Your guide to
Short-Term and Limited-Benefit Health Plans in Texas
Short-term and limited-benefit plans work very differently from comprehensive health insurance. Our agency helps you understand what these plans are, what they may leave out and how they compare with ACA-compliant coverage.
What it covers
How these plans work
These plans are not ACA-compliant major medical coverage. Benefits, limits and exclusions vary widely, so the details of each policy matter.
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Short-term health plans
Designed to provide temporary coverage for a limited time. How long a plan can last depends on federal and state rules and on the policy.
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Limited-benefit plans
Pay set amounts or cover only certain services, up to limits stated in the policy, rather than paying broadly for your medical care.
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Pre-existing conditions
These plans may not cover pre-existing conditions, and the insurer may ask health questions before accepting an application.
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Essential health benefits
They may not cover essential health benefits, such as maternity care, mental health services or prescription drugs.
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Benefit limits
Policies may cap what they pay per service, per day or overall, which can leave you responsible for large medical bills.
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No premium tax credits
Premium tax credits are available only for Marketplace plans, so they cannot be used toward these plans.
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Why it matters
Not a substitute for comprehensive coverage
Short-term and limited-benefit plans are not ACA-compliant major medical coverage. They may not cover pre-existing conditions or essential health benefits, and they are not a substitute for comprehensive health insurance.
Before choosing one, it helps to read what the policy excludes, how much it pays and what happens when it ends. If you have a qualifying life event, you may also be able to enroll in a Marketplace plan through a Special Enrollment Period, so it helps to compare both.
When a short-term plan ends, that alone generally does not give you a Special Enrollment Period for a Marketplace plan.
Answers
Short-term and limited-benefit plan questions
Straight answers to common questions. If yours is not here, call or text our agency.
No. Short-term plans do not have to follow ACA rules for comprehensive coverage, so they may exclude pre-existing conditions and essential health benefits.
A limited-benefit plan pays set amounts or covers only certain services up to stated limits. It is not major medical coverage and is not a substitute for comprehensive health insurance.
Yes. Insurers that offer short-term plans may review your health history and can decline an application or exclude certain conditions, depending on the policy.
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Tell us what you need
Your name, a number that reaches you, an email, and a few quick questions about the coverage you pick. Our team reviews it and calls you back.
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Next step
Let’s review your needs to find the coverage that fits you.
Request a quote online, or call or text our agency. If your current policy already fits, we will tell you that too.