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.  This means you need to answer no to 6-7 questions to qualify.  The Flex Term plan will pay for a Wellness Exam with a $50 copay (but not the tests that go with it).   

DO YOU FEEL PRICED OUT OF TRADITIONAL COVERAGE?

    I offer 3 different STM plans, which cost about half, to a third of what the Marketplace plans cost for 2026.  Why?  Because STM plans only insure you for a 3 month contract.  They are not obligated to pay for expensive prescription drugs, and they do not cover pre-existing conditions--just new illnesses and injuries you suffer.

    If health insurance is unaffordable for you, how could a person be insured on short term medical plan in Oregon for a year?  Consider the example of Bob, age 50, healthy with no pre-existing conditions.  The least expensive Marketplace plan for Bob would cost $600 monthly, or  $7200 per year.   Here is an example of Bob enrolling in STM insurance for 2026.

 The example below is for illustration purposes only.

1/1-3/31/26 Bob enrolled in the Pivot Health Deluxe Plan with a $5000 deductible. The plan cost $375 total for 3 months of coverage, averaging $125 per month.   

4/1-6/30/26 Bob enrolled in the Flex Term STM plan for a 90 day plan with the $5000 deductible.  The plan costs $627, averaging $209 per month.   The plan covers a Wellness exam with a $50 copay, Bob had scheduled a Wellness exam with his doctor to review lab work he had ordered beforehand from the local Quest lab:

Order Lab​ work online from Questhealth.com

7/1-9/30/26  Bob enrolled again in the Pivot Health plan for $375 for 3 months.

10/1-12/31/26  Bob again enrolled in the Flex Term plan for $627 for 3 months.   

SUMMARY FOR BOB:   Alternating between the 2 STM plans, Bob spent $2004 in premiums total for the 4 contracts.   This saved Bob $5200 * compared with buying a Bronze plan on the Marketplace.    

*   This illustration 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 3 plans--Pivot Health,  Flex Term and the Allstate National (from least to most expensive).  You can enroll for up to 3 months with each company, but cannot re-apply with the same company until 60 days has passed.  You also need to answer NO to the 6 questions in the application to be accepted.

    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 a 90 day, single-pay,  Pivot Health Deluxe plan, or the Choice plan if you need a lower premium.   As a companion plan, I recommend the stand-alone, Accident policy from Allstate with a $10,000 benefit to cover costs related to an accident.    

Allstate Accident page

2.  After the 3 months is up, if you are healthy, I would enroll in a single-pay, 60 day,  Flex Term STM plan.  It costs about about 1/3 more than the Pivot Health plan.  I would they enroll for 90 days in the Pivot Health plan again, if you can still answer no to the qualifying questions.

COMPANY 1:  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 with a claim form.   

   The brochure outlines side-by-side the different plans and benefit options. The Deluxe plan offers the lowest out-of-pocket maximum. Please review the plan coverage plan limitations and exclusions section of the brochure prior to enrolling by clicking on the link below:

 REVIEW the Pivot Health Brochure

Coverage can begin next-day.   Click the link below for a quote and to enroll:

QUOTE-ENROLL in 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.

COMPANY 2:  Flex Term plan (Less expensive compared with the Allstate plan)

   The Flex Term plan is underwritten by Everest Reinsurance Company, which has an A+ Rating with AM Best.    The plan offers a $50 copay for a Physician or $50 for a Wellness visit, before the deductible.   (I schedule my annual exam while covered under this plan personally).   I get my lab work done in advance, then go to the exam to review the results.

Before you enroll be sure to review the plan brochure and plan limitations and exclusions by reviewing the brochure below:

REVIEW the Flex Term Brochure

Click the link below for a quote and to enroll:

QUOTE-ENROLL in Flex Term

 COMPANY 2:  Allstate Health Solutions (Twice the price of Pivot Health Plan)

   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 (Provider 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 view the Brochure:

Allstate STM 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.  Click the link below to get a quote and enroll:

Quote & Enroll in Allstate STM Plan

  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.  

 SAVE MONEY ON LAB WORK PRIOR TO YOUR WELLNESS EXAM:

      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.

Order Lab​ work online from Questhealth.com   

EXAMPLE:   I order the Comprehensive Men's lab package for $288.75 prior to my wellness visit while on the Flex Term plan.   Once I get the results, I schedule my $50 wellness visit and go over the results with my doctor.  Yes, you can order your own labs.  

UNDERSTAND THE OUT OF POCKET MAXIMUM:   

     It's important to note with Short Term that the plan deductible does NOT go towards meeting the plans out of pocket maximum:  This is an important distinction compared with most traditional health insurance plans.  

    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.

        Short Term Medical Disclosure