Quick Answer: Short-term health insurance costs $75 to $200 per month and can fill a narrow gap between coverage periods. But as of 2026, federal rules cap these plans at 4 months total, they exclude pre-existing conditions and maternity care, and most people who qualify for ACA subsidies will save more money with a marketplace plan. This article explains when short-term coverage is a reasonable bridge and when it is a trap.
Short-term health insurance sounds like a practical stopgap: affordable premiums, instant coverage, no open enrollment window required. In practice, the math only works for a very narrow slice of people in very specific situations. If you are between jobs, just turned 26, or waiting for employer benefits to begin, these plans can fill a defined gap. For everyone else, especially anyone who might qualify for ACA marketplace subsidies or Medicaid, short-term coverage almost always leaves you exposed.
Here is what you need to know about short-term health insurance in 2026 before you decide.
What Short-Term Health Insurance Actually Is
Short-term limited-duration insurance (STLDI) is a category of private health coverage that was designed to cover temporary gaps. Unlike ACA marketplace plans, STLDI policies are not required to cover the ten essential health benefits mandated by the Affordable Care Act. That exemption is why they cost less, and it is also why they cover less.
As of September 1, 2024, federal rules limit STLDI plans to an initial term of three months with one possible one-month renewal, for a total of four months. After a four-month policy expires, you cannot buy another STLDI plan from the same insurer within 12 months of your original effective date. This regulatory change, finalized by the Centers for Medicare and Medicaid Services (CMS.gov), significantly reduced the usefulness of these plans compared to the pre-2024 era when some people used them for up to 36 months.
In 2026, STLDI plans are either banned outright or effectively unavailable in at least 15 states and Washington, D.C. States where no short-term plans are sold include:
- New York (state law prohibits sale)
- California (STLDI banned)
- Massachusetts (STLDI banned)
- New Mexico (renewals prohibited; no insurers participating)
- Vermont (limited to 3 months; no insurers participating)
- Rhode Island (state rules are strict enough that no insurers offer plans)
- Washington (allowed up to 3 months; no insurers participating)
Delaware, Maryland, and Oregon allow STLDI but cap plans at three months, consistent with the new federal floor.
If you live in one of these states, short-term coverage is simply not an option. Check your eligibility for ACA marketplace coverage at coveredusa.org/screener instead.
What Short-Term Plans Cover (and What They Don't)
This is the most important part. Short-term health insurance is not a stripped-down version of regular health insurance. It is a fundamentally different product with different rules about what qualifies as a covered event.
Typical STLDI coverage:
- Emergency room visits (with high cost-sharing)
- Hospitalization for accidents and sudden illness
- Some outpatient surgery
- Some physician visits
What STLDI typically excludes:
- Pre-existing conditions (any health issue you had before enrolling)
- Maternity care and prenatal services
- Mental health treatment and substance use disorder services
- Preventive care including annual physicals and vaccinations
- Prescription drug coverage (or very limited Rx coverage)
- Birth control and reproductive care
- Cancer treatment if diagnosed before the policy start date
The pre-existing condition exclusion is the biggest risk. Insurers selling STLDI plans review your medical history and can deny claims for anything they determine relates to a prior condition. If you had a back injury two years ago and you fall while enrolled in a short-term plan, the insurer can argue the treatment is related to your pre-existing condition and deny the claim.
According to KFF Health News, this exclusion creates enormous financial exposure for policyholders who mistakenly assume their coverage is comprehensive.
2026 Cost Comparison: Short-Term vs. ACA Plans
The premium difference is real. Short-term plans typically cost $75 to $200 per month for an individual. The average ACA marketplace plan costs approximately $687 per month before subsidies in 2026. That price gap drives a lot of short-term plan purchases.
But the subsidy calculation changes everything.
ACA subsidies are available to people earning between 100% and 400% of the federal poverty level (FPL), and in some states even above 400% FPL depending on benchmark plan pricing. Subsidies do not apply to short-term plans at all. So the correct comparison is not the sticker price of an STLDI plan against the sticker price of an ACA plan. It is the STLDI sticker against your actual after-subsidy ACA premium.
2026 Federal Poverty Level (FPL) Reference for ACA Subsidy Eligibility:
| Household Size | 100% FPL (2026) | 138% FPL (Medicaid threshold) | 400% FPL (subsidy cliff) |
|---|
| 1 | $15,960 | $22,025 | $63,840 |
| 2 | $21,640 | $29,863 | $86,560 |
| 3 | $27,320 | $37,702 | $109,280 |
| 4 | $33,000 | $45,540 | $132,000 |
| 5 | $38,680 | $53,378 | $154,720 |
| 6 | $44,360 | $61,217 | $177,440 |
| 7 | $50,040 | $69,055 | $200,160 |
| 8 | $55,720 | $76,894 | $222,880 |
Source: ASPE.HHS.gov 2026 Poverty Guidelines. Each additional person adds approximately $5,680.
