Short-Term Health Insurance Plan

Short-term health insurance plans have a limited duration. No more is available until 12 months from the effective date of the first policy. These plans were initially geared toward people who needed temporary medical insurance to bridge the gap between plan years for standard-term plans. For instance, people who are switching employers, starting graduate school, or young adults who have become ineligible for coverage under their parents' plans and are searching for their own insurance might use a short-term insurance plan until obtaining a more permanent solution. Other examples are:

• Recent college graduates who need temporary coverage
• Part-time or temporary employees
• Between jobs and looking for an affordable temporary alternative to COBRA
• Newly employed and waiting for health benefits to begin
• Recently retired and waiting for Medicare eligibility

The WPS Short-Term Health Insurance Plan lets you choose your coverage period, from 28 days to 90 days. You can apply for a new plan when the initial one ends, but the combined coverage period cannot exceed 120 days in a 12-month period.

Short-term health insurance coverage varies greatly depending on the plan and the insurance company. These types of plans are not required to comply with Affordable Care Act (ACA) guidelines and can be lower cost. ACA plans are required to provide certain levels of coverage—called Minimum Essential Coverage. Short-term health plans are not required to meet the same standards. Short-term medical insurance typically provides some level of coverage for: preventive care, doctor visits, urgent care, and emergency care. There may also be coverage for prescriptions. Some plans also offer cost savings for seeing in-network providers. Note: Make sure to read the “exclusions and limitations” information before buying any plan. This will highlight what is covered and not covered by a certain plan but may not be all inclusive. For full plan details, read the policy’s certificate. These plans will not cover claims for conditions that exist prior to the effective date.

Short-term health plans are available to customers who can pass medical underwriting. The WPS Short-Term Health Insurance Plan lets you choose your coverage period, from 28 days to 90 days. You can apply for a new plan when the initial one ends, but the combined coverage period cannot exceed 120 days in a 12-month period. WPS short-term policies have a six-day waiting period for any illness. WPS policies will pay claims related to injuries/accidents that do occur in the first six days provided they are not related to an accident or injury that existed or happened prior to the effective date of the policy.

Customers are eligible for Affordable Care Act individual policies outside of the Open Enrollment Period if they have a Qualifying Life Event (e.g., marriage, divorce, birth, permanent move, etc.). If they do not have a qualifying event, they can apply for a short-term health insurance policy. If they pass the underwriting questions, they can be issued a policy. Note: Preexisting conditions may not be covered under a short-term health plan.

If you are considering temporary health insurance, typical upfront costs include:

• Premium: This is the monthly fee you pay for having coverage. The premium will vary depending on the level of coverage you choose, including deductible and coinsurance, as well as the types of services covered.
• Deductible: The deductibles on short-term health plans can be significantly higher than for traditional health plans. You pay out of pocket for services until you meet your deductible. Then your plan starts sharing costs.
• Coinsurance: This is the percentage of costs you share with your plan after you meet your deductible. It’s often shown as a percentage. Most short-term plans have a deductible and use coinsurance.
• Copayment: This is a fee you may pay when you visit a doctor; usually payable at the time of the visit. Some short-term plans require you to pay a copay for certain doctor visits.
• Other out-of-pocket costs: If there are health care services not covered by your short-term plan, you could end up paying all costs. For example, some short-term plans may not cover or may limit your coverage for maternity care, mental health or substance use services, vision care, or dental care—these are costs you’d have to pay yourself for any services you receive.
• Other costs may apply depending on what type of coverage you buy. Read all plan information carefully before choosing so you are informed on what your plan may actually cost you.

Individuals who are 18–64 years old are eligible.

Rates are based on age, policy duration, gender, and the Wisconsin county in which you live.

Yes. The WPS application contains questions pertaining to your medical history. If you select yes to any of these medical underwriting questions, you will not be eligible for a WPS short-term policy.

If the primary applicant is declined, a spouse over the age of 18 can become the primary applicant. If there is no spouse, all applicants would be declined. WPS does not offer child-only plans.

No, the short-term plan does not cover preexisting conditions. The insurer will reduce the length of time during which a preexisting condition exclusion may be imposed by the aggregate of your consecutive periods under the new health plan. Coverage periods are consecutive if there are no more than 63 days between coverage periods.

Expenses for injuries are eligible for coverage as of your plan's effective date. Coverage for illnesses have a six-day waiting period, so expenses related to illnesses are eligible for coverage beginning on the seventh day following the effective date.

Coverage begins the day after the online application is submitted or the postmark date of the paper application. You can also choose to set the effective date up to 60 days from today’s date. Coverage will not be in effect unless a full month’s premium has been collected.

There is a $1 million policy maximum.

Yes, exclusions and limitations do apply. Full details are in the WPS policy packet provided for enrollment.

No. Find out more about the Medicare Part D late enrollment penalty.

WPS Short-Term Health Insurance Plan uses the WPS Statewide Network. Our WPS Statewide Network includes more than 65,000 health care providers, a wide range of clinics and specialty care centers, and 200+ hospitals throughout Wisconsin, as well as parts of Illinois, Iowa, and Minnesota (nationwide network coverage is not included with these plans). Out-of-network claims are processed subject to maximum allowable charges.

Yes, the WPS Short-Term Health Insurance Plan offers coverage outside of Wisconsin, but may be subject to out-of-network benefits. The WPS Short-Term Health Insurance Plan is a PPO; therefore, there is coverage for out-of-network providers. If claims are for emergency services out of network, these would be subject to the customer’s in-network benefits.

If you move outside of Wisconsin after the WPS Short-Term Health Insurance Plan policy is in effect, you can retain the policy for the duration of the policy term. Because the plan is only available to Wisconsin residents, once the policy term expires, you will not be eligible for another term if you move out of state.

If you have reached your 120 day maximum policy period with WPS, you may not apply for another short-term policy within a 12-month period. You will have to wait until your 12-month timeframe is over.

No, short-term policies are not renewable. You may apply for additional policy terms provided they do not exceed 120 days of consecutive coverage in a 12 month period.

Yes. Your effective date can be any date during the month with a 28-day coverage period. Partial months of coverage will be prorated based on the monthly premium.

Your short-term plan will coordinate with other health insurance policies. Please refer to your policy for additional details.

Yes. WPS reserves the right to rescind a policy in the event there is a failure to disclose or misrepresentation of required information during the application process.

Yes, however, this is a temporary policy offered with a 28 day minimum term. Termination should be a rare occurrence.

Policies are billed monthly. The premium due date is the first day of each month.

Yes, WPS requires payment of a full month’s premium at the time of application submission.

You can pay by credit card, automated payment (ACH), or check. More information is available on our premium payments page.

There is a 10-day grace period following the premium due date.

If your premium is not received prior to the 10-day grace period, your policy will be terminated.

If paying by check, please send payments to:
WPS Health Insurance
P.O. Box 18232
PALATINE, IL 60055-0001

Customers should call the Customer Service number on their WPS ID card. If you’re not yet a customer, please contact one of our sales associates at 800-332-0893.