Wisconsin Short Term Health Insurance
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
UHC Short Term Insurance
More About UHC
Company Information
Golden Rule Insurance Company, a UnitedHealthcare company, is the underwriter and administrator of these plans. With over 60 years of experience servicing individuals and families, Golden Rule provides quality products, timely claims handling, and outstanding customer service.
Also available are Short Term Medical, Individual Dental Plans. The different plans are described below:
Short-term health insurance may be the best option if you are looking for multiple plan choices that offer benefits not always found in short-term plans, such as preventive care.
While some UHC plans restrict your care to network health care providers, UHC has a sizable network.
UHC is a well-known and reputable insurance company.
Pros
- Option to cancel coverage with no penalty
- Dental add-on coverage available depending on your state
- Coverage for preventive care
- Plans with minimal coverage have low prices
Short-Term Medical Secure Plans – Plan Comparison
| Plan Designs | Secure Edge | Secure Bridge | Secure Net |
|---|---|---|---|
| Office visit copay | $50 1 copay for 30-90 days 2 copays for 91-180 days 3 copays for 181-364 days |
$50 1 copay for 30-90 days 2 copays for 91-180 days 3 copays for 181-364 days |
$50 1 copay for 30-90 days 2 copays for 91-180 days 3 copays for 181-364 days |
| Deductible | $1,000 $2,500 $5,000 $7,500 |
$1,000 $1,500 $2,500 $5,000 $7,500 $10,000 |
In-Network: $3,500 $5,000 $7,500 $10,000 Out-of-network deductible is two times the in-network deductible. |
| Coinsurance and out-of-pocket (not including deductible) |
20% – $1,000, $2,000, $3,000, $4,000 50% – $2,500, $5,000, $7,500, $10,000 |
20% – $1,000, $2,000, $3,000, $4,000 30% – $1,500, $3,000, $4,500, $6,000 50% – $2,500, $5,000, $7,500, $10,000 |
In-Network: 0%1 – $0 20% – $3,500, $5,000, $7,500, $10,000 30% – $3,500, $5,000, $7,500, $10,000 Out-of-network coinsurance is 50% and the out-of-pocket is two times the in- network out-of-pocket ($7,000 for 0%/$0). |
| Maximum benefit | $1,000,000 | $2,000,000 | $2,000,000 |
| Covered Expenses | Secure Edge | Secure Bridge | Secure Net |
|---|---|---|---|
| Doctor administering anesthetics | Up to 20% of the surgeon’s benefit2 | Up to 20% of the surgeon’s benefit | No benefit-specific limit |
| Assistant surgeon | Up to 20% of the surgeon’s benefit2 | Up to 20% of the surgeon’s benefit | No benefit-specific limit |
| Surgeon’s assistant | Up to 15% of the surgeon’s benefit2 | Up to 15% of the surgeon’s benefit | No benefit-specific limit |
| Ambulance, ground or air services | Up to $250 per occurrence | Ground: Up to $500 per occurrence Air: Up to $1,000 per occurrence |
No benefit-specific limit |
| Organ, tissue or bone marrow transplants | Up to $150,000 per coverage period | Up to $150,000 per coverage period | Up to $150,000 per coverage period |
| Acquired Immune Deficiency Syndrome (AIDS) | Up to $10,000 per coverage period | Up to $10,000 per coverage period | Up to $10,000 per coverage period |
| Emergency room | Up to $500 per day | No benefit-specific limit | No benefit-specific limit |
| Outpatient hospital surgery or ambulatory surgical center | Up to $1,000 per day | No benefit-specific limit | No benefit-specific limit |
| Hospital room, board and general nursing care | The amount billed for semi- private room or 90% of the private room billed amount, up to $5,000 per day | The amount billed for semi- private room or 90% of the private room billed amount | The amount billed for semi-private room or 90% of the private room billed amount |
| Intensive care unit | Three times the amount billed for a semi-private room or three times 90% of the private room billed amount, up to $6,250 per day |
Three times the amount billed for a semi-private room or three times 90% of the private room billed amount | Three times the amount billed for a semi- private room or three times 90% of the private room billed amount |
| Inpatient doctor visits | Up to $500 per confinement | No benefit-specific limit | No benefit-specific limit |
UHC Provider Network
UnitedHealthcare Choice Network (EPO) DE, FL, IA, IN, KS, LA, MI, MO, MS, NE, NV, PA, SC, TN, TX, WI, WV, WY: There are no non-network benefits. You must use a network doctor or hospital. These plans pay no benefits for out-of-network expenses except for emergencies. Emergency treatment from a non-network provider will be treated as network eligible service.