If your household income falls below your state's Medicaid threshold (138% FPL in expansion states), you likely qualify for Medicaid rather than marketplace coverage. If you are above 100% FPL and below the subsidy phase-out, you qualify for ACA premium tax credits. The KFF subsidy calculator can show your estimated subsidy based on income, household size, and state.
Many people buying short-term plans to save money are leaving significant subsidy money on the table.
When Short-Term Health Insurance Makes Sense in 2026
The honest answer is: rarely, but sometimes.
Short-term coverage is reasonable in these specific scenarios:
1. You have a defined, short gap between employer coverage periods. If you are starting a new job in 60 days and your prior employer coverage just ended, a short-term plan can cover that specific window. You know exactly how long you need coverage, you are healthy, and you have no chronic conditions that could trigger exclusions.
2. You are 26 and just aged off a parent's plan, and you do not qualify for subsidies. If your income is above 400% FPL and you are in good health, a short-term plan may cost significantly less than an unsubsidized ACA plan for the months before your next employer open enrollment.
3. You missed ACA open enrollment and do not have a qualifying life event for a Special Enrollment Period. This is a legitimate bridge use case. However, check whether you qualify for a SEP first.
Qualifying Life Events that trigger a 60-day Special Enrollment Period in 2026 include:
- Losing job-based or other qualifying coverage
- Getting married or divorced (if divorce results in lost coverage)
- Having a baby or adopting a child
- Turning 26 and losing coverage under a parent's plan
- Moving to a new state or coverage area
- A permanent move that makes new plans available
- Gaining citizenship or lawful status
- Release from incarceration
If any of these apply, you can enroll in an ACA marketplace plan through Healthcare.gov without waiting for open enrollment. A marketplace plan gives you full ACA protections including pre-existing condition coverage, which a short-term plan will never provide.
When Short-Term Health Insurance Is the Wrong Choice
Short-term plans are the wrong choice in these situations:
You have any pre-existing condition. If you have diabetes, asthma, a past cancer diagnosis, mental health conditions, or virtually any ongoing health concern, a short-term plan exposes you to claim denials on the exact treatments you are most likely to need.
You are pregnant or planning to become pregnant. Maternity care is almost universally excluded from STLDI plans.
You qualify for ACA subsidies. If your income falls between 100% and 400% FPL (or higher in some states), you may be able to get an ACA plan for $0 to $100/month after subsidies. Paying $150/month for a short-term plan that covers less is not a deal.
You live in a state where STLDI is unavailable. California, New York, Massachusetts, and roughly a dozen other states have no short-term plan market. Your alternatives are ACA marketplace plans, Medicaid, or going uninsured.
You need mental health or substance use services. ACA plans are required to cover behavioral health at parity with medical benefits. Short-term plans routinely exclude this category entirely.
How to Apply for ACA Coverage Instead
If you are reading this because you are in a coverage gap and wondering whether a short-term plan is your only option, the answer is almost certainly no.
Step 1: Check whether you qualify for Medicaid. In the 41 states (including D.C.) that have expanded Medicaid under the ACA, anyone below 138% FPL qualifies year-round regardless of open enrollment. Medicaid has no monthly premiums and covers pre-existing conditions.
Step 2: Determine if you have a qualifying life event. Review the SEP list above. Job loss is the most common trigger. If you lost coverage within the past 60 days or expect to lose it in the next 60 days, you qualify for a marketplace SEP right now.
Step 3: Estimate your subsidy at Healthcare.gov. Go to healthcare.gov and run the subsidy calculator with your household size and estimated annual income. The result often surprises people who assumed they could not afford marketplace coverage.
Step 4: Compare plans. On the marketplace, Silver plans are the benchmark for subsidies and typically offer the best balance of premium and out-of-pocket costs for most buyers. Bronze plans have lower premiums but higher deductibles.
Step 5: Enroll. ACA open enrollment for 2026 plan year coverage ran from November 1 through January 15 in most states. If you have a SEP, you can enroll immediately. If you do not, you have options for the next open enrollment period starting November 1, 2026.
