Short-term medical insurance · 2026 guide

Short-term medical insurance —
licensed major medical protection at a fraction of the ACA cost.

Short-term medical (STM) insurance is licensed health insurance built for people who are generally healthy, want to keep monthly costs low, and want a financial safeguard against a large unexpected medical bill. Typical premiums run $70–$165/month — a fraction of unsubsidized ACA premiums. STM is backed by your state Department of Insurance and provides real coverage for hospitalizations, surgery, and emergency care. It works best for gaps in coverage and for healthy individuals above the ACA subsidy cliff who prioritize low monthly cost over comprehensive coverage depth.

For individuals under 65 · Not employer-sponsored · Updated July 2026 · CMS, DOL, healthinsurance.org

Duration rules are in flux — verified July 2026

Short-term medical duration rules have changed twice in recent years and a third change is pending. The 2024 federal rule (effective September 1, 2024) limits STM to a 3-month initial term and 4 months total including renewals. On August 7, 2025, the Departments of Labor, HHS, and Treasury announced they will not prioritize enforcement of this rule and encouraged states to follow suit, while new rulemaking begins. In practice today, what you can buy depends on your state and carrier filings — most policies in the market remain 3–4 months, though at least one carrier was offering 12-month terms in Texas as of early 2026. All 7 states covered by this site (TX, FL, GA, TN, NC, IN, OH) allow STM. Sources: DOL tri-agency statement, August 7, 2025 · 2024 Final Rule, Federal Register · healthinsurance.org STM state tracker.

What does short-term medical insurance cover?

Licensed insurance — but not comprehensive coverage

Short-term medical (STM) plans — also called short-term limited-duration insurance (STLDI) — are licensed health insurance policies sold by state-regulated insurers. They provide real coverage backed by your state Department of Insurance. That means the carrier has claims-paying obligations, you have the right to file complaints with the DOI, and the coverage is regulated as insurance.

What STM is not: it is not an ACA-compliant major medical plan. It is exempt from the ACA’s requirements to cover essential health benefits, cover pre-existing conditions, and eliminate annual and lifetime benefit limits. Every STM plan is different, but the exclusions below are common across most plans in the market.

What it is

Licensed health insurance for a defined temporary period — regulated by your state Department of Insurance

Monthly cost

Typically $70–$165/month depending on age, state, deductible, and coinsurance — significantly less than unsubsidized ACA plans

Term duration

Currently 3-month initial / 4-month total under 2024 federal rule — enforcement suspended August 2025, new rule pending; state law controls in practice

Enrollment

Any day of the year — no open enrollment window · coverage can start as soon as next day after approval

Qualification

Short health questionnaire — not full underwriting · some carriers offer guaranteed-issue options

Provider network

Most plans use large national PPO networks — UnitedHealthcare STM plans access 1.8M+ providers

Pre-existing conditions

Not covered — STM is designed for healthy applicants; conditions diagnosed before the term are excluded from coverage

Is it MEC?

No — STM does not qualify as ACA minimum essential coverage and cannot be used to qualify for ACA special enrollment

Subsidies available

No — STM is not eligible for ACA premium tax credits

DOI oversight

Yes — licensed insurance regulated by your state insurance commissioner

Commonly covered by most STM plans

Hospitalization

Inpatient hospital stays for illness or injury — subject to deductible and plan limits

Emergency care

ER visits for genuine emergencies — subject to deductible and coinsurance

Outpatient surgery

Surgical procedures in outpatient facilities — check for per-cause deductibles

Doctor visits

Some plans include office visits after deductible; some include a fixed number of visits with copays

Diagnostic tests

Labs, imaging, and other diagnostics — typically subject to deductible

Prescriptions

Varies — some plans include limited drug coverage or discount cards; many do not

Commonly NOT covered

Pre-existing conditions

Not covered — STM is designed for healthy applicants covering a defined period; conditions diagnosed before the term began are excluded

Maternity

Pregnancy and maternity care is commonly excluded from STM plans

Mental health

Mental health and substance use disorder treatment is typically excluded or severely capped

Preventive care

Annual physicals, immunizations, and preventive screenings are typically not covered

Dental / vision

Not included — separate coverage required

STM works best for

Generally healthy individuals above the ACA subsidy cliff People who want a low monthly cost with major medical protection Coverage gaps between jobs or before employer coverage starts Missed ACA open enrollment with no qualifying life event Recently aged off a parent’s plan Early retirees bridging a short gap to Medicare

STM is typically not the right fit for

Anyone with income qualifying for ACA subsidies — subsidized ACA will almost always cost less Anyone who gets sick during the term — the plan will not renew you for that condition Maternity, ongoing mental health treatment, or prescription-heavy needs Anyone needing long-term continuous coverage — consider a Health Share instead

How long can I keep a short-term plan?

