Eligibility and Coverage
Eligibility requirements vary by state.
Alaska and Texas residents:
You are eligible for Moda Health short term medical insurance if you and any family members who apply for coverage:
- Are under age 65 and will remain under age 65 for the term of the policy
- Are not eligible for Medicare benefits and will not be eligible for Medicare benefits for the duration of the policy
- Are not pregnant. If any member of your family is pregnant, you may not apply for coverage until the pregnancy concludes.
- Are not covered under any other hospital or medical plan (for Alaska residents only)
Children are eligible for short term medical:
- Subscribers under age 18 will need a responsible party over age 18. Subscribers age 17 and under cannot have dependents.
- Dependent children who are married or age 26 and older must apply for their own policy
What is and isn't covered
What it covers
Short term medical insurance covers major hospital, medical and surgical expenses resulting from an unexpected accident or new illness. It usually covers:
- Medical services
- Hospital stays
- Doctor visits
- Urgent care
- X-rays & miscellaneous services
- Out-of-hospital care
What it doesn't cover
Short term medical insurance is for people with coverage gaps who are not eligible for Medicaid, Medicare, or are outside of Open Enrollment. It does NOT cover:
- All ACA plan benefits
- Pre-existing illnesses, injuries or medical symptoms diagnosed, treated, or prescribed within the last 5 years. A condition can also be considered pre-existing if the symptoms were severe enough that a prudent person would seek diagnosis, advice, care, or treatment (even if you didn't).