SHORT TERM MEDICAL INSURANCE 

    In Oregon Short-Term Medical (STM) insurance contracts are limited to a 90 days maximum per contract.  A Short Term medical plan is a type of limited-benefit health insurance.  The policy is not subject to the Affordable Care Act/Obamacare regulations.  Generally pre-existing conditions, preventative services and tests, and prescription drugs are not covered.  The coverage is also not guaranteed-issue, meaning you need to answer no to 6-7 questions to qualify.

DO YOU FEEL PRICED OUT OF TRADITIONAL COVERAGE?

    These 2 STM plans cost about half of what the Marketplace plans cost for 2026.  Why?   Because they are only insuring you for a 3 month contract, and they are not obligated to pay for expensive prescription drugs.    How would a person be on short term medical plans in Oregon for a year?  Consider the example of Bob, age 50, healthy on no expensive medications and not a diabetic.   
The example below is for illustration purposes only.

1/1-3/31 Bob enrolled in the Allstate National $5000 plan with 50/50%   $1174 for 3 months of coverage ($392 per month average)   Bob also added the stand-alone Allstate National Plan enhancer Accident policy for $32 per month.   (This would continue all year to protect him from big expenses related to an accident)    

4/1-6/30 Bob enrolled in the  Pivot Health Deluxe Plan with $5000 deductible:  $375 for 3 months of coverage ($125 per month average)

7/1-9/30  Bob was healthy and enrolled again the Allstate National plan. Again, $1174 for 3 months of coverage.

10/1-12/31  Bob again was healthy and enrolled in the Pivot Health plan to end out the year, costing him $375 for the 3 months of coverage.

If Bob purchased 2 Pivot health plans and 2 Allstate National plans (3 month contracts), the Short Term medical option would save $4054 in premiums in 2026 compared with purchasing the least expensive Marketplace plan (The Providence Connect 9800 plan.  This assumes that every 3 months Bob could requalify for the next STM plan, and that the STM plan rates remained unchanged for 2026.

    I contract with 2 companies--Pivot Health and the Allstate National plan.  You can enroll for up to 3 months with each company, but cannot re-apply with the same company until 60 days has passed.  This means you can apply with Pivot Health for up to 90 days, then the Flex Term plan for up to 90 days.  After that you can reapply for Pivot Health, and so forth, as long as you still qualify.

   Generally, STM plans were designed for someone needing medical insurance for a limited amount of time while waiting for other coverage to begin.  With traditional insurance being unaffordable to many today, STM is a more affordable solution.   This is not a good option if you take expensive medications and have pre-existing conditions you need treatment for.

   Please take the time to read the brochure plan limitations and exclusions prior to enrolling in coverage to see if the coverage is right for you.  It is important to make an informed decision.  

 WHEN DOES COVERAGE BEGIN AND HOW DO I QUALIFY?

    Coverage can begin as early as next-day, or you can select a future day for the plan to start.  To qualify you have to answer NO to the 6 or 7 qualifying questions. I always recommend if possible to have the coverage end the last day of a month. For example, if your plan starts effective October 1, have your coverage end on December 31. This will benefit you should you transition to a new plan.

HOW DO I RECOMMEND USING SHORT TERM MEDICAL INSURANCE?

   1.  I recommend starting with the higher-cost Allstate National Plan.   You have freedom to go to providers that accept the Aetna Open Choice PPO Network.   This includes a million providers nationally, and many of our local health clinics in the Portland area.  I recommend adding the stand-alone Accident policy with Allstate (Called the Plan Enhancer) with a $10,000 benefit.  This will help you should you have a large bill related to an accident. This policy will continue beyond the 3 months indefinitely until you cancel it.

2.  After the 3 months is up, if you are healthy, I would enroll for 3 months in the Pivot Health Deluxe plan.  Select the deductible and price-point you are comfortable paying.  When this contract is up you can re-enroll (if you qualify) in the Allstate National plan. 

COMPANY 1:  Allstate National  (Twice the price of Pivot Health)

   The Allstate Health Solutions plan is underwritten By Allstate Corporation.   The plan offers a range of deductible and coinsurance options.   The only service covered before the deductible is a visit to an Urgent Care with a $50 copay.   Although you have freedom to use any provider, you will pay less if you select a provide in the Aetna Open Choice PPO Network (search link below).

   Prior to making application please review the plan brochure, especially the plan limitations and exclusion section so you understand what you are purchasing.   Click on the link below to quote All State National:

Allstate National Brochure

  You can read about the coverage and browse the plan limitations at the link below.  When you get to the final page of the application, you can save 20% if you single-pay for the 3 months of coverage.

Quote & Enroll in Allstate STM Plans

  Allstate National clients that see an in-network provider will pay less when they see a contracted provider. Tell your provider that you have an insurance plan that uses the Aetna Open Choice PPO network. You can search providers using the link below:

Search Aetna Open Choice PPO Network 

  You can tell your provider that you have a health plan that includes the Aetna Open Choice PPO Network.   There are over 1 million providers in this network nationwide. You can choose a single pay option and save 20%.    I recommend adding the $10,000 Plan Enhancer stand-alone Accident policy.   

COMPANY 2:  PIVOT HEALTH  (1/2 the price of Allstate National)

     Pivot Health Plan is underwritten by Companion Life Insurance Company.  Pivot Health has no contracted provider network:  so you can see any doctor that agrees to bill the plan.  If the provider is unwilling to bill Pivot Health, ask for a cash price, pay the bill, and submit the claim to Pivot Health directly.   I can help you get a claim form.

 Pivot Health Brochure

   Please review the plan coverage plan limitations and exclusions section of the brochure prior to enrolling.  The qualifying enrollment questions are also included in the brochure below.  All the plans include free Telehealth services.   The brochure outlines side-by-side the different plans and benefit options.

The Deluxe plan offers the lowest out-of-pocket maximum.   There are lower cost options available.

Click the link below for a quote:

Quote Pivot Health    

     Pivot health offers many plan options tailored to your pricing needs.  I recommend the Deluxe plan as it has a $3000 out of pocket maximum (after your deductible is met).  The Deluxe plan offers 3 combined visits to  Urgent Care, Primary Care, or a Specialist visit before your deductible.  24/7 TeleDoc service is also included at no cost.   

Application Notes for Pivot Health:   

     When you get to the payment section of the application you will see a 'pre-pay' option. If you single-pay for the 3 months of coverage, you save about 20% in premiums. However, by pre-paying you are not allowed to cancel early with a refund if you only need a month of coverage.

Quick Links for Pivot Health Customer Service

Customer service can be reached at 844-630-7500 to cancel your plan.

To cancel your plan prematurely you can call customer service or email clientservices@insurancebenefitadministrators.com

UNDERSTAND THE OUT OF POCKET MAXIMUM:   

    Since STM plans do not cover prescription drugs, I recommend going to http://www.goodrx.com and looking up your drugs for a discount..  You will find the best cash pricing at local pharmacies.   It's a great tool that will also show you discount programs for expensive drugs.

SAVE MONEY ON LAB WORK:

      If you live in the Portland area and want to save on the high cost of Lab work, you can purchase your own lab work at Quest Diagnostics, then bring the results to the provider of your choice.    There are multiple offices around the Portland area.

 https://www.questhealth.com/?itm_campaign=QD-Patients-GetTested-HP

   EXAMPLE:    You can use Quest to order a colorectal screening home test, Comprehensive Metabolic Panel, Cholesterol Panel, TB, A1c, CBC, STD screenings, and more.

        Short Term Medical Disclosure