Duration rules — what the law says and what’s happening in practice

STM duration rules have changed three times since 2017. The current situation is genuinely complex — what you can buy today depends on your state, which carriers are filing products, and a federal enforcement picture that changed in August 2025. Here is the timeline, accurately stated and sourced.

The regulatory timeline

2018 federal rule — up to 364 days

Under rules finalized in 2018 by the Trump administration, STM plans could have initial terms of up to 364 days and total duration of up to 36 months with renewals. Most of the country operated under these rules for several years.

2024 federal rule — 3 months / 4 months total (effective September 1, 2024)

The Biden administration finalized a rule limiting STM to a 3-month initial term and 4 months total including renewals. It also barred buying another STM policy from the same insurer within 12 months. The rule applies to plans sold or issued on or after September 1, 2024. Source: Federal Register, April 3, 2024 and CMS Fact Sheet.

August 7, 2025 — enforcement suspended, new rulemaking announced

The Departments of Labor, HHS, and Treasury announced they will not prioritize enforcement of the 2024 duration limits and are beginning a new rulemaking process. They also encouraged states to adopt a similar approach. The 2024 rule remains technically in effect but is not being enforced at the federal level. Source: DOL tri-agency statement, August 7, 2025.

In practice — July 2026

Most STM policies in the market are still capped at 3–4 months because carriers have not yet updated their filings in most states. At least one carrier was offering 12-month terms in Texas as of early 2026. State law controls what is available — all 7 states covered on this site (TX, FL, GA, TN, NC, IN, OH) permit STM, and none bans terms beyond 4 months at the state level. A new federal rule is pending; expect changes. Track current state availability at healthinsurance.org’s STM state tracker.

What this means if you are buying STM today

Because federal rulemaking is pending, do not assume any specific duration is available without confirming with your carrier and state insurance department. What is available in your state today may change as new federal rules are finalized and carriers update their product filings. If you need coverage beyond 4 months, consider whether a Health Share or ACA plan is a better fit — both allow year-round or open-enrollment enrollment respectively.

Why are short-term plans so much cheaper?

Why STM costs so much less than an ACA plan

STM premiums typically run 50–80% below unsubsidized ACA premiums. Understanding why helps you evaluate whether the trade-off makes sense for your situation.

Medical underwriting. ACA plans are guaranteed issue — they cannot turn you down or charge more based on your health history. STM plans use medical underwriting — applicants answer a health questionnaire, and people with significant health conditions may be declined or have conditions excluded. This allows carriers to insure a healthier-than-average pool, which reduces the cost for everyone who qualifies.

No essential health benefit mandates. ACA plans must cover ten categories of essential health benefits — hospitalization, emergency care, maternity, mental health, prescriptions, preventive care, and others. STM plans are exempt from these mandates, which means they can exclude entire categories of care and cap benefits at dollar amounts well below what care actually costs.

Benefit limits and per-cause structures. Many STM plans carry per-cause deductibles (a separate deductible for each medical condition rather than one annual deductible), daily hospital benefit caps, and overall dollar maximums per illness. These cost-sharing structures shift more financial risk onto the enrollee — which reduces the insurer’s exposure and the premium cost accordingly.

Short term by design. STM is priced for a healthy person covering a defined short period of time — not for the ongoing coverage of someone who will use the plan heavily over years. The risk profile of STM enrollees differs structurally from ACA enrollees, which produces a lower average cost that carriers can price accordingly.

How STM fits for people above the subsidy cliff

For a generally healthy individual above the 400% FPL cliff ($62,600 for a single adult in 2026) who faces full ACA premiums of $661+/month in Texas, an STM plan at $70–$165/month represents a meaningful reduction in monthly cost while still providing licensed major medical protection for hospitalizations and large bills. The calculus changes if you qualify for ACA subsidies — check your subsidy eligibility first. And if you want ongoing coverage without term limits, a Health Share structured for long-term membership is often a better fit. STM makes the most financial sense for defined short gaps where the alternative is either a much higher ACA premium or no coverage at all.

What to know before enrolling

STM trade-offs — honest and in plain language

STM is a focused product — low monthly cost, major medical protection, built for healthy people covering a defined period. Like any coverage type, it has real trade-offs that matter depending on your situation.

If you get sick, the plan will not renew you for that condition

This is the most important thing to understand about STM. A condition that develops during your current term becomes a pre-existing exclusion for any subsequent term. If you have a health event mid-term, you can finish that term with coverage — but when it ends, that condition will likely be excluded going forward. For people who want ongoing protection regardless of what happens to their health, a Health Share or ACA plan is a better structural fit. STM is best suited for people who are healthy today and expect to remain so during the coverage period.

