Health insurance

Short-term health insurance: a bridge, not a plan

Short-term plans are cheap because they can decline you, exclude your pre-existing conditions, cap benefits and skip essential health benefits. That makes them a legitimate gap filler and a bad primary coverage choice.

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Short-term limited duration insurance, STLDI in regulatory shorthand, is medical coverage sold outside the Affordable Care Act's individual market rules. Because it is not a qualified health plan, an insurer may ask about your medical history, decline your application, exclude pre-existing conditions entirely, impose dollar limits on benefits, and omit categories of care the ACA requires. That is the entire reason the premium is low.

The pricing gap is genuine. Published 2026 pricing data puts typical short-term premiums between $100 and $400 a month depending on age, deductible and state, and eHealth reports its short-term customers paid an average of $125 a month for individual coverage and $251 for family coverage. Compare that with eHealth's reported ACA averages of roughly $380 a month for bronze plans rising above $510 for gold, before subsidies.

The comparison is misleading in one crucial way: those ACA figures are pre-subsidy. KFF found 87% of 2026 marketplace enrollees received a premium tax credit and the average net premium was $178 a month. For a large share of buyers, a subsidized silver plan with cost-sharing reductions costs about the same as a short-term plan and covers vastly more. Check subsidy eligibility before you seriously consider STLDI.

There is a narrow set of situations where a short-term plan is the right tool: a gap of a few weeks or months before employer coverage starts, a wait for Medicare eligibility, or an income too high for subsidies combined with genuinely good health and a specific end date in view. Everything after this paragraph is about buying it with your eyes open.

Fit test

When a bridge plan is defensible

The first three cases are reasonable. The last three mean you should be shopping the marketplace instead.

Good fit

Waiting for employer coverage

A new job with a 30, 60 or 90 day benefits waiting period is the textbook use case. You know the exact end date, you are between comprehensive plans, and the gap is short.

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Defensible

Missed open enrollment, no qualifying event

If you have no special enrollment period and Medicaid does not apply, a short-term plan can carry catastrophic risk until the next open enrollment. Check Medicaid and CHIP first, since they enroll year round.

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Compare carefully

Early retiree waiting for Medicare

A few months before turning 65, in good health, income too high for meaningful subsidies. Compare against a bronze marketplace plan and COBRA, since a serious diagnosis in the gap is exactly what STLDI excludes.

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Buy ACA instead

You have any ongoing condition

Diabetes, asthma, cancer history, mental health treatment, pregnancy or a maintenance prescription. Short-term plans routinely exclude pre-existing conditions outright, so the coverage would not apply where you need it.

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Check subsidies

Your income qualifies for subsidies

With 87% of marketplace enrollees subsidized and average net premiums around $178 a month in 2026, a comprehensive plan is often priced within a few dollars of a short-term plan. Run the subsidy math first.

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Not covered

You are pregnant or planning to be

Maternity care is an ACA essential health benefit and is almost universally excluded from short-term plans. Pregnancy also does not trigger a marketplace special enrollment period, though birth does.

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What it costs

Short-term versus marketplace coverage, 2026

Monthly premium ranges from published carrier and broker data. The right column is what actually decides the comparison.

Coverage type	Typical monthly premium	Pre-existing conditions	Essential health benefits
Short-term, individual	$100 to $400, averaging about $125	Commonly excluded entirely	Not required, maternity and mental health often absent
Short-term, family	Averaging about $251	Commonly excluded entirely	Not required
Bronze marketplace, unsubsidized	About $380	Fully covered	All ten required
Gold marketplace, unsubsidized	Above $510	Fully covered	All ten required
Marketplace after subsidies, 2026 average	$178 net	Fully covered	All ten required
Silver with cost-sharing reductions, under 150% FPL	Often near $0 net premium	Fully covered	All ten required, average deductible about $87

Short-term ranges from 2026 pricing data compiled by RealCostReport and eHealth customer averages. ACA figures from eHealth 2025 average premiums and KFF 2026 marketplace analysis. Short-term premiums vary sharply by age, deductible, coinsurance and state, and applications can be declined or rated up for health history. Enhanced premium tax credits expired December 31, 2025, which raised net marketplace premiums for 2026.

