How Long Can You Keep a Short-Term Health Plan? 2026 Rules by State

ByIris

How long you can keep a short-term health plan in 2026 depends on your state, but the federal regulatory baseline that governs most of the country is in transition: the Biden administration’s 4-month cap is technically still on the books, the Trump administration announced in August 2025 that it would not enforce it, and new federal rulemaking now listed in HHS’s July 2026 regulatory agenda is expected in August 2026, meaning the effective maximum in most states right now is back to 36 months through renewals but a new rule could be published before year-end.

This is one of the most genuinely confusing topics in individual health coverage right now because the rules have changed three times in eight years, enforcement of the current rule has been suspended, and new rules are in the pipeline without a firm effective date. This post explains the full regulatory timeline, what the rules actually mean for someone shopping in 2026, which states ban short-term plans entirely, which states impose their own stricter limits, and who these plans actually fit.

What is a short-term health plan, and what does it cover?

A short-term, limited-duration health plan (STLDI) is a type of health insurance that sits entirely outside the ACA’s individual market framework. Short-term plans are not subject to the ACA’s essential health benefit requirements, cannot be enrolled in using a Marketplace Special Enrollment Period, do not have to cover pre-existing conditions, and are not required to cap annual out-of-pocket costs the way ACA-compliant plans are.

According to KFF’s analysis of short-term plan marketing, short-term plans typically do not cover maternity care, mental health services, or substance use treatment. They are medically underwritten, meaning your application and claims can be denied based on health history, and the definition of “pre-existing condition” is typically evaluated at the time a claim is filed, not just at application. The advantage is availability year-round with no open enrollment period, lower monthly premiums, and coverage starting as quickly as the following day in most cases. The trade-off is meaningfully less protection at the moments it matters most.

What is the current federal duration rule for short-term plans?

This is where things get complicated, and getting it right matters because the answer changed in late 2025.

The regulatory history runs as follows:

2017 (Obama-era rule): Short-term plans were limited to a maximum initial term of 3 months with no renewals allowed, making them genuinely short-term by design.

2018 (first Trump administration): The maximum initial term was extended to 364 days, with renewals allowed up to a total of 36 months. This essentially allowed short-term plans to function as year-round, multi-year coverage for some buyers.

September 2024 (Biden administration final rule): A new rule took effect limiting short-term plans to a maximum initial term of 3 months plus one 1-month extension, for a total of 4 months. The rule also required specific consumer notices and cracked down on the practice of “stacking” separate short-term policies from the same issuer.

August 2025 (second Trump administration): In a joint statement, the Departments of HHS, Labor, and Treasury announced they would not prioritize enforcement of the Biden-era 4-month rule, citing a directive to review regulations for undue burdens on consumers and businesses, according to the official DOL statement on short-term plan enforcement. The agencies confirmed they intend to undertake formal rulemaking. HHS’s 2026 Regulatory Agenda published July 3, 2026 lists the Short-Term, Limited-Duration Insurance rule as expected in August 2026, making this one of the most imminent pending rules in the individual health insurance space as of this writing.

2026 (current situation): The 4-month rule technically remains federal law, but the federal government has announced it will not enforce it while new rulemaking is pending. In practice, according to healthinsurance.org’s 2026 guide to short-term plans, plans with durations up to 36 months have become available for purchase again in most states, because the market has reverted to the pre-Biden baseline in the absence of federal enforcement.

New rulemaking is listed in HHS’s July 2026 regulatory agenda as expected in August 2026, meaning a new rule could be published within weeks of this writing. The direction of that rulemaking is expected to restore or formalize longer durations rather than reinstate the 4-month cap, but the final rule has not been published as of this writing. Anyone purchasing a short-term plan right now should confirm the current available duration directly with the carrier and their state’s Department of Insurance before enrolling, and should be aware that a finalized federal rule in August 2026 could affect plan availability on short notice.

Which states ban short-term plans entirely?

State law operates independently of the federal regulatory baseline, and several states have banned short-term plans or made them functionally unavailable regardless of what the federal government does or doesn’t enforce. According to healthinsurance.org’s 2026 state availability data, 15 jurisdictions (14 states plus the District of Columbia) have no short-term plans available in 2026.

