

Short Term Medical Prescription Drug Card Discounts

Drug
Strength and
quantity
Retail price
Price using
card
Percentage
savings
Lipitor 10 mg, qty 30 $96.99 $69.99 28%
Levaquin 500 mg, qty 10 $145.99 $98.79 32%
Nexium 20 mg, qty 30 $179.99 $125.89 30%
Singulair 10 mg, qty 30 $124.99 $88.24 29%
Zyrtec 10 mg, qty 30 $83.99 $56.59 33%

>Retail pricing based on Walgreens Pharmacies in Milwaukee and Oconomowoc, Wisconsin, June 6, 2007. Pricing examples are for illustration purposes only. Prices are subject to change without notice and may vary by region. Payment must be made at the time of service to receive discount. Prescription drug savings do not guarantee benefits under your STM plan.

Short Term Medical Plan Exclusions

Short Term Medical Insurance coverage is designed to protect you in the event of an unexpected illness or injury. Because of this, medical insurance coverage for preventive care, pre-existing conditions, physicals, pregnancy, immunizations, dental or eye care services are not covered by short term medical plans. Any medical expense incurred outside the U.S. or Canada is also excluded from temporary insurance plans. Individuals that need medical coverage outside the country can get an international travel insurance policy.

Payment Options

Most short term health insurance programs will make the applicant pay the entire amount of the premium for the policy up front. With Assurant health insurance, you get the option of either paying for the entire amount up front, or making a monthly payment.

Single payment option: This is ideal if you know the exact number of days that your coverage is needed. The minimum number of days you may apply for is 30 days, the maximum is 365 days. No refunds are available after the 10-day free look period.

Monthly payment option: If you are unsure of how long you will need coverage, this option would be the best for you. The “pay as you go” option gives you the flexibility to continue coverage for as long as it is needed, or simply stop payments and discontinue the plan once your temporary health insurance need ends.

You can pay with either Visa or Master Card, automatic charge to a checking account, or by check.

If you pay your initial 35 day premium by MasterCard or VISA, each additional 30 days of coverage will be automatically charged to your account for up to 365 days. If your temporary medical insurance need ends prior to this date, simply call 1-800-800-5453 and the automatic account charge will be stopped. Seven day advance notice is required to ensure future account charges are stopped.

If you choose to pay monthly by the automatic charge to checking account, you must submit the first 35 day premium via check along with a separate voided check. All subsequent monthly payments will be automatically debited from your checking account for up to 365 days. If your short term health insurance needs end prior to this date, simply call 1-800-800-5453 and we will stop the automatic account charge. Seven day advance notice is required to ensure future account charges are stopped.

If you pay your initial 35 day premium by check, you will be sent a sheet of payment coupons shortly after you receive your policy. Each coupon is for an additional 30 days of coverage.

Purchasing an Additional Plan

Short term health insurance plans are not renewable. However, if your temporary health insurance need continues beyond your policy period, you may apply for a new plan under the following circumstances:

  • No claims were submitted while covered under a previous short term medical insurance plan
  • There has been no significant change to your health
  • Any previous or current health condition or symptom will be considered a pre-existing medical condition that will not be covered under a new plan.

How HIPPA Legislation affects Short Term Medical Plans

Under HIPAA, short term medical policies are generally exempt from the Federal Health Insurance Portability and Accountability Act (HIPPA). This means that when issuing a Short Term Medical policy, insurance carriers do not have to: guarantee renewability, guarantee issue or waive the pre-existing condition limitation for federally eligible individuals.

In Illinois, an individual must maintain health coverage for 18 consecutive months without any break in coverage longer than 63 days to avoid pre-existing condition limitations. Previous creditable coverage includes:

  • A group health plan
  • Health insurance coverage
  • Part A or Part B of title XVIII of the Social Security Act (Medicare)
  • Title XIX of the Social Security Act, other than coverage consisting solely of benefits under section 1928 (Medicaid)
  • Chapter 55 of title 10, United States Code (Champus)
  • A medical care program of the Indian Health Service or of a tribal organization
  • A state health benefits risk pool
  • A health plan offered under chapter 89 of title 5, United States code (Federal Employee Health Benefit Plan)
  • A public health plan (as defined in regulations)
  • A health benefit plan under section 5(e) of the Peace Corps Act