Deductibles and out-of-pocket costs are higher than a Health Share

STM deductibles typically run $1,000–$10,000 with coinsurance of 20–30% after the deductible and out-of-pocket maximums of $5,000–$25,000 or more. Health Share Annual Unshared Amounts typically run $1,000–$5,000 with sharing of 100% above that threshold. For a large medical event, a Health Share member often reaches full sharing at a lower out-of-pocket cost than an STM enrollee reaching their plan maximum. Factor total out-of-pocket exposure — not just the monthly premium — when comparing these two options.

Out-of-network care can significantly increase your costs

Most STM plans use PPO networks, but going out of network can result in dramatically higher cost-sharing — in some cases doubling your out-of-pocket exposure versus in-network care. Unlike Health Shares (which generally have no network restrictions), STM requires you to confirm your providers are in-network before care whenever possible. Emergency care at the nearest facility is typically covered regardless of network, but scheduled procedures at out-of-network facilities are not.

Per-cause deductibles and benefit structures vary widely

Some STM plans carry per-cause deductibles — a separate deductible for each medical condition rather than one annual deductible — and benefit caps per illness. This means a plan may have an attractive overall deductible but apply it separately to each condition. Review any plan’s full schedule of benefits, not just the headline premium and deductible, before purchasing.

Technical facts — important for planning

STM plans do not qualify as ACA Minimum Essential Coverage (MEC). Losing an STM plan does not trigger an ACA Special Enrollment Period — when your term ends, you cannot use that to enroll in an ACA plan outside of open enrollment unless you have a separate qualifying life event. Plan your transition before the term starts, not after it ends. In states with individual mandates (California, Massachusetts, New Jersey, Rhode Island, Vermont, and DC), an STM plan does not satisfy the state mandate requirement. Source: healthinsurance.org.

Who actually should use one?

Top short-term medical carriers in 2026

The STM market shifts with the regulatory picture — carrier availability varies by state and product offerings change as federal rules evolve. The carriers below are frequently cited in 2026 coverage roundups. Verify availability and current plan designs in your state before purchasing.

Carrier	What to note
UnitedHealthcare (Golden Rule)	Largest network access — 1.8M+ providers, 7,200+ hospitals; several plan designs include prescription coverage. Widely available across the 7 launch states.
Pivot Health	Low-cost plan designs including 0% coinsurance options; copay-based plans with $5 generic drug copays. Competitive pricing for healthy applicants.
Allstate Health Solutions (formerly National General)	Multiple plan tiers including unusual guaranteed-issue STM options for applicants with health conditions — a meaningful differentiator in a market that typically requires underwriting.
Everest	Frequently cited among top STM carriers; competitive pricing. Verify state availability as carrier presence varies.
Independence American	Regular inclusion in STM comparison roundups; competitive pricing. Verify state availability and current product filings.

Sources: Forbes Advisor — Best Short-Term Health Insurance 2026 · ValuePenguin STM comparison. Carrier lineups in the STM market shift with regulatory changes — verify availability in your state before purchasing.

How do short-term plans compare to health shares?

STM vs Health Shares — the structural differences

Both STM and Health Shares are used by people who need coverage outside of the ACA marketplace, often at lower cost than unsubsidized ACA plans. They are structurally different products — the table below states the key differences factually.

The most important structural difference

STM is licensed insurance. Its claims obligations are backed by your state Department of Insurance. If a claim is wrongly denied, you have a defined appeals process and regulatory recourse. Health Shares are not insurance and carry no DOI-backed guarantee — sharing of medical bills is voluntary under the member guidelines. Health Shares are governed by contract law, are subject to state Attorney General oversight, and are bound by their published sharing guidelines — but the legal framework is different from, and generally less protective than, regulated insurance. Neither of these facts makes one product universally better than the other — they are different tools with different structures and different appropriate use cases.

	Short-term medical insurance	Health Share
What it is	Licensed insurance, temporary by design	Voluntary medical cost sharing among members — not insurance
Regulatory backing	State Department of Insurance regulatory guarantee · defined appeals process	Member guidelines contract · state AG consumer-protection oversight · no DOI guarantee
Duration	Capped terms — currently 3–4 months in most of the market; rules are changing (see above)	Continuous, year-round membership — no term limits
Pre-existing conditions	Excluded with look-back periods · post-claims underwriting risk	Typically shared after defined waiting periods per guidelines · varies by ministry
Enrollment	Any day · next-day start available	Any day · continuous membership
Typical monthly cost (individual)	$70–$165/month · varies by age, state, deductible	$115–$470/month · varies by household size, AUA, and ministry
Renewal	May require requalifying · condition in term one becomes exclusion in term two	Ongoing membership per guidelines · no requalifying required
Mental health	Typically excluded or severely capped	Often excluded or limited · virtual mental health membership fills this gap
Maternity	Typically excluded	Varies by ministry · often limited or subject to waiting periods
ACA minimum essential coverage	No · losing STM does not trigger ACA SEP	No

