Short-Term Health Insurance in Florida: Rules, Costs & Options (2026)

Current Florida Short-Term Insurance Rules (2026)

Florida follows the federal rules for short-term health insurance. Here are the key parameters as of 2026:

The September 2024 Rule Change Explained

In March 2024, the Biden administration finalized a rule (effective September 1, 2024) that significantly limited short-term health insurance plans. The rule was prompted by concerns that consumers were being enrolled in short-term plans without fully understanding their limitations, leading to surprise claim denials and coverage gaps.

What Changed

• Duration reduced: Maximum initial term dropped from 364 days to 3 months. Maximum total duration (with renewals) dropped from 36 months to 4 months.
• Enhanced disclosures: Plans must now prominently display notices that they are not ACA-compliant, do not cover pre-existing conditions, and are not a substitute for comprehensive coverage.
• Application clarity: Carriers must ask clear, standardized health questions and explain how pre-existing condition exclusions work before enrollment.

Impact on Florida Consumers

The rule change means short-term plans are no longer viable as a year-round coverage strategy. Before September 2024, some Floridians used short-term plans as their primary health insurance for years by stringing together renewable 364-day policies. That is no longer possible. Short-term plans are now strictly what their name implies: short-term gap coverage for brief transitions.

Political Uncertainty

It is worth noting that short-term insurance rules have changed with each presidential administration. The Obama administration initially limited short-term plans to 3 months in 2016, the Trump administration expanded them to 364 days with 36-month renewals in 2018, and the Biden administration reverted to shorter limits in 2024. Future administrations may change the rules again. As of April 2026, the 3+1 month rule remains in effect.

What Short-Term Plans Cover

Short-term plans provide medical coverage for new, unexpected health events. Coverage details vary by carrier and plan level, but most Florida short-term plans include:

Typically Covered Services

• Inpatient hospitalization: Room and board, surgery, anesthesia, and associated hospital charges for admitted patients.
• Emergency room visits: Treatment for medical emergencies, though copays or coinsurance may be high ($200-$500 copay is common).
• Outpatient surgery: Ambulatory surgical center procedures.
• Doctor office visits: Most plans cover primary care and specialist visits after a copay, though some plans only cover these after the deductible is met.
• Diagnostic imaging: X-rays, CT scans, MRIs, and ultrasounds (usually after deductible).
• Laboratory services: Blood work, urinalysis, and other diagnostic tests.
• Urgent care: Treatment at urgent care centers for non-emergency conditions.
• Ambulance services: Emergency ground and air ambulance (often with limits).

Coverage Structure

Most short-term plans in Florida use a deductible + coinsurance structure:

1. You pay 100% of costs until you meet your deductible ($2,500-$10,000)
2. After the deductible, the plan pays a percentage (commonly 50% or 70%) and you pay the rest (coinsurance)
3. Coverage continues until you hit the plan's benefit maximum ($250,000-$1,000,000)

Some plans offer a per-visit copay structure for doctor visits separate from the deductible, making routine care more predictable.

What Short-Term Plans Do NOT Cover

This is arguably the most important section of this guide. The exclusions on short-term plans are extensive and significant:

Universal Exclusions (All Short-Term Plans)

• Pre-existing conditions: Any condition diagnosed, treated, or symptomatic during the medical look-back period (typically 3-5 years) is completely excluded. This includes controlled conditions like managed diabetes, medicated hypertension, treated depression, asthma, and more.
• Maternity and newborn care: Pregnancy, prenatal care, delivery, and postpartum care are not covered. If you become pregnant while on a short-term plan, all pregnancy-related expenses are your responsibility.
• Mental health and substance abuse: Therapy, counseling, psychiatric medication, inpatient mental health treatment, and substance abuse treatment are excluded on most plans.
• Preventive care: Annual physicals, wellness screenings, immunizations, and routine bloodwork are not covered (or covered with limited benefits on some plans).

