Updated for 2026. Short term medical (STM) rules changed twice in two years, and the map looks very different than it did in 2025. Here is where you can still buy a year-long short term plan, where the term is capped at 90 or 180 days, where short term coverage is banned outright, and what licensed agents put in its place when it is not an option.
Short version: the federal 3-month/4-month cap is still on the books but is not being enforced. State law is what controls right now, so 364-day initial terms and multi-year renewals are back in most states. Fifteen states plus D.C. still have no short term product for sale, and in most of those we use a fixed indemnity plan such as UnitedHealthcare's Health ProtectorGuard instead.
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What changed since our 2025 article
The 2025 version of this page told you that every state was capped at a 3-month initial term and a 4-month maximum. That was correct at the time. It is no longer how the market operates.
- April 2024 final rule. The Departments of Labor, Health and Human Services, and the Treasury limited STLDI sold on or after September 1, 2024 to a 3-month initial term and 4 months total including renewals, plus a new consumer notice. Year-long plans disappeared nationwide.
- August 7, 2025 non-enforcement statement. The same three Departments announced they do not intend to prioritize enforcement of that definition, including the notice requirement, while new rulemaking is pending. They also said they will not penalize states that apply their own definition of STLDI.
- 2026 practical effect. Carriers began re-filing the products they sold before September 2024. In states whose own law permits it, 364-day initial terms and total durations up to 36 months (often sold as "tri-term" plans, three stacked 12-month terms issued at once) are available again.
- Still pending. A replacement STLDI rule sits on the federal regulatory agenda. Until it is finalized, durations can change with little notice. Anything you buy today is governed by the policy form your carrier has filed in your state, not by a headline.
What this means for you: the 4-month cap is not being enforced, but it has not been repealed either. Buy on what your carrier's filed form actually says, and expect the rules to move again once the new rule lands.
What changed since our 2026 article
Nothing in the federal or state rules above has changed. What is new is a carrier-specific option in Texas.
- Allstate Health Solutions' STM 4x3 (Texas). National General/Allstate now lets Texas applicants bundle three separate short term medical policies into a single enrollment, each with its own roughly 4-month term, for up to 12 months of coverage total.
- How it actually works. This is three stacked policies, not one continuous policy and not four concurrent ones. Each of the three policies gets its own ID card, and the coverage period, deductible and copays reset when the next policy in the bundle starts.
- The upside over stacking on your own. Pre-existing condition limits are anchored to the start of the first policy in the bundle, not reset with each of the three, and pricing for all three is shown upfront at application. It can also be packaged with Recuro Health add-on benefits (telehealth, virtual behavioral therapy, an Rx discount).
Two separate rules control your term length
- Your state's law. Insurance is regulated primarily at the state level. A state can be more restrictive than the federal government, and many are.
- Your carrier's filing. Even where a state allows 364 days, an individual carrier may only offer 3-month or 6-month terms there. The state cap is a ceiling, not a promise.
National General (Allstate Health Solutions) short term plans use Aetna's Open Choice PPO network and remain one of the more widely filed products nationally. Availability by state still varies by carrier.
2026 short term health insurance rules by state
Current as of August 2026. Durations reflect state law under the current federal non-enforcement posture. Carrier filings can be shorter than the state maximum, and these rules are actively changing. Confirm before you enroll.