Documents you will need:
- Social Security numbers for everyone in your household
- Employer and income information (pay stubs, W-2s, or tax returns)
- Information about any current health coverage
- Immigration or naturalization documents if applicable
- Birth certificates for new dependents
Common reasons ACA applications get delayed or denied:
- Income estimate does not match IRS records (reconcile on your tax return)
- Citizenship or immigration status cannot be verified
- Social Security number mismatch
- Enrollment submitted outside your SEP window
- Failure to pay first premium within the required window
Use the free eligibility screener at CoveredUSA to see which programs you qualify for based on your state, household size, and income. It takes about two minutes. Check your eligibility now at CoveredUSA, it takes 2 minutes.
Short-Term vs. ACA: Side-by-Side Comparison
| Feature | Short-Term Plan (STLDI) | ACA Marketplace Plan |
|---|
| Pre-existing conditions | Excluded | Covered (required by law) |
| Maternity care | Usually excluded | Required essential benefit |
| Mental health coverage | Usually excluded | Required at parity |
| Preventive care | Usually excluded | Required at $0 cost-sharing |
| Prescription drugs | Limited or excluded | Required essential benefit |
| Maximum duration (2026) | 4 months total | Annual (renews each year) |
| Subsidies available | No | Yes (income-based) |
| Annual/lifetime caps | Allowed | Prohibited |
| Available year-round | Yes | Only with SEP or during OE |
| States available | About 35 states | All 50 states + D.C. |
Source: HealthCare.gov and CMS.gov.
Frequently Asked Questions
Is short-term health insurance worth it in 2026?
For most people, no. The 2026 federal limit of four months total and the exclusion of pre-existing conditions, maternity care, and mental health services make these plans unsuitable for anyone with ongoing health needs. The only scenario where STLDI is clearly worth it is a healthy individual facing a well-defined, short coverage gap who does not qualify for ACA subsidies and does not have a qualifying life event for a Special Enrollment Period.
How long can I keep a short-term health insurance plan in 2026?
Under federal rules that took effect September 1, 2024, the maximum initial term is three months with one possible one-month renewal, for a total of four months. After four months, you cannot buy another STLDI plan from the same insurer for 12 months. Some states set stricter limits. In states like Delaware, Maryland, and Oregon, the maximum is three months with no renewal.
Can short-term health insurance be my only coverage?
It can, but it carries significant financial risk. STLDI plans can deny claims related to any pre-existing condition, and they impose annual and lifetime benefit caps that are prohibited under ACA plans. A single hospitalization for a condition the insurer deems pre-existing could leave you with tens of thousands of dollars in uncovered medical bills.
Do I need to wait for open enrollment to get an ACA plan if my short-term plan runs out?
Not necessarily. If your short-term plan ending is your only coverage loss, it generally does not qualify as a loss of minimum essential coverage, which means it may not trigger a Special Enrollment Period. However, if you had a qualifying life event (job loss, move, marriage, etc.) that caused you to choose the short-term plan in the first place, that event may still support a SEP. Talk to a licensed broker to confirm. You can check your options through CoveredUSA.
How much does short-term health insurance cost in 2026?
Short-term plans typically cost $75 to $200 per month for individuals. Premiums vary by age, state, deductible level, and coverage limits. A healthy 30-year-old might pay around $100/month for a plan with a $5,000 deductible. Compare this to an ACA Silver plan, which averages $687/month before subsidies but may cost far less with income-based premium tax credits.
What states ban short-term health insurance in 2026?
As of 2026, short-term health plans are unavailable in at least 15 states and Washington, D.C. due to outright bans or state rules that effectively prevent insurers from offering plans. These include California, New York, Massachusetts, Vermont, New Mexico, Rhode Island, and Washington. If you live in one of these states, your options are ACA marketplace plans, Medicaid, CHIP (for children), or other coverage types. Use the screener at CoveredUSA to find what you qualify for.
What happens if I get sick and my short-term plan says it's a pre-existing condition?
The insurer can deny the claim. You would be responsible for the full cost of treatment. STLDI plans are not required to provide an appeals process equivalent to ACA plans, though some state laws create minimum requirements. This risk is the core reason most consumer advocates and licensed insurance professionals advise against STLDI for anyone with any health history.
Is there a better option than short-term health insurance for a coverage gap?
Yes, in most cases. If you lost job-based coverage, you have 60 days to enroll in an ACA marketplace plan through a Special Enrollment Period. If your income is below 138% FPL in an expansion state, you qualify for Medicaid year-round. If you are between 26 and 65 and your income is above Medicaid limits, an ACA plan with premium tax credits is almost always more cost-effective than STLDI once subsidies are factored in. Run the numbers before defaulting to a short-term plan.
