Short Term Medical (STM)

Short Term Medical (STM*)

  • Health coverage to bridge a gap between health plans.
  • Coverage timeframe ranges from 30-365 days of coverage.
  • Good for people between jobs, recent college grads., and dependents who have lost coverage through a parent's policy.
    *STM plans are also available for individuals traveling to a foreign country (10 days - 2 years).
Carrier Link
Assurant Health Logo Click for Assurant Health
HumanaOne Logo Click for HumanaOne

Are you considering purchasing Short Term Medical insurance?

Overview

Are you considering purchasing Short Term Medical (STM) Insurance? Please review the following information before you quote:

You MUST be honest in your application for health insurance. If medical conditions are not adequately disclosed, your policy could be rescinded back to the policy issue date or coverage could be denied. Your completed application becomes a permanent part of your insurance contract.

The underwriting guidelines for individual health insurance are very strict. More than half of all applicants are either declined outright or offered policies limited by exclusions or riders (meaning a carrier will deny coverage for a specified pre-existing condition). If you do get declined, or are offered a policy with riders/exclusions, and are a resident of Wisconsin, you may qualify for Wisconsin's Health Insurance Risk Sharing Pool (HIRSP).

If you are applying for a plan to cover yourself and dependents, the carrier does not have to accept the family as a whole. Carriers reserve the right to decline or rider any individual family member based on underwriting criteria.

Pre-Existing Conditions and Other Non-Covered Services

Most STM policies do not cover pre-existing conditions. Generally, with an STM policy, a pre-existing condition is defined as a medical condition due to sickness or injury for which the insured received medical treatment or advice from a provider at anytime preceding the effective date of coverage, regardless of whether the condition was diagnosed or not diagnosed; or that produced signs or symptoms preceding the effective date of coverage, which should have caused an ordinarily prudent person to seek diagnosis or treatment.

Most STM policies do not cover routine physical exams, well child care, interscholastic and intercollegiate sports injuries, expenses incurred outside the United States, pregnancy or childbirth, and other conditions as specified in the policy. There are specific carriers that provide STM policies for individuals that are traveling outside the United States.

The purpose of STM policies is to provide coverage for unexpected illnesses and accidents.

You determine the length of time you require coverage. These policies can be purchased for as few as 30 days or for as long as 6 months although there is one carrier that offers a plan for up to 1 year. Most STM policies are not renewable. However, if your temporary need continues beyond your policy period, most carriers allow you to apply for a new plan assuming no claims were incurred under one of your previous STM plans and there has been no significant change in your health.

If you or your dependents are declined for coverage (or are offered a policy with riders/exclusions) and you are a Wisconsin resident, you can apply for a state government-run plan called HIRSP. For more details on how this plan works, go to www.hirsp.org.

Payment Options

Most carriers request that you make full payment for your coverage period up-front and will not provide refunds if you prematurely end the policy. Some carriers allow you to pay on a month by month basis. Depending on your needs, you will want to review the payment options for the carriers you are considering.

 

We hope this information helps you. Above is a chart of carrier options, along with instructions on how you can obtain an online quote. Please feel free to contact our office with any questions.