Rating factors

What to verify before you buy a short-term plan

Read the policy, not the quote page. These six items decide whether the plan is worth anything.

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The pre-existing condition clause. Find the lookback period, often 12 to 60 months, and the exact definition. Many plans exclude any condition for which you had symptoms, sought advice, or took medication, whether or not it was diagnosed.
Whether it is guaranteed renewable. KFF notes short-term plans are not guaranteed renewable, so a carrier can decline to continue coverage. If you develop a condition mid-term, the renewal you were counting on may not exist.
Benefit caps and per-service limits. Look for overall maximums, per-day hospital limits, and separate surgery or anesthesia schedules. A $1 million maximum with a $1,000 per day room limit is not comprehensive protection.
That losing it does not open a marketplace window. Short-term coverage is not minimum essential coverage, so its expiration is not a qualifying event for a marketplace special enrollment period. Time the end date to open enrollment or a known event.
Prescription coverage, or its absence. Many short-term plans offer only a discount card rather than pharmacy benefits. Price your maintenance drugs at cash rates before assuming the plan helps.
The network and balance billing exposure. Short-term plans often use rental networks with thin local participation. Federal surprise billing protections apply to some situations, but out-of-network exposure on a non-ACA plan is generally larger.
The required disclosure notice. Federal rules require these plans to carry a prominent notice stating the coverage is not comprehensive and does not have to comply with ACA requirements. If you cannot find it, do not buy from that source.

Federal duration limits are in flux, so verify before you buy

The permitted length of a short-term plan has changed three times in eight years, and it is unsettled again. According to healthinsurance.org's tracking of the rules, plans sold before 2019 were limited to under three months, a 2018 rule allowed initial terms of up to 364 days with total duration up to 36 months including renewals, and a rule effective September 1, 2024 cut that to a maximum of four months of total duration including any renewals.

That 2024 limit is now largely unenforced. healthinsurance.org reports that in August 2025 federal regulators announced they would not enforce the 2024 duration limits, and that as a result 36-month plans became available again in many states. KFF's late-2025 review adds that formal rulemaking to roll back the 2024 restrictions was targeted for completion by the end of 2026.

Practical takeaway. Do not rely on any duration figure you read, including these. Ask the carrier in writing how long the specific policy runs, whether it can be renewed, and what happens at the end of the term. Then check your state insurance department, because state limits are frequently stricter than federal ones and are not affected by federal non-enforcement.

Period	Federal duration limit	Status
Before 2019	Under 3 months total	Superseded
2019 through August 2024	Up to 364-day initial term, 36 months total with renewals	Superseded, then effectively revived
September 1, 2024 rule	4 months total including renewals	Adopted, then subject to federal non-enforcement from August 2025
2026 outlook	Rulemaking to roll back the 2024 limits targeted for completion by end of 2026	Unsettled, confirm with carrier and state

Two federal requirements have been consistent throughout. Short-term plans must display a prominent notice stating that the coverage is not comprehensive health coverage and is not required to comply with federal market requirements, and the coverage does not count as minimum essential coverage. The second point has a consequence most buyers miss: because it is not minimum essential coverage, losing a short-term plan does not trigger a marketplace special enrollment period.

What these plans exclude, and where you cannot buy one

Coverage varies by carrier, but the exclusion list is remarkably consistent. Expect all of the following unless the policy explicitly says otherwise in writing.

Pre-existing conditions. The core exclusion. Typically defined broadly enough to capture any condition with symptoms, treatment or medication in a lookback window, and applied for the full policy term.
Maternity and newborn care. An ACA essential health benefit, almost universally excluded from short-term plans, along with fertility treatment.
Mental health and substance use treatment. Often excluded outright or subject to tight visit and dollar limits. Federal parity requirements do not apply the way they do to ACA plans.
Preventive care at no cost. ACA plans must cover a list of preventive services with no cost sharing in network. Short-term plans generally do not, and some cover no preventive care at all.
Prescription drug benefits. Frequently replaced by a discount card. Specialty drugs are effectively uncovered.
Pediatric dental and vision. Essential benefits under the ACA, not required here. See standalone dental and vision options if you need them.
Habilitative and rehabilitative services. Physical therapy, occupational therapy and durable medical equipment are often capped or excluded.