National General Short Term Medical
More About National General
Company Information
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 $1,000,000
- Deductible options of $1,000, $2,500, or $5,000
- Coinsurance Percentage of In-Network plan 100/0, 80/20 and 50/50
- Doctor Office Visit and Urgent Care Co-pay of $50
Standard Issue Plans
| Deductible* | Coinsurance | Out-Of-Pocket Max | Coverage Period Max |
|---|---|---|---|
| $1,000 | 50% / 50% | $2,500 | $250,000 |
| 80% / 20% | $1,500 | $1,000,000 | |
| $2,500 | 50% / 50% | $2,500 | $250,000 |
| 80% / 20% | $1,500 | $1,000,000 | |
| 100% | $0 | $1,000,000 | |
| $5,000 | 50% / 50% | $3,750 | $250,000 |
| 80% / 20% | $2,000 | $1,000,000 | |
| 100% | $0 | $1,000,000 | |
| $10,000 | 100% | $0 | $1,000,000 |
| $25,000 | 100% | $0 | $1,000,000 |
* Per-person deductible and out-of-pocket amounts are capped at 3x the individual amounts for a family greater than three. This means that when three insured family members satisfy their individual deductibles and out-of-pocket amounts, the remaining individual deductibles and out-of-pocket amounts will be deemed as satisfied for the remainder of the coverage term. 2 Short Term Medical plans do not cover costs associated with pre-existing conditions.
National General Provider Network
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.
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.
Short Term Health Insurance FAQ
How Is Short Term Health Insurance Different Than Obamacare?
Affordable Care Act plans typically have broader benefits than found in Short Term health insurance and, without the premium subsidies available to some qualified purchasers, cost much more than Short Term plans.
All health plans that fit in the Affordable Care Act must have “10 Essential Health Benefits.” Short Term health insurance plans, in comparison, do not have a standardized set of benefits. Short Term plans usually offer what would be described as “major medical coverage” that covers healthcare costs in the event of serious medical issues. Most Short Term plans also cover normal doctor visits for routine illnesses and injuries.
Considering the prevalence of ACA insurance plans with narrow networks, consumers should heavily research plans before enrolling to ensure that they are not putting themselves at risk for high out-of-network costs.
For those needing broad coverage, short term insurance may be a good option. 100 percent of short term insurance plans sold through Independent Health Agents have out-of-network coverage. Enrollees in these plans can be ensured that they will have access to high quality providers without incurring unknown and potentially sizable costs.
The chart below details some of the major benefit differences between Short Term health insurance plans and Affordable Care Act plans. It is important to note that Affordable Care Act plans do not deny care for pre-existing conditions nor do they reject applicants based on health problems.
| Short Term Health Insurance Plans | Affordable Care Act Plans | |
| Coverage availability | Apply any time and get coverage as early as the next day | Apply only during Open Enrollment (or Special Enrollment due to a qualifying event) and get coverage in 2-6 weeks |
| Coverage duration | Coverage duration is less than three months. Many plans can be cancelled at any time. | As long as the plan is available. You can change plans during Open Enrollment (or Special Enrollment with a qualifying event) |
| Prescription drug coverage | Many Short Term health insurance plans provide a drug discount card but do not provide drug coverage. Some newer plans have a prescription drug coverage option for generic drugs not associated with a pre-existing condition. Brand name drugs and specialty drugs are typically uncovered. | Minimum of 1 drug per class must be covered but the minimum number of drugs per class is often more due to the benchmark chosen for each particular state. |
| Maternity and newborn care | Complications of maternity are covered but not standard childbirth services. | Full coverage. Applicants cannot be denied based on pregnancy as a precondition. |
| Mental health services | Coverage is included only when mandated at state level. | Coverage included, but states vary on their definition of “mental health” services, so while some do include learning disabilities or conditions like Autism, other states do not. |
| Substance use disorder services | Coverage is included only when mandated at state level. | All ACA plans have full coverage. |
| Rehabilitative and habilitative services | Coverage is included only when mandated at state level. | All ACA plans have full coverage. |
| Preventive care | Some plans have selected preventive care benefits with cost-sharing. However, most plans do not cover preventive care services. | Preventative services must be provided without cost-sharing (cf.https://www.healthcare.gov/preventive-care-benefits) |
| Pediatric services – oral and dental care | Coverage is included only when mandated at state level. | All ACA plans have full coverage. |
| Healthcare provider networks | Short Term plans typically have broad acceptance among healthcare providers. Some have a preferred network with negotiated pricing for healthcare services and a larger non-preferred network where the plans pay ‘usual and customary’ fees for covered healthcare. | These plans have been noted for a significant use of “narrow networks” to increase the ratio of enrollees to healthcare providers. |
| Uninsured tax penalties | The maximum penalty is the national average premium for a bronze plan. For 2021, the tax is 2.5% of modified adjusted gross household income or $695 per person, whichever is greater. | ACA plans meet the requirements for avoiding the tax penalty. |
| Coverage of pre-existing conditions | These plans evaluate health status and pre-existing conditions when processing an insurance application and determine whether the applicant is approved or rejected for coverage. | These plans do not consider health status or pre-existing conditions when processing an insurance application. |
What does short-term health insurance cover?
