Availability of short-term health insurance in Nebraska

Yes. As of 2024, there were at least five insurers offering short-term health insurance in Nebraska.

The average monthly premium for a short-term health insurance plan sold in Nebraska was $198.39 in 2023, according to data from IHC Specialty Benefits.

State statute (44-787) defines short-term health insurance in Nebraska as a policy lasting less than 12 months.

Federal regulations that took effect in 2017 limited short-term plans to no more than three months, and prohibited their renewal. These rules were effective in any state — including Nebraska — that didn’t have stricter limits in place.¹

That changed under Trump administration’s rules that took effect in late 2018, allowing short-term plans to have initial terms up to 364 days (ie, the same as Nebraska’s existing law), and total duration, including renewals, of up to 36 months.

However, under new federal rules, short-term plans issued or sold on or after Sept. 1, 2024 are limited to total durations of no more than four months, including renewals. Since these rules are stricter than Nebraska’s, the federal rules will be applicable in the state.

Short-term health insurance in Nebraska can be purchased by applicants who can meet the underwriting guidelines the insurers use.

Most short-term health insurance policies can be purchased by people who are younger than 65 and who do not have any of the short list of medical conditions that will result in an application being rejected.² But the specific requirements vary from one insurance company to another.

Short-term health insurance plans generally do not cover pre-existing conditions, and they often use post-claims underwriting. This means that if a claim is filed, the insurer can go back through the person’s medical records to determine whether the claim is related to a pre-existing medical condition.³

Short-term health plans also generally exclude coverage for some of the ACA’s essential health benefits (most commonly, maternity care, prescription drugs, and mental health care),² and impose dollar limits on the coverage they do provide. It’s important to carefully read the plan details before purchasing a short-term policy, to make sure that you understand the limitations of the coverage.

If you need health insurance coverage in Nebraska, first check to see if you’re eligible to enroll in an ACA-compliant major medical plan. These plans are available through the Nebraska exchange/Marketplace or directly from an insurance company.

Open enrollment for ACA-compliant plans runs from November 1 – January 15 each year. Outside of that window, you may still be able to enroll, if you experience a qualifying life event that triggers a special enrollment period. And if you have an eligible household income, you may be able to get a premium subsidy that would make your coverage much less costly than you might have expected — perhaps even less expensive than a short-term health plan.

ACA-compliant plans are purchased on a month-to-month basis, so you can enroll in coverage even for only a few months until another policy takes effect. So if you’ll soon be enrolled in Medicare or an employer’s plan, for example, you can sign up for an ACA-compliant plan during open enrollment or a special enrollment period, and then schedule it to end when your new coverage takes effect.

In your life there may be times when a short-term health insurance plan is the only realistic option, for example:

• If you missed open enrollment for ACA-compliant coverage and do not have a qualifying event that would trigger a special enrollment period.
• If you’re newly employed and have to wait up to three months before you can enroll in your employer’s health plan (and don’t qualify for a special enrollment period that would allow you to enroll in an ACA-compliant plan).
• If you’ll soon be enrolling in Medicare and have no other coverage options in the meantime.
• If you’ve already enrolled in an ACA-compliant plan but have to wait up to several weeks before the plan takes effect (for example, until January 1 or February 1 if you’re enrolling during open enrollment).
• If you’re not eligible for Medicaid or a Marketplace premium subsidy for an ACA-compliant plan, and can’t afford to pay full price (most exchange enrollees do qualify for subsidies,⁴ so be sure to check your subsidy eligibility).

New federal rules for short-term health plans were finalized in early August 2018 (as noted above, these will be replaced with new rules that apply to policies issued or sold starting in September 2024).

In September 2018, the Nebraska Department of Insurance published a bulletin clarifying that while the state would allow short-term plans to follow the federal guidelines in terms of the length of the initial term and the total allowable duration of the plan, the state was also imposing a variety of other requirements for short-term plans. Notably, short-term plans in Nebraska are required to:

• Provide a clear comparison of how the benefits in the short-term plan compare with the benefits required by an ACA-compliant individual market plan. The Department suggests that a comparison chart is a good way to go about this, and notes that examples of benefits that would need to be compared are “annual and lifetime limits, maternity coverage, mental health benefits, pre-existing condition restrictions, and pharmacy benefits.”
• Clearly state whether the plan can be renewed, how to go about renewing it, and how much it will cost to renew it.
• Clearly state any annual or lifetime limits that apply to the policy.
• Provide a 10-day free look period, as required under Neb. Rev. Stat. § 44-710.18.
• Disclose the details of the plan’s provider network, including maintaining an up-to-date website that shows all of the currently contracted network providers.
• Nebraska Revised Statute 44-710.03 and 44-710.04 are applicable to short-term health plans.

The Nebraska Department of Insurance had previously published a consumer alert in October 2016, warning residents to beware of “high-pressure telemarketers selling short-term health insurance products that are not compliant with the Affordable Care Act (ACA) despite their promises.”

Short-term health insurance plans in Nebraska must be filed with the Nebraska Department of Insurance (via SERFF), must cover state-mandated benefits, and must comply with the state’s internal and external appeal requirements.