When job-based coverage ends, an ACA marketplace plan starts in two months, or a family moves between states mid-year, there is often a window where going completely uninsured feels like the only alternative to an expensive COBRA premium. Short-term health insurance exists to fill that window. Also called short-term medical or STM plans, these policies can be purchased outside Open Enrollment and often take effect within 24 hours of approval — a speed the ACA marketplace cannot match. The trade is significant: short-term plans are not ACA-compliant, they can deny applicants based on medical history, and they exclude entire categories of care that a marketplace plan would cover. Understanding exactly what that trade involves is the difference between a useful bridge and a costly surprise. What short-term health insurance actually is — and who it is designed for Short-term health insurance is a category of limited-duration medical coverage sold outside the ACA regulatory framework. Unlike marketplace plans, STM policies are underwritten based on medical history: the insurer reviews your application, asks about pre-existing conditions, and can decline coverage or exclude specific conditions from the policy. The duration is the other defining feature — policies are sold in monthly increments and in most states have historically been renewable for up to 36 months, though federal and state rules have varied this substantially in recent years. Because they are not ACA plans, they are not sold through HealthCare.gov and are not eligible for premium tax credits. You pay the full premium directly to the insurer. The people for whom STM plans make the most sense are those in a genuine, time-bounded gap: a worker who left an employer in October and whose new employer benefits do not start until January, a recent college graduate aging off a parent's plan before their first job begins, or someone who missed Open Enrollment and has no qualifying life event. STM plans are not a good fit for anyone with a chronic condition, anyone expecting surgery or a course of specialist treatment, or anyone who qualifies for a marketplace plan with subsidies — in those cases the ACA plan almost always delivers better value on a total-cost basis. See [how health insurance works](/how-health-insurance-works) for a primer on the full coverage landscape, including when marketplace plans, Medicare, and employer coverage each apply. What short-term plans cover — and the exclusions that matter most Coverage on a short-term plan is typically structured around an emergency and acute-care core: hospitalization, emergency room visits, physician office visits, and sometimes outpatient surgery. Some plans include limited prescription drug coverage, though formulary depth is far shallower than any ACA plan's minimum requirements. What short-term plans almost universally exclude is the list where the financial exposure is highest: pre-existing conditions (any condition diagnosed or treated before the policy start date), preventive care mandated by the ACA (annual physicals, screenings, vaccines), mental health and substance use treatment, maternity care, and prescription drugs for chronic conditions. Understanding these exclusions is not a detail — it is the core of the product. A policy that covers a $40,000 emergency hospitalization is still catastrophically expensive if it excludes the $8,000 cancer treatment you did not know you would need. Review the [glossary](/glossary) for precise definitions of "pre-existing condition," "exclusion rider," and "ACA-compliant plan" before comparing any short-term policy to a marketplace alternative. The dollar structure of short-term plans varies more widely than marketplace plans. Deductibles range from $1,000 to $10,000 or higher, coinsurance after the deductible is typically 20–30%, and policy maximums — the ceiling on what the insurer will pay in total — are often set at $250,000 or $1 million per term rather than the effectively unlimited lifetime maximums required of ACA plans. That policy maximum matters enormously in a serious illness or accident: a major trauma hospitalization with ICU, surgery, and rehabilitation can exceed $500,000. If the policy maximum is lower, the remainder is yours. Read the Schedule of Benefits carefully before you sign; the summary card on a comparison site does not substitute for the actual policy document. Short-term plans vs ACA marketplace plans: the real comparison The clearest way to frame the comparison is across three axes: cost, coverage, and access. On cost, short-term plans can be 30–80% cheaper in monthly premium than an ACA marketplace plan for the same demographic profile — but that comparison ignores the subsidy. If your household income qualifies for a premium tax credit (generally up to 400% of the federal poverty level, and in some years higher due to legislative expansions), the after-subsidy cost of a marketplace plan can be competitive with or lower than the short-term premium. Before concluding that a short-term plan is cheaper, run the actual subsidy estimate at HealthCare.gov or ask a broker to calculate it. The sticker-price premium comparison is almost always misleading. Use [our plan comparison tool](/compare) to see how ACA options stack up against each other in your market; your broker can layer in subsidy calculations to make the price apples-to-apples. On coverage, the gap is substantial: ACA plans must cover the ten essential health benefits (including maternity, mental health, preventive care, and prescription drugs), cannot deny coverage or charge higher premiums based on medical history, and have no policy maximum. Short-term plans guarantee none of these. On access, short-term plans have one genuine advantage: speed. You can apply and be covered in 24–48 hours, any day of the year, with no Open Enrollment window. That temporal flexibility is the product's entire value proposition — and it is genuinely valuable in the specific gap scenarios described above. For anyone navigating Medicare eligibility alongside a gap-coverage question, the [Medicare guide](/medicare) explains the separate enrollment windows that apply once you turn 65 and why an STM plan is rarely the right bridge in that context. State-by-state availability: Texas, Florida, and where short-term plans are restricted Short-term