Common Additional Exclusions

• Outpatient prescription drugs (excluded entirely on many plans)
• Dental and vision care
• Chiropractic treatment
• Physical therapy and rehabilitation (or limited to a small number of visits)
• Durable medical equipment
• Home health care and skilled nursing
• Weight loss surgery and treatment
• Cosmetic procedures
• Infertility treatment
• Self-inflicted injuries
• Injuries from high-risk activities

Short-Term Health Insurance Costs in Florida (2026)

Short-term plans are priced based on age, health status, tobacco use, and the chosen deductible and benefit level. Unlike ACA plans, short-term carriers can charge different rates based on your health.

Monthly Premium Ranges by Age (Non-Smoker, Moderate Deductible)

Note: These are estimated ranges based on available Florida carriers. Actual quotes depend on your specific health history and the carrier's current rates. Smokers typically pay 20-50% more.

Available Short-Term Carriers in Florida (2026)

Several insurance carriers offer short-term plans to Florida residents. Here is an overview of the major options:

United Healthcare Short-Term (Golden Rule)

One of the largest short-term carriers nationally. Offers multiple deductible and coinsurance options. Uses the UnitedHealthcare Options PPO network, which is broad in Florida. Plans include optional prescription drug riders. Known for relatively efficient claims processing.

National General (now part of Allstate)

Offers short-term plans with customizable benefit levels. Multiple deductible options from $2,500 to $10,000. Coinsurance options of 50/50, 70/30, and 80/20. Uses the First Health PPO network. Optional add-ons for prescription drugs, telemedicine, and accident coverage.

Companion Life

Provides short-term major medical plans in Florida. Competitive pricing for younger applicants. Uses the PHCS/Multiplan network. Plans include emergency room and hospitalization coverage.

IHC Group (Independence Holding Group)

Offers short-term plans through various subsidiary brands. Multiple plan designs available. Network access through PHCS/Multiplan. Includes some unique benefit structures for outpatient care.

Pivot Health

An InsurTech company offering short-term plans with a modern online experience. Competitive rates for healthy individuals. Quick online enrollment with same-day or next-day coverage. Uses the First Health network in Florida.

How to Enroll in Short-Term Insurance in Florida

The enrollment process for short-term plans is fast and straightforward compared to ACA marketplace enrollment:

Step-by-Step Process

1. Apply online or by phone: Most carriers offer online applications that take 10-20 minutes. You can also apply through a licensed agent.
2. Complete the health questionnaire: Answer questions about your medical history, current medications, height/weight, and tobacco use. Answer honestly; inaccurate answers can result in claim denials later.
3. Choose your plan: Select your deductible, coinsurance level, and benefit maximum. Add optional riders (prescription drugs, dental, etc.) if desired.
4. Receive approval: Most applications are approved within minutes to 24 hours. Some may require additional medical information.
5. Coverage begins: Depending on the carrier, coverage can start as soon as the next day or up to 14 days after application.

No Enrollment Period Required

Unlike ACA marketplace plans, short-term insurance can be purchased any day of the year. There is no open enrollment period or special enrollment period requirement. This immediate availability is one of the primary advantages of short-term coverage.

Who Should Consider Short-Term Health Insurance

Short-term insurance is appropriate in a narrow set of circumstances. You may be a good candidate if:

Good Candidates

• Between jobs with a short gap: You left one employer and start a new job in 1-3 months. Your new employer's coverage begins after a waiting period, and you need temporary protection.
• Missed marketplace open enrollment: You did not enroll during the November-January window, do not have a Special Enrollment Period trigger, and need some coverage until the next enrollment period.
• Waiting for other coverage to begin: You are waiting for Medicare (turning 65 soon), a spouse's employer coverage to start, or another plan's effective date.
• Young and healthy: You are under 40, in excellent health with no pre-existing conditions or medications, and want the cheapest possible temporary coverage.
• Leaving the country soon: You are moving abroad in a few months and just need basic coverage until departure.