| State | Max initial term | Max total duration | Notes |
|---|---|---|---|
| Alabama | 364 days | Up to 36 months | Renewals permitted |
| Alaska | 364 days | Up to 36 months | Renewals permitted |
| Arizona | 364 days | Up to 36 months | Renewals permitted |
| Arkansas | 364 days | Up to 36 months | Department bulletin (Oct. 2025) confirms sales under state law during federal rulemaking |
| California | Not available | Sale of short term plans prohibited | |
| Colorado | Not available | State benefit mandates make the product unmarketable; no carriers selling | |
| Connecticut | Not available | Short term plans must cover ACA essential health benefits; no carriers selling | |
| Delaware | 90 days | 90 days | No renewal; no new policy within the same 364-day period |
| District of Columbia | Not available | No carriers selling | |
| Florida | 364 days | Up to 36 months | Renewals permitted |
| Georgia | 364 days | Up to 36 months | Renewals permitted |
| Hawaii | Not available | Restricted for anyone eligible for an ACA plan | |
| Idaho | 364 days | 364 days | No renewal inside a 365-day period; 60-day gap before a new policy from the same carrier |
| Illinois | Banned | Public Act 103-0649, effective January 1, 2025. First state to ban STM outright. A 2026 repeal bill (SB2757) is stalled in committee | |
| Indiana | 180 days | Up to 36 months | Renewals permitted |
| Iowa | Per Iowa regulation | Iowa Insurance Division rescinded its 4-month bulletin; authorized carriers may sell for the duration Iowa rules allow. Confirm current filings | |
| Kansas | 364 days | Up to 24 months | Renewals permitted |
| Kentucky | 364 days | Up to 36 months | Renewals permitted |
| Louisiana | 180 days | Up to 36 months | Renewals permitted |
| Maine | Not available | State benefit requirements; no carriers selling | |
| Maryland | 90 days | 90 days | No renewal, no reapplication after expiration |
| Massachusetts | Not available | Sale of short term plans prohibited | |
| Michigan | 185 days | 185 days | No renewal within a 365-day period |
| Minnesota | Not available | No carriers selling | |
| Mississippi | 364 days | Up to 36 months | Renewals permitted |
| Missouri | 180 days | Up to 36 months | Renewals permitted while each term stays at or under six months |
| Montana | 364 days | Up to 36 months | Renewals permitted |
| Nebraska | 364 days | Up to 36 months | Renewals permitted |
| Nevada | 185 days | 185 days | No renewal within the same calendar year |
| New Hampshire | 180 days | Up to 18 months | Two additional 6-month periods permitted |
| New Jersey | Not available | Sale of short term plans prohibited | |
| New Mexico | Not available | No carriers selling | |
| New York | Not available | Sale of short term plans prohibited | |
| North Carolina | 364 days | Up to 36 months | Renewals permitted |
| North Dakota | 185 days | Up to two terms | One reapplication permitted within 12 months |
| Ohio | 364 days | Up to 36 months | Renewals permitted |
| Oklahoma | 364 days | 364 days | Not renewable |
| Oregon | 90 days | 90 days | 60-day break required before new coverage |
| Pennsylvania | 364 days | Up to 36 months | Renewals permitted |
| Rhode Island | Not available | Sale of short term plans prohibited | |
| South Carolina | 364 days | Up to 36 months | Renewals permitted |
| South Dakota | 185 days | 185 days | Not renewable. Insurers must certify the policy is not sold as a substitute for major medical |
| Tennessee | 364 days | Up to 36 months | Renewals permitted |
| Texas | 364 days | Up to 36 months | Renewals permitted |
| Utah | 363 days | 363 days | Not renewable |
| Vermont | Not available | Short term plans must meet ACA essential health benefit standards; no carriers selling | |
| Virginia | 364 days | Up to 36 months | Renewals permitted |
| Washington | Not available | No carriers selling | |
| West Virginia | 364 days | Up to 36 months | Renewals permitted |
| Wisconsin | 364 days | Up to 18 months consecutive | 64-day break required before new coverage with the same insurer |
| Wyoming | 364 days | Up to 36 months | Renewals permitted |
Where you can still get a full year (or longer)
Check plans and pricing in your state →
Alabama, Alaska, Arizona, Arkansas, Florida, Georgia, Idaho, Kansas, Kentucky, Mississippi, Montana, Nebraska, North Carolina, Ohio, Oklahoma, Pennsylvania, South Carolina, Tennessee, Texas, Utah, Virginia, West Virginia, Wisconsin and Wyoming allow an initial term of roughly 12 months. Most of those also allow renewals out to 36 months, which is what makes the tri-term structure possible.
