It isn't Obamacare. It's private short-term insurance. It does not count as minimum essential coverage.
There are health questions. The company reviews your medical history and can turn you down. Approval is not guaranteed.
It doesn't cover pregnancy. If you're pregnant or trying to be, this isn't your plan. Further down I'll tell you which one is.
What you already have waits 12 months. Conditions you had before the policy aren't covered during the first year.
I'm putting this first instead of burying it at the bottom. A plan you don't understand is a plan that will let you down the day you need it.
Is this plan right for you?
I'd rather tell you now than later
It does work for you if…
You don't qualify for government help, or you can't use the Marketplace.
You're reasonably healthy and don't see the doctor often.
You're between 19 and 63 years old.
You want real coverage for an emergency or a serious illness, not just a discount.
You need to start now, without waiting until December.
It doesn't work for you if…
You're pregnant or planning to be soon.
You have a chronic illness that needs ongoing treatment.
You qualify for a Marketplace subsidy — there you'll almost always pay less and get more coverage.
You're 64 or older.
You want something permanent. This lasts almost 3 years and then you have to sort it out again.
If you qualify for a subsidy, I'll tell you. Some people assume they don't qualify when they actually do. Before selling you a private plan I check whether the Marketplace suits you better. That check costs you nothing.
What TriTerm Medical is
Three policies back to back, one single application
Most short-term plans last a few months and then you have to reapply, with health questions all over again. TriTerm doesn't work that way: it's three 12-month terms chained together adding up to almost 3 years, and the health questions are asked only once, at the start.
1
First year. Your coverage begins. What you already had before the policy isn't covered yet. Preventive care kicks in after 6 months.
2
Second year. It renews on its own, with no new health questions. And here's the important part: the conditions you came in with are now covered, because you completed 12 months on the plan.
3
Third year. Same as the second. When it ends you need to find other coverage: the plan can't be extended further.
The premium goes up in years 2 and 3. UnitedHealthcare says so openly: between 16% and 25% more. When I give you the price, I'll also give you what you'll pay in the other two years, not just the first.
What it includes
What it covers and up to how much
Lifetime maximum
$1 a $2 millones
Per covered person, depending on the state. It's the ceiling on what the policy pays in total.
Deductible of your choice
$2,500 a $15,000
The higher the deductible, the lower the premium. It's the main lever for adjusting the price.
Doctor visits
Office visits and urgent care included on most plans.
Prescription drugs
Most plans include tiered prescription coverage. The cheapest version doesn't have it.
Preventive care
Routine check-ups and screenings. In the first year it starts after a 6-month wait.
Who you can include
Your spouse and unmarried children under 26 at the time of application.
Provider network
UnitedHealthcare's broad national network. It reaches about 80% of doctors and hospitals in an area.
Out of network it spirals. With an out-of-network doctor you pay a 25% penalty that doesn't count toward the deductible, your deductible doubles, and there is no out-of-pocket maximum. Before you sign up I check that your doctors are in network. This isn't a detail: it's the difference between a capped bill and one with no ceiling.
There's a cheaper version. It's called Value and it drops preventive care and prescriptions to lower the monthly cost. It works if you really only want protection against a big emergency. I'll show you both and you decide.
Are you pregnant or trying to be?
Then this plan isn't the one for you
TriTerm does not cover pregnancy or childbirth. Some emergency complications are covered, but a normal pregnancy isn't. I want you to read that here and not in the fine print when you're already three months along.
For childbirth without Marketplace coverage there's another route: a hospital indemnity policy that pays you a fixed lump sum when you're admitted. It isn't the same as health insurance, but it's real money toward the delivery bill, and it can be bought without going through the Marketplace.
In the state where you buy the policy. A PO box won't do.
A payment method
For the monthly charge, usually a bank account or card.
Answering truthfully
The health questions. A false answer can void the policy at the exact moment you claim on it.
Between 19 and 63 years old
The primary applicant. They can't be 64 or older when applying. Coverage ends at 65.
Being a resident of the state
Of the state where the policy is issued. That's residency, not citizenship: the application doesn't ask about your immigration status.
$40 application fee
It is not refunded, not even if you're turned down. That's why I go over your case with you before you apply.
About your immigration status: these plans aren't bought on HealthCare.gov, so they don't go through the immigration status check the Marketplace requires. The application asks about your health, not your paperwork.
About ID: any photo ID from your home country works, and it doesn't matter if it's expired. Even so, message me before you apply: there's a $40 fee that isn't refunded, and I'd rather go over your case with you before you pay anything.
Frequently Asked Questions
The ones I get asked most
Is this cheap Obamacare?
No. It's a different thing. Obamacare can't turn you down or exclude what you already have; this can. In exchange, you can buy this any day of the year and without going through the Marketplace.
Can they turn me down?
Yes. Your medical history and previous applications are reviewed. Approval isn't guaranteed. Note: the $40 application fee isn't refunded even if you're declined, so it's worth reviewing the case first.
Can I see any doctor?
It's best to stay in network. It's broad — about 80% of the providers in an area. Outside it you pay a 25% penalty, double the deductible, and there's no spending cap. I check your doctors before you sign up.
What happens when the 3 years are up?
You need to find new coverage and answer health questions again. It's worth thinking about it from the second year on.
What if I get seriously ill while covered?
If the illness begins during the policy, it's covered up to the plan maximum. What isn't covered in the first year is what you already had beforehand.
How much does it cost?
It depends on age, state, deductible and who's being covered. Message me and I'll send you the price for all three years, not just the first.
Left out of the Marketplace?
I'll review your case free and tell you the truth, even when the truth is that it isn't right for you
THIS COVERAGE IS NOT COMPREHENSIVE MAJOR MEDICAL INSURANCE. TriTerm Medical is limited-duration health insurance, is medically underwritten, and does not cover preexisting conditions during the first 12 months. This coverage is not required to comply with certain federal market requirements for health insurance, principally those contained in the Affordable Care Act (ACA), and it is not minimum essential coverage. Review the policy carefully for its exclusions and limitations, including those relating to hospitalization, emergency services, maternity, preventive care, prescription drugs and mental health. The policy may have annual or lifetime limits. Underwritten by Golden Rule Insurance Company, a UnitedHealthcare company. In Georgia, policy forms GRI-IST-EXT1B-P (Max plans) and GRI-IST-EXT1B-P-VAL (Value plans); in Florida the forms are different. The policy is non-renewable and requires residency in the state where it is issued. Availability, benefits and rates vary by state. This page is general information and does not replace the policy documents.
And what if you do qualify for help?
Plenty of people assume they don't qualify and it turns out they do. Before going private it's worth checking: with a subsidy you almost always pay less and get more coverage.
