Reviewed September 2026.
Short-term product gaps: Short-term medical insurance. This page is the side-by-side compare against a HealthCare.gov or state Marketplace plan, including premium tax credits.
Compare grid
| Factor | Short-term limited-duration | Marketplace major medical |
|---|---|---|
| Pre-existing conditions | Often excluded or waiting-period limited | Covered under ACA rules (plan cost-sharing still applies) |
| Essential health benefits | May omit maternity, mental health depth, broad Rx | Required for non-grandfathered individual plans |
| Premium subsidies | None | PTC / APTC if income and other rules fit |
| Medical underwriting | Common | Guaranteed issue in the individual market (with limited exceptions) |
| Duration | Weeks to months; renewal rules vary by state/federal policy | Full plan year; special enrollment for qualifying events |
| Networks / balance bills | Often thin; watch out-of-network ER bills | SBC + network rules; No Surprises Act may help in some ER settings |
| Deductible / OOP math | Read caps carefully; annual maximums possible | Four cost numbers on the SBC (Deductibles) |
Job-loss bridge choices also include COBRA: COBRA vs Marketplace SEP. Enrollment calendar: Open enrollment.
Worked sketch: 90-day gap after a layoff
Morgan leaves work April 30. COBRA is $540/month. A broker emails a 90-day short-term policy at $165/month with a $7,500 deductible and a pre-existing exclusion. Marketplace SEP quotes a silver plan at $210/month after estimated APTC with a $5,000 deductible and $9,200 OOP max.
| Path | 3-month premium | If Morgan’s known hypertension leads to a $32,000 admit |
|---|---|---|
| Short-term | ~$495 | Hypertension-related care may be excluded; facility bills land on Morgan |
| Marketplace silver | ~$630 | Cost-sharing per SBC; essential benefits and appeal rights apply |
| COBRA | ~$1,620 | Same doctors; highest premium, lowest network surprise |
Morgan picks Marketplace when subsidy-eligible and any chronic condition exists. Morgan treats short-term as a last-resort bridge only after reading every exclusion line.
When short-term still enters the conversation
- Documented short gap, no PTC-eligible Marketplace option yet, and no material pre-existing risk
- Travel or waiting period measured in weeks, with cash to cover a full denied claim
- Explicit acceptance that the policy is not comprehensive major medical
Checklist
- Run a Marketplace application (or state exchange) for APTC before buying short-term.
- List every current condition and prescription; match them to short-term exclusions.
- Compare SBCs: deductible, OOP max, maternity, mental health, Rx.
- Price COBRA for the same months if you need the old network.
- Calendar SEP and open-enrollment deadlines so a short-term term does not expire into a gap.
Educational only. Not insurance advice. Short-term rules vary by state and year; read the outline of coverage and confirm Marketplace eligibility for your household.