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Final Rule on Short-Term Limited-Duration Insurance

~ Published on August 3, 2018 by Willona Stallings ~

On Wednesday, the federal government issued a final rule allowing insurers to sell short-term, limited-duration insurance plans that cover far fewer services than the Affordable Care Act (ACA) and fail to cover pre-existing conditions.

It is important to note a few things about these plans:

  • Short-term, limited-duration plans are not technically considered health insurance under federal law, making them exempt from the requirements of the ACA.
  • These plans are not required to cover essential health benefits, including preventive health screenings like mammograms and wellness visits.
  • Oftentimes coverage for maternity or prenatal care, prescription drugs, mental health services, and substance use disorder treatment is not available through these plans.
  • The rule allows for the sale and renewal of short-term, limited-duration plans that can now cover an initial period of less than 12 months, and, taking into account any extensions, a maximum duration of no longer than 36 months in total.
Essentially, short-term limited-duration plans were designed to fill temporary gaps in health coverage, according to the Centers for Medicare and Medicaid Services.

This news, coupled with the 84% decrease in Navigator funding, means we must all work tirelessly to ensure North Carolinians are educated and well-informed about their healthcare options and are aware of the risks associated with these plans during Open Enrollment Period 6.

Be well,
NC Get Covered staff

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