plan availability is determined by both federal duration rules and state law, and the two are not always aligned. Under federal rules that have shifted between administrations, the maximum duration of an individual short-term policy has ranged from 90 days to 12 months, with renewals allowed for up to 36 months total in some rule sets. States have authority to impose stricter limits, and several have done so aggressively. New York, California, New Jersey, and Massachusetts have effectively banned short-term plans or capped them at 90 days with no renewals — in these states the ACA marketplace is the only realistic private coverage option for gap situations. Check your state's insurance department website for the current rule, as federal and state regulations in this area have been revised multiple times. Texas and Florida are two of the most active short-term plan markets in the country. Both states have historically permitted the federal maximum duration and have multiple carriers competing for STM business, which means broader plan variety and more competitive pricing than you would find in a restricted state. In Texas, STM plans are regulated by the Texas Department of Insurance (TDI), and the required disclosure language on every STM policy must notify the buyer that the plan is not ACA-compliant and does not guarantee coverage of pre-existing conditions. Texas-specific carrier networks, the counties where each plan has the densest hospital participation, and how STM plans fit alongside employer and marketplace options in major metros are covered in detail on the [Texas coverage page](/coverage/texas). In Florida, the dynamic is similar — high STM competition, a large self-employed and gig-economy population that makes gap coverage a recurring need, and a market that rewards careful shopping over defaulting to the first plan a search engine returns. If you are in a state where short-term plans are available but restricted to 90 days, do the math carefully: a 90-day policy renewed three times is not the same economic or legal instrument as a 12-month policy, because each renewal involves re-underwriting. A condition you develop during the first 90-day term may be excluded as a pre-existing condition on the renewal — and in some states, the renewal is treated as a new application with no continuity protection. This is the scenario that catches people off guard most often: they buy a 90-day plan in good faith, receive treatment during that term, and then face an exclusion rider or outright denial on the renewal. The [pricing page](/pricing) outlines ACA marketplace plan tiers and premium ranges for context when deciding whether the STM premium savings justify the gap in protection. Enrollment timing: when you can buy, how long you can keep it, and the renewal trap One of the most commonly misunderstood features of short-term plans is that they do not have a fixed enrollment calendar. Unlike ACA marketplace plans (which require enrollment during Open Enrollment, November 1 – January 15, or a Special Enrollment Period triggered by a qualifying life event), short-term plans can be purchased any day of the year. You apply, pass medical underwriting, and coverage typically begins within 24–72 hours. This on-demand availability is the correct use case for STM coverage — it exists to catch the person who has just lost coverage and cannot wait for an enrollment window. The limitation counterbalancing that flexibility is duration. Federal rules and most state rules put a ceiling on how long you can stay on a short-term plan, either per policy term or in aggregate. The practical implication: a short-term plan is not a multi-year coverage strategy. If your gap situation resolves (your employer benefits kick in, you qualify for a Special Enrollment Period, the next Open Enrollment begins), you should transition to ACA-compliant or employer coverage as soon as that window opens. If you find yourself continuously renewing an STM plan because it is cheaper, you are accepting the pre-existing condition exclusion risk and the policy maximum exposure indefinitely — a trade that is favorable for the very healthy and potentially catastrophic for everyone else. When your SEP window opens — which can happen after losing employer coverage (60-day window), getting married, having a child, or moving — act immediately. The [how health insurance works](/how-health-insurance-works) guide covers SEP triggers and deadlines in detail. If you have missed an SEP or want to understand which gap scenario applies to you, [taking the quiz](/quiz) takes under two minutes and produces a tailored coverage shortlist. Is a short-term plan right for you? How to decide — and what to do next The decision framework is simpler than the product landscape suggests. An STM plan is a reasonable bridge when all three of the following are true: (1) you are in a genuine, time-bounded gap between two forms of ACA-compliant or employer coverage; (2) you do not have any active or recent pre-existing conditions that would be excluded or that are likely to surface within the coverage term; and (3) you have verified that the after-subsidy cost of a marketplace plan is meaningfully higher than the STM premium. If any of these three conditions is uncertain or false, the calculus shifts toward the ACA marketplace, COBRA continuation, or Medicaid, depending on your income and state. The worst outcomes with short-term plans almost always follow the same pattern: a buyer chooses an STM plan to save on premiums, develops or discloses a condition mid-term, and then discovers that the condition is excluded from the renewal or that the policy maximum is insufficient for the treatment they need. Those outcomes are not inevitable, but they are predictable in hindsight — and they are avoidable with the right information before the first premium clears. If you are weighing a short-term plan against a marketplace option and want a side-by-side view of what each actually covers and costs given your specific doctor list, prescription list, and income, [request a quote](/quote) — the process takes fifteen minutes and the analysis is free. When you are ready to move from comparison to enrollment, [Get Started](/#cta) connects you with a licensed advisor who can confirm the fastest path to coverage that does not leave you exposed.