Where the term is short but coverage exists
Delaware, Indiana, Iowa, Louisiana, Maryland, Michigan, Missouri, Nevada, New Hampshire, North Dakota, Oregon and South Dakota all cap the initial term below a year. In several of these you get one term and cannot renew, which means you are re-underwritten or left without coverage at the end. Plan the exit before you buy.
The 15 states with no short term option
California, Colorado, Connecticut, District of Columbia, Hawaii, Illinois, Maine, Massachusetts, Minnesota, New Jersey, New Mexico, New York, Rhode Island, Vermont and Washington. Some ban the product by statute. Others require short term plans to cover essential health benefits or otherwise look like ACA coverage, which drove every carrier out of the market. The result for you is the same: nothing to buy.
No short term plan in your state? Look at fixed indemnity
This is the section that did not exist in the 2025 article, and it is now the more important half of the page. When short term medical is off the table, the workable alternative for most people is a fixed indemnity plan, and the one we place most often is Health ProtectorGuard from UnitedHealthOne, a UnitedHealthcare company.
What a fixed indemnity plan actually is
Fixed indemnity is not health insurance and it is not a substitute for ACA minimum essential coverage. Say that out loud before anything else, because the way it pays is genuinely different from what people expect.
- It pays set dollar amounts for covered services, defined in the policy schedule, regardless of what the provider actually bills.
- There is no deductible and no coinsurance in the traditional sense. Benefits are capped per service, per day, or per year instead.
- Benefits are paid to you or assigned to the provider. If the benefit exceeds the bill, you keep the difference. If the bill exceeds the benefit, you owe the rest.
- Because it is an excepted benefit, it is regulated differently from STLDI, which is why it remains for sale in several states where short term medical is banned.
That last point is the whole reason this matters. Illinois banned short term plans outright on January 1, 2025, and Health ProtectorGuard is still available there. Same for Colorado, Hawaii, Maine, Minnesota and Rhode Island.
Health ProtectorGuard at a glance
- Carrier: UnitedHealthOne (Golden Rule Insurance Company, a UnitedHealthcare company)
- Network: UnitedHealthcare Choice Plus PPO, roughly 1.8 million providers and 7,000+ hospitals nationwide, so you get network-negotiated rates on top of the fixed benefit
- Plan tiers: Select, Preferred and Premier, which step up the daily hospital benefit and the number of covered office visits and prescription fills per year
- Benefit categories: daily hospital confinement, ICU/CCU, emergency room, surgery on a tiered schedule, office visits, labs and imaging, prescription fills
- Extras: HealthiestYou by Teladoc virtual visits and Optum Perks prescription discounts are typically bundled in
- Underwriting: medically underwritten, with a pre-existing condition exclusion of up to 12 months
- Term: not subject to STLDI duration caps, so it does not expire on a 3-month or 4-month clock
Sample plan designs and pricing
Health ProtectorGuard comes in three tiers. The table below shows the benefit schedule and sample premiums so you can see how the fixed-dollar structure actually works. These are Illinois sample rates. Your premium will differ.
| Benefit | Premier 5000 | Preferred 4000 | Select 2000 |
|---|---|---|---|
| Inpatient hospital confinement | $5,000/day, unlimited days | $4,000/day, unlimited days | $2,000/day, unlimited days |
| ICU / CCU (adds to confinement) | +$5,000/day (60 days) | +$4,000/day (60 days) | +$2,000/day (60 days) |
| Hospital admission | $3,000 | $3,000 | $2,000 |
| Emergency room | $1,000/day | $500/day | $300/day |
| Ambulance (ground / air) | $1,000 / $5,000 | $1,000 / $5,000 | $1,000 / $5,000 |
| Surgical procedure (7-tier schedule) | $500 to $50,000 | $375 to $37,500 | $250 to $25,000 |
| Outpatient surgical facility | $4,000/day | $2,000/day | $1,000/day |
| Doctor office visit | $150 | $100 | $80 |
| Specialist / urgent care | $150 / $200 | $125 / $125 | $100 / $100 |
| Generic / brand Rx (per fill) | $20 / $60 | $20 / $60 | $10 / $40 |
| MRI / CT / PET (per test) | $1,000 | $400 | $400 |
| Wellness exam | $150 | $125 | $100 |
| Calendar-year / lifetime maximum | $2M / $5M | $2M / $5M | $2M / $5M |
| Sample monthly premium | $337.47 | $243.04 | $152.42 |
Sample rates are for a 45-year-old male, non-tobacco, in Cook County, Illinois (ZIP 60613), quoted 08/01/2026. Premiums vary by state, ZIP code, age, gender and tobacco use, and are subject to change. Request a personalized quote for exact pricing.
