TriTerm medical insurance

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Insights:

TriTerm is a type of short-term health insurance plan offered by UnitedHealthcare.

Short-term health insurance offers low-cost, limited coverage plans for most Americans who are looking to bridge a health insurance gap in coverage.

Short-term health plans are allowed in most states. These plans are for one year, with the chance to extend coverage for 36 months in most states. One major provider of these plans is UnitedHealthcare, which offers a short-term health insurance product called TriTerm.

Take the time to determine if a TriTerm policy or another type of short-term health insurance coverage is right for you. Weigh the pros and cons and shop around carefully for the best options.

Key Takeaways

TriTerm plans offer up to $200 per person for preventive care per year, a limited number of $50 copay office visits, and prescription drug coverage.
Short-term health plans are temporary health insurance that isn’t Affordable Care Act-compliant and offer limited coverage for low premiums.
Most states allow people to have short-term health insurance for a year with the option to extend coverage for two more years.
A handful of states don’t allow short-term health plans or limit the length of time.

What is TriTerm short-term health insurance?

Short-term health insurance offers a stopgap coverage option for those temporarily not covered by other types of health insurance, such as employer-sponsored insurance, group health insurance, and individual plans purchased on the ACA marketplace.

One type of short-term health insurance is TriTerm, which is offered by the nation’s largest health insurance company UnitedHealthcare and underwritten by Golden Rule Insurance Company. TriTerm makes coverage available for up to approximately three years — which is often three times the maximum length of a typical short-term policy.

TriTerm’s coverage is available for up to three consecutive terms, with each term lasting a maximum of 364 days.

It’s also important to point out that TriTerm is different from TRICARE. TRICARE may sound similar to TriTerm, but it’s a health care program for active-duty members, retirees, and their families

What does TriTerm medical cover?

UnitedHealthcare offers a variety of TriTerm medical plans that include a range of benefits and customizable benefit structures, says John Bartleson with Health Benefits Connect in Englewood, Colorado.

“TriTerm plans usually provide limited coverage for preventive care, routine office visits, and prescriptions and may provide some coverage for hospice and home healthcare services,” says Brian Martucci, the Minneapolis-based finance editor for Money Crashers.

John Staub, brand development manager for Indianapolis-headquartered Remodel Health, says TriTerm is preferred among consumers looking for some preventive care coverage, which isn’t usually found in short-term health insurance plans.

TriTerm offers:

Up to $200 per person coverage for preventive care, per term
Office visits for illness or injury that cost $50 per visit copay for the first four-doctor office visits, per person, per term, with a Copay Select plan
Prescription coverage, often for a $25 copay for each prescription with certain plans after you pay your deductible
A single application process. Once you are approved, you don’t have to reapply to obtain coverage after your term expires.

Short-term health insurance plans like TriTerm aren’t Affordable Care Act-compliant. That means they don’t have to offer the same level of benefits found in an ACA plan, including minimum essential coverage like prescription drugs, maternity, outpatient, and mental health and substance abuse care. It’s critical to read the fine print in short-term health plans to understand what each plan covers and doesn’t cover.

What are the advantages of TriTerm medical insurance?

The main advantage of short-term insurance plans like TriTerm is that they are generally much less expensive than even the cheapest Affordable Care Act (ACA) plan.

“I like the United Healthcare TriTerm plans because they provide the most value based on the amount of coverage you get for the monthly price. They also have one of the largest provider networks of doctors and hospitals,” Bartleson notes.

Another benefit of short-term health insurance policies, such as TriTerm, is that you can get coverage fast.

“Coverage often begins the day after approval,” adds Martucci.

The main plus of TriTerm medical insurance is “the peace of mind knowing that you have up to 36 months of health insurance coverage with a top-rated health insurance carrier,” explains Bartleson. “And you can cancel the policy at any point during the term.”

Staub says a good candidate for short-term health insurance is someone between jobs who don’t want to pay the expensive costs for COBRA coverage offered by their previous employer and who isn’t sure how long they’ll have to wait to get health coverage at their next job.

Other benefits of TriTerm medical insurance

Staub points out that allowing up to three years of coverage for a short-term medical insurance policy is more generous than other short-term plans that may only last three to 12 months.

“Plus, there’s no open enrollment period with TriTerm plans. You can enroll at any time,” Staub continues.

Martucci notes that an optional accident benefit rider may be available at additional cost to TriTerm policyholders to help cover eligible out-of-pocket expenses related to care for qualifying accidental injuries.

What are the disadvantages of TriTerm medical insurance?

These policies aren’t for everyone.

Bartleson says pre-existing conditions aren’t covered, which is a reason why short-term health plans are much cheaper than standard health insurance.