States where short-term plans are not available: California, Colorado (allowed but no carriers sell them due to state benefit requirements), Hawaii (prohibited for anyone eligible for ACA coverage), Illinois, Maine (functionally unavailable due to state restrictions), Massachusetts, Minnesota, New Jersey, New Mexico (limited to 3 months with no renewals; no carriers offer them), New York, Rhode Island (no plans offered due to strict state standards), Vermont, Washington (allowed for up to 3 months but no carriers offer them), Wisconsin, and the District of Columbia.

These states have either banned short-term plans outright or imposed state requirements strict enough that no insurer chooses to sell them there. The federal enforcement posture does not change state law, so consumers in these states cannot purchase short-term plans regardless of what the Trump administration does or doesn’t enforce at the federal level.

What are the rules in states where short-term plans are available?

In states where short-term plans are available, the maximum duration varies considerably based on state law, the carrier, and, for now, which federal baseline the carrier is operating against in the absence of active federal enforcement. According to PivotHealth’s state-by-state duration guide and healthinsurance.org’s state regulatory overview, here is a representative breakdown of how states vary:

States following the pre-Biden federal baseline (up to 364-day initial term, up to 36 months total with renewals): Florida, Georgia, Indiana, Ohio, Texas, Arizona, Tennessee, North Carolina, Kansas, and most other states not listed above.

States with their own stricter duration limits:

  • Delaware: up to 90 days with no re-application during any 364-day period
  • Oregon: up to 3 months with restricted renewals
  • Virginia: initial term up to 3 months, total duration up to 6 months

States where short-term plans are available with state-specific conditions: Connecticut allows up to 180 days but requires carriers to cover ACA essential health benefits, which means Connecticut short-term plans are significantly more comprehensive than the national norm.

For any specific state not listed here, confirming the current duration rules directly with your state’s Department of Insurance before purchasing is the most reliable approach, since carrier availability and duration limits can differ even among insurers within the same state, and the regulatory environment is genuinely in transition.

Who do short-term plans actually fit?

Short-term plans work best in a narrow, well-defined set of circumstances, and KFF’s analysis is direct about the profile: they are most appropriate for healthy individuals facing a genuine, temporary, defined coverage gap who don’t qualify for ACA subsidies and don’t have a qualifying life event to trigger a Marketplace Special Enrollment Period.

The specific situations where short-term plans genuinely make sense include: waiting for employer coverage to begin at a new job (especially if the waiting period is 60 to 90 days), bridging a gap between COBRA expiration and the next open enrollment period, young adults who just aged off a parent’s plan and have no qualifying life event, and people in the small number of states where COBRA premiums are prohibitively expensive and the Marketplace gap is real.

Short-term plans are a poor fit for anyone with ongoing prescription medication needs, a chronic condition requiring specialist care, a pregnancy in progress or planned in the near term, mental health treatment, or any history of a significant medical event in the past several years. The medical underwriting for short-term plans is evaluated at claim time, not just at application, which means a claim can be denied for a condition that was not disclosed or not considered significant at enrollment.

What does a short-term plan actually cost, and what does it cover?

Monthly premiums for short-term plans typically run $50 to $200 for a healthy individual, significantly less than both COBRA and unsubsidized ACA coverage. Deductibles typically range from $1,000 to $15,000, and some plans impose benefit caps, limiting the total amount they will pay out over the term of the policy. According to healthinsurance.org, some short-term plans have out-of-pocket maximums of $20,000 or more, compared to the ACA’s $10,600 hard cap for compliant plans in 2026, meaning the total cost exposure in a serious medical event can be substantially higher than with ACA coverage.

Federal regulations still require all short-term plans to include a consumer notice on the first page of all marketing and enrollment materials stating that the coverage is “NOT comprehensive coverage” and does not comply with ACA consumer protections, according to the August 2025 DOL statement, which confirmed that the notice requirement remains in effect even as other Biden-era provisions go unenforced.

Does a short-term plan qualify me for a Marketplace Special Enrollment Period when it ends?

No, and this is one of the most consequential things to know before purchasing. The expiration or termination of a short-term health plan does not trigger an ACA Marketplace Special Enrollment Period. Short-term plans are not ACA-compliant coverage, and losing non-ACA-compliant coverage does not count as a qualifying life event under Marketplace rules.

According to HealthCare.gov’s SEP guidance, the qualifying events that trigger a Marketplace SEP are limited to losing qualifying health coverage, which specifically includes ACA-compliant plans, COBRA, Medicaid, Medicare, employer-sponsored coverage, and similar comprehensive products. A short-term plan’s expiration does not meet this standard.

