In Texas, short-term health insurance is a unique topic that is different from in many other states. Texas legislators did not impose stricter regulations on short-term coverage and, therefore, these plans follow federal regulations plan duration and renewals.
If short-term plans are not affordable or you find yourself not requiring a comprehensive insurance plan, a health care membership through Mira may be an option. By purchasing a membership for $45 per month, you gain access to $99 urgent care visits, up to 80% off prescriptions, same-day laboratory testing, and gym membership discounts. Sign up today.
Best Short Term Coverage Options in Texas
Other more affordable options for short-term health insurance in Texas may include catastrophic health coverage, fixed-indemnity health insurance, or care membership plans.
Catastrophic Health Insurance
Catastrophic health insurance is only available to individuals under the age of 30 due to the higher liability of individuals over that age range. Furthermore, only individuals who have a hardship or affordability exemption can apply for coverage. Hardship exemptions are available via application.
Catastrophic health plans generally have lower premiums but are ineligible for a premium tax credit to be applied to the cost. In 2020, the annual deductible for all catastrophic health coverage plans was $8,150. After the deductible is met, the same rules apply regarding copay or coinsurance.
Once your deductible has been met from out-of-pocket expenses, catastrophic health coverage covers high cost, emergency medical bills that would otherwise be unaffordable. Catastrophic plans also cover other essential benefits such as preventative screenings, some vaccinations, annual checkups, and some birth control. Note that some plans place limits on visits to primary care physicians.
Fixed-Indemnity Health Insurance
Fixed-indemnity plans provide a set portion of coverage for certain expenses. These plans usually pay for a certain percentage of the cost per-incident basis but occasionally work on a per-period basis.
These plans usually provide fewer benefits than full insurance plans, but their monthly premiums are usually smaller. Oftentimes, these plans do not cover pre-existing conditions and act similarly to short-term health insurance on qualifications and disqualifications.
Common coverage under a fixed indemnity plan may include:
- First day at the hospital
- Daily hospital care fee
- Intensive care unit fees
- Emergency room and ambulance fees
- Surgery expenses
- Fees for certain imaging services
Most fixed-indemnity plans do not have an annual deductible, and their premiums can be as low as $25 per month. Benefits can cover anywhere from $50-$2,000, depending on the type of medical service you receive.
Care Membership Plans
Care memberships are not traditional health insurance but can be a great option for individuals looking for a low-cost plan with basic benefits. If you do not qualify for a federal insurance program, you may also want to consider a care membership. These are great for interim coverage or for longer periods of time.
Mira offers a care membership plan for $45 per month. Discounts offered through our care membership include $99 urgent care visits, up to 80% off of prescriptions, and same-day lab tests. Unlike many care plans, Mira also partners with gyms and other fitness centers to provide you with low-cost memberships.
Care memberships through Mira start the same day you purchase the plan, unlike short-term plans that start at least the day after. This is a great option for people who are not covered by any plan but are seeking coverage last minute. If you expect longer coverage, you can subscribe to our cheaper annual plan for a flat rate of $300. Mira has dozens of member locations in Texas and is in the process of creating new partnerships so that your coverage benefits you even more.
Short Term Health Insurance in Texas
As in the rest of the United States, short-term health insurance in Texas is an interim form of coverage as an individual transitions between two long-term insurance plans. The key difference in Texas is the length of time for which these plans are available.
Texas short-term coverage options are all initially available for up to a total of 12 months but can be extended to a maximum of 36 months. At this point, the individual does no longer qualifies for the short-term plan, and the plan will end. After an individual is no longer eligible for a short-term plan, it is recommended that individuals check and determine their eligibility for federal or state Medicaid or the Children’s Health Insurance Program (CHIP).
Short-term medical insurance plans are not as comprehensive as many employer-sponsored health insurance options. These plans do not include primary or routine care but are designed to include affordable options for emergency care, including:
- Emergency room and intensive care
- Inpatient care
- Hospital room and board
Some insurance plans may include other benefits, such as mental health services and/or addiction and psychological counseling services, but many plans do not. Remember that short-term coverage never includes pre-existing conditions, and therefore, these benefits must be purchased preemptively to the need for care.
Also, note that some conditions that you may develop during your time covered under a short-term health insurance program may prohibit you from renewal. These are the same conditions that would have disqualified you from receiving coverage in the first place. This may include but is not limited to:
- Men weighing more than 300 pounds or women weighing more than 250 pounds
- Losing U.S. resident status
Under short-term health insurance programs, you do not meet Minimum Essential Coverage (MEC) requirements under the Affordable Care Act (ACA). Because of this, you will likely be required to pay a tax penalty for not meeting MEC.
How Much Short Term Health Insurance Costs in Texas
Short-term health insurance is usually more affordable than the alternative ACA marketplace plans that are also available. While the deductible that needs to be met is similar, the monthly premium for the plan is cheaper on average.
Prices on Short Term Plans Versus ACA Plans in Texas 2021
Short Term Insurance
ACA Marketplace Insurance
Average Monthly Premium
Average Annual Deductible
These prices demonstrate that short-term health insurance plans are generally more affordable in Texas, but these plans are usually less comprehensive than ACA plans.
ACA plans may include more benefits and maybe a better option if you need short-term coverage for longer than a month or two. Short-term plans may be a better option if you need coverage for a month or two and predict that you will not need emergency care in the shorter time window.
Short Term Health Insurance in Texas Frequently Asked Questions (FAQs)
Understanding short-term health insurance is critical to maintaining good health if you are between jobs or other long-term insurance options. Here are some common questions associated with short-term coverage.
How are monthly premiums calculated for insurance policies?
Premium costs are dependent not only on the type of plan you purchase but also on other factors. Some factors may include:
- Applicant age
- Number of persons covered under the plan (single/married)
- Whether or not you have children
- Personal health risk factors including tobacco products
- Location of residence
Factors that are not allowed to be used in the calculation include gender or medical history, specifically disability.
What are other types of plans available in Texas?
If you no longer qualify for a short term plan and need a long term insurance plan, the state of Texas has four major options:
- Health Maintenance Organization (HMO) Plans
- Exclusive Provide (EPO) Plans
- Preferred Provider (PPO) Plans
- Point-of-Service (POS) Plans
Another type of plan available is a specified disease insurance plan. These policies are used for specific diseases only, such as cancer.
Am I required to have short-term health insurance?
No. You are not required to have short-term health insurance, but it is highly recommended. Having short-term coverage can help you to save money in the long term if any emergency expenses occur. Short-term health insurance does not meet the MEC under the ACA, and you will, therefore, be required to pay the ACA tax penalty.
Knowing the ins and outs of short-term health insurance can save you hundreds of dollars if you run into any unexpected medical expenses in between long-term coverage. Texas has unique short-term coverage options that you can purchase as insurance.
Mira in Texas is a great option for affordable coverage and benefits. Our expanding network of providers is available to members at a low cost. Sign up to start your short-term coverage today.