“Generally speaking, pre-existing conditions are defined as any condition for which medical advice, diagnosis, care, treatment, any diagnostic procedures, or further evaluation, was recommended or received within 24 months immediately before the date the covered person became insured under the policy,” Bartleson says.

“Or it can be a condition that had manifested itself in a manner that would have caused an ordinarily prudent person to seek medical advice, diagnosis, care, or treatment within the 12 months immediately prior to the date the covered person became insured under the certificate. Another pre-existing condition can be a pregnancy existing on the effective date of coverage,” Bartleson adds.

Pre-existing conditions will usually not be covered by a short-term policy until at least 12 months have elapsed after the policy went into effect.

Another drawback to most short-term policies is that they can’t be renewed once they expire. You’re allowed to apply for a different short-term plan if you still need coverage and have no other good options.

“Additionally, those accustomed to more generous group or individual health insurance policies might balk at the high copays and coinsurance requirements for preventive care and prescriptions in these short-term plans,” explains Martucci.

TriTerm medical insurance state variations

Be aware that TriTerm coverage is currently only available in about 20 states, and eligibility and coverage inclusions may vary by locale as well, according to Martucci.

Also, the coverage duration can vary by state.

“In most states, the 36-month maximum length of the policy is 364 days, not 365 days, between each of three coverage terms. In South Carolina, the duration is 11 months each term,” Bartleson says. “Calling a licensed insurance broker can help you determine the maximum coverage duration for your state.”

In addition, short-term plans are ultimately under the authority of the state in which they’re licensed.

“Since these laws can change regularly, it’s important to follow the latest developments in your state when it comes to short-term medical plans,” recommends Staub.

Frequently Asked Questions

Can anyone get TriTerm short-term health insurance?

Applicants must be between 19 and 63 years old and maybe turned down for health reasons. You also have to live in a state that allows short-term health plans.

You must answer medical questions to qualify, including questions asking if you had any major health conditions within the last five years.

“If your answer is ‘no’ to many of these health questions, the policy will likely be issued,” Bartleson says.

How long can I keep a TriTerm medical plan?

TriTerm coverage lasts for up to approximately three years, consisting of three consecutive 364-day terms, depending on rules and restrictions in your state. You’re allowed to cancel the policy at any point during the term.

Is there open enrollment for TriTerm medical?

There is no open enrollment period for TriTerm medical insurance. Applications are accepted year-round.

Could enrolling in a TriTerm medical plan affect my taxes?

Carrying TriTerm coverage instead of an ACA-compliant plan will only affect your taxes if your state imposes a tax penalty for not having ACA-compliant health insurance, says Martucci.

Congress ended the individual mandate tax penalty. Only a handful of states require standard health insurance protection, including Massachusetts, New Jersey, and California.

For self-employed individuals, certain portions of their insurance premiums can be considered tax-deductible; for better clarity, consult a tax professional, accountant, or health insurance agent/broker.

Is there flexibility to pick the coverage options that are right for me?

TriTerm plans and other short-term health insurance plans commonly provide limited coverage for preventive care, routine office visits, and prescriptions, and may offer some coverage for hospice and home healthcare, says Martucci.

Also, individual and family coverage options are available. An optional accident benefit rider may be available at additional cost to TriTerm policyholders to help cover eligible out-of-pocket expenses related to care for qualifying accidental injuries.

What’s the maximum amount that TriTerm will pay?

The lifetime maximum benefit amount for TriTerm medical plans is $2 million.

Can you start using the benefits right away after you enroll in TriTerm?

Most TriTerm benefits are available to covered individuals right away. But some states have specific waiting periods for certain medical services, says Bartleson.

Also, there can be a six-month waiting period for preventive care benefits and a 12-month waiting period for any services related to a documented pre-existing condition, Martucci notes.

Can you continue to see your doctor with TriTerm?

You can continue to visit and receive care from your preferred physicians if they belong to the TriTerm provider network.

Bartleson explains that TriTerm medical plans use the UnitedHealthcare network of doctors and hospitals, including over 1.4 million physicians and other medical professionals and 6,500 hospitals and other medical facilities nationwide. Before signing up for a plan, make sure your providers accept that coverage or you may wind up paying for all of those visits.

Erik Martin

Contributing Researcher

Erik J. Martin is a Chicago area-based freelance writer whose articles have been published by AARP The Magazine, The Motley Fool, The Costco Connection, USAA, US Chamber of Commerce, Bankrate, The Chicago Tribune, and other publications. He often writes on topics related to insurance, real estate, personal finance, business, technology, health care, and entertainment. Erik also hosts a podcast and publishes several blogs, including Martinspiration.com and Cineversegroup.com.