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The Standoff: Health Benefit Plans vs. Short-Term Coverage

If you’re unable to enroll in major medical health insurance, you still have options. Two of the most common types of coverage are short-term coverage and health benefit plans. But which plan is right for you? Which plan will be the most affordable? Every situation is unique, so below we compare health benefit plans to short-term health insurance to help you make the right decision for you and your family.


Understanding Health Benefit Plans

Before you decide to purchase a health benefit plan, it’s important to understand what these types of plans do and do not cover. A health benefit plan does not qualify as the type of coverage required by the ACA, meaning that you may still have to pay the tax penalty if you purchase a standalone health benefit plan.

Compared to major medical insurance, health benefit plans cover a much more limited set of illnesses, medical procedures and hospital visits, so be sure to read your policy carefully to see what your plan will cover. Keep in mind health benefit plans typically do not cover pre-existing conditions or the 10 essential health benefits required by the ACA.

However, health benefit plans do not have a deductible. With a health benefit plan, there are less surprises when it comes to paying your medical bills. Health benefit plans make a fixed payment to you when you’re treated for a medical illness or injury, so you always know how much you’ll have to pay out-of-pocket.


Understanding Short-term insurance

Similar to health benefit plans, short-term health insurance does not meet the ACA’s minimum required coverage, meaning you may still have to pay the tax penalty even if you have short-term coverage.

Short-term coverage is just that – short term. A short-term health plan can range from one to 12 months of coverage. Short-term coverage is ideal for those looking to bridge an insurance gap until they can enroll in a major medical plan during Open Enrollment or during a Special Enrollment period. Unlike a health benefit insurance plan, short-term plans typically have a deductible, but these plans may cover a higher percentage of your medical costs.


So, which type of coverage should I choose?

Health insurance is not one-size-fits-all. To talk to a GoHealth agent about which type of plan is right for you and your family, call (866) 909 – 0798.

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