Your Profile Matches If:

• You have no chronic conditions or ongoing prescriptions
• You have not been diagnosed with any significant health issues in the past 5 years
• You do not plan to become pregnant during the coverage period
• You understand and accept the coverage limitations
• You only need coverage for 1-4 months

Who Should Avoid Short-Term Health Insurance

Short-term plans are not appropriate for many Floridians. You should seriously consider other options if:

Avoid Short-Term Insurance If:

• You have any pre-existing conditions: Even well-controlled conditions like managed hypertension or Type 2 diabetes will be excluded. If something goes wrong related to that condition, you have no coverage.
• You take regular prescription medications: Most short-term plans do not cover outpatient prescriptions, or coverage is very limited.
• You are or might become pregnant: Maternity care is universally excluded from short-term plans.
• You need mental health services: Therapy, psychiatric care, and counseling are excluded from most short-term plans.
• You need coverage for more than 4 months: The 3+1 month limit means short-term is not a long-term solution.
• You qualify for ACA marketplace subsidies: A subsidized marketplace plan will almost certainly be both cheaper and more comprehensive than a short-term plan.
• You are over 55: Premiums are high for older adults, and the risk of needing care for conditions related to age makes the pre-existing exclusion particularly dangerous. See our early retiree guide for better options.

Better Alternatives for Most People

Before purchasing a short-term plan, consider these alternatives that provide more comprehensive coverage:

ACA Marketplace Plans

If you qualify for a Special Enrollment Period (job loss, move, marriage, etc.) or it is during Open Enrollment (November 1 - January 15), a marketplace plan is almost always superior. With subsidies, marketplace plans can cost less than short-term plans while covering pre-existing conditions, prescriptions, mental health, and preventive care. See our COBRA alternatives guide for a full comparison.

COBRA

If you just left an employer with 20+ employees, COBRA continues your exact employer plan. It is expensive ($763/month average) but provides comprehensive coverage including pre-existing conditions. COBRA can be elected retroactively within 60 days, making it an effective safety net.

Health Sharing Ministries

If you need ongoing coverage and do not qualify for marketplace subsidies, health sharing ($150-$360/month) offers lower costs than short-term with the possibility of longer-term membership, though it comes with its own set of limitations. See our non-ACA options guide.

Spousal Coverage

If your spouse has employer coverage, your loss of coverage qualifies you to join their plan. This is often the most straightforward solution.

Direct Primary Care

For routine care needs during a short gap, a DPC membership ($75-$150/month) provides unlimited primary care visits. Pair with a short-term plan for catastrophic protection if needed. Learn about this approach on our self-employed insurance page.

Understanding the Short-Term Claims Process

If you do enroll in a short-term plan, understanding how claims work can help you avoid surprises:

In-Network vs. Out-of-Network

Short-term plans typically use PPO networks. Going to in-network providers means the carrier has negotiated rates, reducing your cost. Out-of-network care is either not covered or covered at a significantly reduced rate (commonly 50% of "reasonable and customary" charges, which may be far less than the actual bill).

The Claims Review Process

1. Provider submits claim: Your doctor or hospital sends the bill to the short-term carrier.
2. Carrier reviews medical history: The carrier may request your medical records to check for pre-existing condition connections.
3. Claim decision: If the condition is deemed new (not pre-existing) and the service is covered under the plan, the carrier processes payment according to your deductible and coinsurance.
4. Explanation of Benefits: You receive an EOB showing what the carrier paid and what you owe.

Appealing Denied Claims

If a claim is denied, you have the right to appeal. Short-term carriers must provide a written explanation of the denial. You can submit additional medical documentation to support your appeal. If the internal appeal is unsuccessful, you can file a complaint with the Florida Department of Financial Services. However, short-term plan appeal rights are less robust than those for ACA-compliant plans.

Frequently Asked Questions: Short-Term Health Insurance in Florida