STLDI coverage was designed as bridge coverage so the consumer has some insurance until better coverage is arranged. The premiums are low and so is the protection.
After passage of the federal Affordable Care Act (ACA, often called Obamacare) standards were proscribed for comprehensive major medical insurance policies. STLDI medical coverage is Short-Term Limited Duration Insurance which is a tempting option.
The STLDI plans can exclude coverage for pre-existing conditions and the plans need not cover essential health benefits such as:
- prescription drugs
- maternity care
- preventative services
- mental health disorder
- substance abuse disorders
Claims can easily be denied or the consumer gets pennies on the dollar. For example, if a person is diagnosed with cancer, the uncovered bills can be astronomical. Those hoping for comprehensive coverage during the pandemic should read over the terms of their coverage thoroughly. Treatment, testing, and how the insurance plan handles pre-existing conditions are all factors that should be reviewed.
When regulations under the ACA were relaxed by the federal government, individual states bore responsibility to regulate the STLDI plans. The original restriction to 12-months of minimal coverage can now be extended to 36 months.
It is no surprise that some insurance companies tout the low premiums. The more reputable insurance companies realize consumers may opt for low-cost, low-coverage and overlook the benefits of truly comprehensive coverage. Pennsylvania is considering legislation to restrict renewability and to provide critical disclosure to consumers.
Consumers at risk who consider STLDI plans are those who lose coverage because:
a. Parents cannot provide coverage despite ACA allowing family coverage for a child to age 26;
b. Those who are laid off by a small company without a COBRA option;
c. Those who are laid off who cannot afford the COBRA premium cost; and
d. Those who no longer qualify for COBRA.
In times of medical surprises (COVID, cancer, accidental injuries or just bad luck) Short-Term Limited Duration Insurance should be recognized for what it provides – minimal coverage at minimal cost.