State availability

KFF reports short-term plans were sold in 36 states as of its late-2025 review, with five states prohibiting them outright and nine states plus the District of Columbia having no plans available because state rules make them impractical to sell. healthinsurance.org's state-by-state tracking counts 15 states plus DC where short-term coverage is not available to consumers for 2026. States that permit them often impose their own duration caps, benefit mandates and rating rules that are stricter than federal law.

Because availability shifts with state legislation and carrier filings, treat any list you find as a starting point and confirm with your state insurance department. If short-term coverage is unavailable where you live, the realistic alternatives are a marketplace plan if you have a qualifying event, Medicaid or CHIP if your income qualifies, COBRA continuation from a prior employer, or in some cases a student health plan or a spouse's employer plan through its own special enrollment window.

A workable sequence if you have a coverage gap

Check Medicaid and CHIP eligibility first, since they enroll year round and cost little or nothing. Then check whether any event in the last 60 days gives you a marketplace special enrollment period. Then price a subsidized marketplace plan, because at 2026 average net premiums of $178 a month it is often competitive with short-term pricing. Then price COBRA, which preserves your current network and deductible credit. Only after all four should a short-term plan be your answer, and then only with a hard end date and a written copy of the exclusions. Our comparison of short-term versus ACA coverage walks through the same decision with worked numbers.

Sources & further reading

Learn first, buy second

Before you fill a coverage gap

Comparison

Short-term vs. ACA health insurance

A side-by-side of coverage, cost and risk for a real coverage gap.

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Subsidies

ACA subsidies explained

Find out whether a comprehensive plan is cheaper than you assume.

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Costs

How much health insurance costs

2026 premiums and deductibles across plan types and income levels.

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Questions

Frequently asked questions

How long can a short-term health plan last?

It depends on the rule in force and your state. A September 2024 federal rule capped total duration at four months including renewals, but federal regulators announced in August 2025 that they would not enforce it, and 36-month plans became available again in many states. Formal rollback rulemaking was targeted for completion by the end of 2026. Confirm the term with the carrier and your state insurance department.

Does a short-term plan cover pre-existing conditions?

Generally no. Insurers can medically underwrite these plans, decline applicants, and exclude any condition you had before the effective date, usually using a lookback period of 12 to 60 months. Definitions are broad enough to capture conditions you had symptoms or medication for even without a formal diagnosis. Read the exclusion language before you pay a premium.

Will losing short-term coverage let me enroll in a marketplace plan?

No. Short-term coverage is not minimum essential coverage, so its expiration is not a qualifying event for a marketplace special enrollment period. Plan the end date to coincide with open enrollment, which runs November 1 to January 15 in most states, or with a separate qualifying event such as a new job or a move.

Which states do not allow short-term health insurance?

KFF found short-term plans sold in 36 states as of late 2025, with five states prohibiting them and nine plus DC having none available in practice. healthinsurance.org counts 15 states plus DC without availability for 2026. Because state rules change with legislation and carrier filings, verify with your own state insurance department rather than relying on a published list.

Is a short-term plan cheaper than an ACA plan?

Before subsidies, usually yes: roughly $125 a month on average for individual short-term coverage against about $380 for an unsubsidized bronze plan. After subsidies the gap often closes or reverses, since 87% of 2026 marketplace enrollees received a premium tax credit and the average net premium was $178. Price your subsidized options before deciding.

Does short-term coverage include maternity or mental health care?

Rarely. Maternity and newborn care, mental health and substance use treatment, and free preventive services are all ACA essential health benefits, and short-term plans are not required to include them. Most exclude maternity entirely and either exclude or tightly cap behavioral health. If you need any of these, buy comprehensive coverage.

Let us check whether a comprehensive plan is actually cheaper

Tell us your gap dates, income and state. We will price marketplace, COBRA and short-term options side by side and flag the exclusions that matter for your health history.

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