This means a person who buys a short-term plan outside of open enrollment, uses it for several months, and then wants ACA coverage when the plan expires will generally have to wait for the next open enrollment period (beginning November 1, 2026 for 2027 coverage) unless a separate qualifying life event occurs in the interim. Planning coverage transitions around open enrollment dates before purchasing a short-term plan is essential, particularly for anyone who might want to return to ACA coverage at a predictable point.

What are the alternatives if a short-term plan isn’t available in my state or doesn’t fit my situation?

For someone who needs coverage outside of open enrollment and doesn’t have a qualifying life event, the realistic alternatives are: COBRA continuation from previous employer coverage, a health sharing ministry (available year-round with no network restrictions and typically lower monthly costs than COBRA), or a Direct Primary Care membership for routine care while accepting the risk of a major medical gap. Each of these has its own trade-offs, and the right choice depends heavily on how long the gap is expected to last and what coverage needs exist during that period.

Frequently Asked Questions

Are short-term health plans available in all states in 2026? No. According to healthinsurance.org’s 2026 state availability data, 15 jurisdictions including 14 states and the District of Columbia have no short-term plans available, due either to outright bans or state regulatory requirements strict enough that no insurers offer them. State law operates independently of the federal enforcement posture, so the Trump administration’s non-enforcement announcement does not make short-term plans available in states that have banned them.

What is the maximum duration for a short-term plan in 2026 at the federal level? The Biden administration’s 4-month cap (3 months initial term plus one 1-month extension) technically remains federal law, but the Trump administration announced in August 2025 it would not prioritize enforcement of that rule while new rulemaking is pending. In practice, plans with durations up to 36 months through renewals are again available in most states where short-term plans are permitted at all, reflecting a return to the pre-Biden baseline. HHS’s 2026 Regulatory Agenda published July 3, 2026 lists the new Short-Term, Limited-Duration Insurance rule as expected in August 2026, so a finalized rule may be published shortly after this post was written. Always confirm current duration limits with your carrier or state Department of Insurance before enrolling.

Does buying a short-term plan affect my ability to enroll in an ACA Marketplace plan later? Expiration or termination of a short-term plan is not a qualifying life event for a Marketplace Special Enrollment Period. If your short-term plan ends outside of the annual open enrollment window (November 1 through December 15) and you have no separate qualifying life event, you generally cannot enroll in a Marketplace plan until the next open enrollment period. This makes it important to plan the end date of a short-term plan around the open enrollment calendar.

Can a short-term plan deny a claim for a pre-existing condition even if I didn’t know I had it? Yes. Short-term plans evaluate pre-existing conditions at the time a claim is filed, not just at application. A condition that was not disclosed or not considered significant at enrollment can still result in a claim denial if a carrier determines it was a pre-existing condition at the time of treatment. This is one of the most significant consumer protection differences between short-term and ACA-compliant plans.

Are short-term plans cheaper than ACA plans? Usually yes, significantly so on a monthly premium basis. Monthly premiums for short-term plans typically run $50 to $200, compared to an average unsubsidized benchmark Silver ACA premium of $625 a month for a 40-year-old nationally in 2026. However, short-term plans typically have higher deductibles, higher out-of-pocket maximums, no cap on annual out-of-pocket costs comparable to ACA plans, and significantly fewer covered benefits, so the total cost in a year where you need significant medical care can be far higher than an ACA plan’s cost would have been.

Can I use an ACA subsidy with a short-term plan? No. Premium tax credits are available only for plans purchased through the ACA Marketplace, and short-term plans are not sold through the Marketplace. Choosing a short-term plan means forgoing any subsidy you might otherwise qualify for. For anyone eligible for a meaningful premium tax credit based on income, a subsidized Marketplace plan is almost always the more cost-effective option even before considering coverage quality.

This article is for general informational purposes only and is not insurance, legal, or financial advice. The federal regulatory status of short-term health plans is actively in transition. HHS’s July 3, 2026 Regulatory Agenda lists the Short-Term, Limited-Duration Insurance rule as expected in August 2026, meaning a new federal rule could be published shortly after this post was written. State laws and carrier availability change independently of federal rules. Always confirm current duration limits, plan availability, and coverage terms directly with your state’s Department of Insurance and the specific carrier before purchasing any short-term health plan. This post was last updated in July 2026.

By the Modern Healthcare Works team