Is short-term health insurance Obamacare?
In addition, short-term health insurance involves an application. Depending on your health status, your application may be declined or your pre-existing condition may be excluded. Obamacare guarantees that all applicants and their pre-existing conditions will be covered, no matter what your health status.
When can I apply for short-term health insurance?
You can apply at any time. There is no fixed open enrollment period. On wisconsinhealthagents.com, you can submit your application and, if approved, your insurance can be effective within as little as 24 hours.
Can I cancel a short term plan at any time?
What conditions on the application will make me ineligible for a short term plan?
If you are looking for insurance to cover your pre-existing conditions, we can refer you to an agent who can help you find a health insurance plan that to cover these conditions:
- For ACA/Obamacare Plans: 312-726-6565
Why would I want coverage for a short period of time?
If you’re between jobs, waiting for coverage from another health insurance plan to start, laid off, on strike, a recent college graduate or seasonal employee and know that you only need coverage for a specific period of time, short-term health insurance may be a great option for you.
How soon can Short Term Medical begin?
Your short term medical coverage can begin the next day if you apply on the internet using a credit card or auto bank debit, as long as the eligibility criteria is met. If you decide to mail your application with a check, the earliest your STM policy can begin is the next day following the U.S. Postal Service postmark. (As long as eligibility requirements are met and application is legible.)
All transmissions take place and are recorded based on the time and date in the Central Time Zone. For example, if you submit your application on-line at or after 10:00 p.m. on March 15th from a location in the Pacific Time Zone, the time of the transmission will be at or after 12:00 a.m. Central Time. The transmission date of your application will be March 16th.
Does a Short Term Medical plan cover prescription drugs?
Yes. However, there are no copayments. When you present your STM prescription card, which is now conveniently part of your ID card, at a participating pharmacy, you will receive a negotiated disounted and then will be subject to deductible and coinsurance amounts.
Look at the real-life savings examples below for some commonly used prescriptions and see what you could save when you use your Short Term Medical (STM) prescription drug card.
| 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.
Is a Short Term Medical plan considered “creditable coverage” under HIPAA?
Under HIPAA, Short Term Medical coverage is generally considered creditable coverage to help satisfy any pre-existing condition period. 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
Should I pay monthly or make a single payment up front?
Most short-term health insurance plans give you the option of paying in monthly installments, or in a single up-front payment. Often, single payment plan costs may be lower than monthly plan costs.
We recommend you select “Monthly“, if you:
- don’t know exactly how long you will need coverage, or
- don’t want to make a single up-front payment
We recommend you select “Single Up-front Payment“, if you:
- know exactly how long you will need coverage for,
- want lower plan costs, and
- don’t mind paying your whole premium up-front
If you select “Single Up-Front payment” you will need to specify the duration of your coverage (30-365 days). Also, if you select “Single Up-Front payment”, you will enjoy the convenience of not having to manually cancel your plan at the end of your coverage period, although typically you will not be able to get a refund once coverage starts. If you need short-term health insurance after your specified duration, you will need to re-apply for a new short-term plan.
Do Short Term Medical plans include dental and vision benefits?
No. Short-term health insurance plans are designed to protect you in the event of an unexpected illness or injury and are not intended to cover dental and vision care. Short-term health insurance plans are for temporary coverage only and therefore do not include some of the benefits offered by standard, longer-term heath insurance plans.
Will purchasing a Short Term Medical plan make it harder for me to get coverage in the future for a pre-exisiting medical condition?
No. Short Term Medical actually makes it easier to get coverage from an employer in the future. It is generally considered creditable coverage and can prevent a break in coverage and help satisfy any pre-existing condition periods.
How will I know if I qualify for Short Term Medical coverage?
In most cases, as soon as you complete the application, the insurance company will notify you online if do not qualify.
If I don’t qualify for a Short Term plan, will my credit card still get charged?
No. If you choose to use a credit card, your card will only be charged if you qualify for short-term coverage. Please note that credit card billing of premiums is optional and you can obtain coverage without using that method of payment.
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What To Know:
- Plans for as little as 30 days up to 36 months. Can cancel anytime.
- Single plan max is 36 months
- Doesn’t cover pre-existing conditions
- Additional add-on options for accident protection, prescriptions and more