The reader looking at STM is often searching for a months-long patch for a temporary gap. For coverage intended to last beyond a temporary gap, see our Health Shares guide — Health Share membership is continuous, with no term expiration, and is built for the same budget over a longer horizon. For anyone who may qualify for ACA subsidies, see our ACA Plans guide — a subsidized ACA plan typically provides better comprehensive coverage at a competitive net cost.

See how STM costs compare to ACA plans and Health Shares for your income

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Common questions

Short-term medical insurance — questions people ask most

Is short-term health insurance real insurance?

Yes. Short-term medical plans are licensed health insurance sold by state-regulated insurance carriers. Claims obligations are backed by your state Department of Insurance — if a claim is wrongly denied, you have a defined appeals process and can file complaints with the DOI. STM is genuine insurance. What it is not: it is not ACA-compliant major medical coverage, it does not satisfy the ACA’s minimum essential coverage requirement, and it does not have to cover the ACA’s ten essential health benefits. Being real insurance and being comprehensive insurance are not the same thing.

Can I renew a short-term health insurance plan?

It depends on the plan and state, and the rules are currently in flux. Under the 2024 federal rule (technically still in effect but not being enforced as of August 2025), total duration including renewals is capped at 4 months. Under the prior 2018 rules, renewals up to 36 months total were allowed. What carriers are actually offering varies by state. The most important thing to understand about renewal: STM plans do not guarantee renewal, and a condition that develops during your first term becomes a pre-existing exclusion if you take out a new term. If you develop a health condition during your STM term and want to continue coverage, you may find that the condition you most need covered is now excluded from any renewal policy.

Is STM right for me if I am generally healthy?

STM is specifically designed for people who are currently healthy and want licensed major medical protection at a low monthly cost for a defined period. If you are in good health, have no significant ongoing medical needs, and are above the ACA subsidy cliff — or in a coverage gap where your only other option is a much more expensive ACA plan — STM can be a practical and affordable solution. The key question to ask going in: if something happens to my health during this term, do I have a plan for ongoing coverage when the term ends? Because a new health condition during the STM period will be excluded from any subsequent term. For people who want coverage that continues regardless of what happens to their health, a Health Share is a better structural fit.

What does STM not cover?

STM plans do not cover conditions diagnosed before your coverage term began, maternity care, most mental health treatment, preventive care, or dental and vision. Coverage for prescriptions varies by plan — some include limited drug coverage, others do not. The plan also does not cover conditions that fall outside its benefit caps. If you go out of network for scheduled care, your out-of-pocket costs will typically be significantly higher than for in-network care — in some cases double. Review the full schedule of benefits for any plan before purchasing so you understand exactly what is and is not covered for your situation.

Does losing a short-term plan trigger an ACA Special Enrollment Period?

No. Losing short-term health insurance does not qualify as a loss of minimum essential coverage under the ACA and therefore does not trigger an ACA Special Enrollment Period (SEP). If you are on an STM plan when it expires and ACA open enrollment is not underway, you cannot use the STM loss to enroll in an ACA plan. This is one of the most important things to plan around before purchasing STM: you need a transition plan for when the term ends, whether that means the next ACA open enrollment, an employer plan, or another coverage type.

What is the difference between a short-term plan and a Health Share?

The most important structural difference is that STM is licensed insurance backed by your state Department of Insurance, while a Health Share is not insurance and carries no DOI regulatory guarantee. Health Shares are governed by contract law and subject to state Attorney General oversight — a different and generally less protective framework. In terms of practical differences: STM has defined terms that expire (subject to evolving duration rules), while Health Share membership is continuous with no term limits. Both typically exclude pre-existing conditions, though Health Shares often share costs for pre-existing conditions after waiting periods rather than excluding them permanently. Both are significantly less expensive than unsubsidized ACA plans. See the Health Shares guide for a complete comparison.

Sources: DOL — STLDI Tri-Agency Statement, August 7, 2025 · Federal Register — 2024 Final Rule · CMS Fact Sheet — STLDI · healthinsurance.org — STM State Overview, March 2026 · healthinsurance.org — 2024 Rule Analysis · Forbes Advisor — Best STM 2026 · KFF.org — 2026 Benchmark Premiums

Short-term medical insurance —licensed major medical protection at a fraction of the ACA cost.