Sample bundles
Because each of these is a fixed indemnity product, they can each pay on the same event. Here is how we commonly bundle them:
| Bundle | Health ProtectorGuard | Accident ProGuard | HospitalWise | Sample total |
|---|---|---|---|---|
| Essential | Select 2000 ($152.42) | $5,000 accident / $10,000 critical illness ($36.85) | Bundle 2 ($60.20) | $249.47/mo |
| Enhanced (most often recommended) | Preferred 4000 ($243.04) | $10,000 accident / $30,000 critical illness ($72.15) | Bundle 2 ($60.20) | $375.39/mo |
| Complete | Premier 5000 ($337.47) | $10,000 accident / $50,000 critical illness ($93.78) | Bundle 2 ($60.20) | $491.45/mo |
Same sample profile as above (ZIP 60613, age 45, male, non-tobacco, quoted 08/01/2026). Each product requires a separate application. HospitalWise is guaranteed issue with a 6-month pre-existing condition exclusion.
What a claim actually pays
Using the Enhanced Bundle, here is what the three stacked products would pay on common events:
| Event | Total benefit paid |
|---|---|
| Doctor visit plus a generic prescription | $120 |
| ER visit for illness, no admission | $1,250 |
| Overnight hospitalization (1 night) | $8,000 |
| 3-night hospital stay | $18,000 |
| Heart attack with a 3-night stay | Up to $48,000 |
Benefits are fixed dollar amounts set by the policy schedule, not a percentage of your bill. If the bill runs higher than the scheduled benefit, the balance is yours.
Where Health ProtectorGuard is available in 2026
AK, AL, AR, AZ, CO, DE, FL, GA, HI, IA, IL, IN, KY, LA, ME, MI, MN, MO, MS, NC, NE, NV, OK, RI, SC, TN, TX, UT, VA, WI, WV and WY. Availability and plan design vary by state and can change; we confirm before quoting.
The overlap that matters: no STM, but HPG is available
| State | Short term medical | Health ProtectorGuard |
|---|---|---|
| Colorado | Not available | Available |
| Hawaii | Not available | Available |
| Illinois | Banned since 1/1/2025 | Available |
| Maine | Not available | Available |
| Minnesota | Not available | Available |
| Rhode Island | Not available | Available |
It also fills a real gap in the short-term-but-not-renewable states. In Delaware, Maryland, Michigan, Nevada, Oregon and South Dakota, a 90 to 185 day plan that cannot be renewed leaves you exposed at the end of the term. A fixed indemnity plan can run continuously alongside or after it.
Where neither is available
California, Connecticut, District of Columbia, Massachusetts, New Jersey, New Mexico, New York, Vermont and Washington have no short term medical and no Health ProtectorGuard. In those states the realistic paths are an ACA marketplace plan (with subsidies if you qualify), COBRA, Medicaid or CHIP, or a standalone accident and hospital indemnity product. Call us and we will walk the options for your state.
Stacking indemnity products
Because every product in this family pays a fixed benefit rather than reimbursing a bill, more than one can pay on the same claim. We commonly pair Health ProtectorGuard with:
- Accident ProGuard for accident and critical illness cash benefits
- HospitalWise for guaranteed-issue hospital cash, useful when underwriting is a concern (it carries its own 6-month pre-existing exclusion)
A single hospitalization can therefore trigger payments from all three. That stacking is the point of the design, and it is how a bundle gets to a number that meaningfully covers a hospital stay.
