TriTerm Medical Insurance FAQs
What’s the difference between TriTerm Medical and a more traditional short-term health insurance plan?
TriTerm Medical1 underwritten by Golden Rule Insurance Company is short term limited duration health insurance. However, a TriTerm Medical insurance plan is more benefit-rich compared to most other short term plans with shorter term lengths. And that is one of the great features of a TriTerm Medical plan - its term length is nearly 3 years of coverage.2 TriTerm Medical is a medically underwritten plan that offers the benefits you are likely looking for: preventive care, doctor office visits, urgent care, prescription drug coverage and more.
After your first 12 months on the plan, eligible services related to some preexisting conditions may be covered. Please note that there are some medical conditions that would make you ineligible for coverage.
There is a $5,000 max benefit per person, per term for outpatient prescriptions. Some plans have tiered pricing where many common prescriptions (tier 1) are $25 copay with no deductible.
After an initial 6-month waiting period in the first term, all TriTerm Medical plans include a $200 benefit per person, per term, for preventive care wellness checks.
Doctor Office Visits
Doctor visits are covered on all TriTerm Medical plans. With Copay Select Max plans, your first 4 doctor visits (per term, per person) cost $50 each with no deductible to meet.
Plans are available for individuals and families; the primary applicant must be between 19 and 63, with coverage ending at age 65. TriTerm Medical insurance is not guaranteed issue. Several factors including prior applications, and medical history come into play when deciding if someone is eligible.
Federal regulations state that a short term health insurance plan's initial term must be less than 12 months and that the plan cannot be extended to total more than 36 months.3 Because of this rule, TriTerm Medical plans are 3 terms that add up to 1 day less than 3 years.
No. TriTerm Medical plans are available year-round, and your coverage can begin as early as 5 days after your application is received.
There is no longer a federal tax penalty for not having ACA insurance. However, there may still be penalties at the state level, so you should consult your tax advisor for more information.
Yes. TriTerm Medical underwritten by Golden Rule Insurance Company offers a variety of plans and deductible choices to help meet your specific budget and needs. Please consider the plan details carefully before deciding.
Each covered person has a $2 million lifetime maximum benefit, on most plans.
There is a 6-month waiting period for preventive care benefits during the first year of the plan, and eligible services related to preexisting conditions won’t be covered until after you’ve been on the plan for 12 months.
Likely, yes. With 1.4 million physicians and other health care professionals, and more than 6,500 hospitals and other medical facilities in the UnitedHealthcare nationwide network,4 there is a good chance your doctor is included.
- This coverage is not required to comply with certain federal market requirements for health insurance, principally those contained in the Affordable Care Act. Be sure to check your policy carefully to make sure you are aware of any exclusions or limitations regarding coverage of preexisting conditions or health benefits (such as hospitalization, emergency services, maternity care, preventive care, prescription drugs, and mental health and substance use disorder services). Your policy might also have lifetime and/or annual dollar limits on health benefits. If this coverage expires or you lose eligibility for this coverage, you might have to wait until an open enrollment period to get other health insurance coverage. These plans are medically underwritten and do not cover preexisting conditions. In several states these health insurance plans are issued as association group plans and are available only to members of FACT, the Federation of American Consumers and Travelers, www.usafact.org (org).
- In SC, plans are three 11-month terms. In IN and OK, plans are three 364-day terms.
- Short-Term, Limited-Duration Insurance Final Rule. Federal Register. Aug. 3, 2018. Retrieved from www.federalregister.gov. "This rule amends the definition of short-term, limited-duration insurance coverage so that the coverage has a maximum initial contract term of less than 12 months and a maximum duration (including the initial contract term and renewals and extensions of the same insurance contract) of no longer than 36 months."
- UnitedHealth Group Annual Form 10-K for year ended 12/31/19.
Product design, availability, term length and additional terms vary by state.
No individual applying for health coverage through the individual Marketplace will be discouraged from applying for benefits, turned down for coverage, or charged more premium because of health status, medical condition, mental illness claims experience, medical history, genetic information or health disability. In addition, no individual will be denied coverage based on race, color, religion, national origin, sex, sexual orientation, marital status, personal appearance, political affiliation or source of income.
References to UnitedHealthcare pertain to each individual company or other UnitedHealthcare affiliated companies.
Each company is a separate entity and is not responsible for another's financial or contractual obligations.
Administrative services are provided by United HealthCare Services, Inc. or their affiliates.
Products and services offered are underwritten by Golden Rule Insurance Company, Health Plan of Nevada, Inc., Oxford Health Insurance, Inc., UnitedHealthcare Life Insurance Company, UnitedHealthcare of the Mid-Atlantic, Inc., UnitedHealthcare of New York, Inc.
This policy is subject to various exclusions and limitations. For costs and complete details of the coverage, call (or write) your insurance agent or the company (whichever is applicable).