See full Health ProtectorGuard plan details, benefit schedules and current rates →
Run your own Health ProtectorGuard quote →
Who short term or fixed indemnity coverage is for
These are bridge products. They work well when you have a defined gap and a plan to get back to comprehensive coverage:
- Aging off a parent's plan at 26
- Between jobs, or waiting out a new employer's group waiting period
- Missed ACA Open Enrollment and no qualifying life event
- A few months out from turning 65 and starting Medicare
- Self-employed or 1099 and priced out of an unsubsidized marketplace plan
Before you assume the marketplace is out of reach: check whether you qualify for a Special Enrollment Period. Loss of job-based coverage, marriage, divorce, birth or adoption, a permanent move out of your plan's service area, and certain income changes all trigger one. In Illinois, note that losing a short term plan does not qualify you for a Special Enrollment Period. If you do not qualify for an SEP, short term and indemnity products can be bought any time of year.
The honest drawbacks
We are a licensed agency and this is the part of the conversation that matters most.
- Pre-existing conditions. Short term plans can decline you outright. Fixed indemnity plans are underwritten too and can exclude pre-existing conditions for up to 12 months. ACA plans cannot do either.
- Benefit caps. Fixed indemnity pays a scheduled amount, not the bill. There is no out-of-pocket maximum protecting you from a catastrophic claim the way an ACA plan has one.
- Maternity and mental health are commonly excluded or sharply limited in both product types.
- Renewability. In many states you must re-apply at the end of a term. If you developed a condition during the term, you may not be accepted again.
- Not minimum essential coverage. Neither product satisfies ACA requirements, and neither counts as comprehensive coverage for any purpose that requires it.
- Rules are in flux. The federal STLDI rule is being rewritten. A future rule could shorten durations again for new sales.
How the 2026 subsidy changes affect this decision
The enhanced premium tax credits created by the American Rescue Plan and extended by the Inflation Reduction Act expired at the end of 2025. Marketplace costs rose accordingly:
- The average monthly premium after tax credits went from $113 in 2025 to $178 in 2026, an increase of 58%.
- The share of enrollees receiving a credit fell from 92% to 87%, the first decline since 2020.
- Enrollment dropped to 23.1 million plan selections for 2026, down about 1.2 million from 2025.
That is a real change in the math, and it is why more people are asking us about short term and fixed indemnity coverage this year. It is not a reason to skip the comparison.
Run the marketplace numbers first. If you still qualify for a meaningful credit, a marketplace plan usually wins, and it remains the only option here that cannot decline you for health status. If you do not qualify, particularly if your income is above 400% of the federal poverty level where the cliff is now much sharper, short term or fixed indemnity coverage may be the realistic choice for a defined gap. Just go in knowing the limits above.
More detail on the federal rules and the 2026 marketplace numbers: Federal Short Term Health Insurance Rules: 2026 Update
Compare your options
We quote short term medical, fixed indemnity, ACA marketplace, dental, vision and group plans side by side, so you can see what your money actually buys in your state before you commit.
Compare plans and get a free quote
Phone 855.847.7020
Email: help@ihealthagents.com
Health ProtectorGuard, Accident ProGuard and HospitalWise are underwritten by Golden Rule Insurance Company, a UnitedHealthcare company. These are fixed indemnity / hospital indemnity policies and are NOT major medical or minimum essential coverage under the Affordable Care Act. They pay limited, fixed dollar amounts and are not a substitute for comprehensive health insurance. Benefit availability, amounts, waiting periods and state variations apply; see each official Outline of Coverage.
This article is general information, not legal or tax advice. State insurance law and federal STLDI regulation are both changing. Benefits, availability and rates vary by state, age and carrier filing, and are subject to change. Always review the policy documents and outline of coverage before enrolling. Last reviewed: August 2026.
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