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TriTerm Medical Insurance Frequently Asked Questions

Yes and no. TriTerm Medical, underwritten by Golden Rule Insurance Company, is limited duration short term health insurance, but it’s designed to be more benefit rich than traditional short term health insurance plans. TriTerm Medical is designed to offer coverage for 1 day less than 3 full years.

It is regular health insurance. A TriTerm Medical plan works like health insurance you may have had before. It covers certain benefit areas. You have a deductible, coinsurance, and maybe copays, depending on your plan. You have limits on coverage that reset at the end of the year.

In benefits, it doesn’t cover all the same areas an Affordable Care Act (ACA) plan does, and you’re not guaranteed acceptance if you apply. But for how it works, it may be similar to health insurance you might be used to.

Because TriTerm Medical is a short term health insurance product it’s subject to a federal regulation that restricts temporary health insurance to 12 month terms totaling no more than 3 years of coverage. Per those regulations, that’s the length a plan like this can be.

TriTerm Medical plans are medically underwritten. Factors like height and weight, prior applications, and medical history will be considered when determining someone’s eligibility.

The plans are available for people between 19 and 63, with coverage ending at age 65. Like other plans, dependents need to be younger than 26 at the time of application.

TriTerm Medical deductibles are set up much the same way as other insurance you may have had in the past. The deductible is the amount that you pay before insurance begins paying its part. They are “per term” meaning that the deductible starts over at the beginning of each term the plan is in effect.

When choosing the TriTerm Medical plan that’s right for you, you’ll have several deductible options available ranging from $2,500 to $12,500 per person, per term. With TriTerm plans, families need to meet two deductibles per term. Generally speaking, choosing a higher deductible gives you a lower premium.

With the Copay Select plans, your first four doctor office visits per term cost $50 and do not have a deductible.

Yes. There is a $2 million lifetime maximum benefit per covered person on most plans.

Yes, these plans have a $5,000 max benefit per person, per term for outpatient prescriptions. In the Copay Select plans, prescription coverage is set up with tiered pricing where many common prescriptions (Tier 1) are $25 copay with no deductible.

Plan 80 and Plan 100 plans include a Preferred Price Card allowing you to purchase prescriptions at the lowest price available.

Yes, after you’ve been on the plan for 12 months, eligible costs related to some preexisting conditions are covered. With that being said though, TriTerm Medical plans are not guaranteed issue.

Yes, all TriTerm Medical plans include a $200 benefit per person, per term, for preventive care wellness checks. There is an initial 6-month waiting period in the first term before you can use the preventive care benefit.

Like other short-term health insurance plans, you don’t need to wait for an open enrollment period to apply for a TriTerm Medical plan. They are available year-round, and your coverage can begin as early as 5 days after your application is received.

TriTerm Health Insurance Plans offered 365 days a year

For preventive care, there is a 6-month waiting period during the first year of the plan. Eligible costs related to preexisting conditions won’t be covered during the first 12 months on the plan.

Probably. The UnitedHealthcare network of doctors comprises 1.3 million physicians and other health care professionals, and more than 6,000 hospitals and other medical facilities nationwide.1 So, chances are, your doctor is already a part of the network.

If you go to a provider for non-emergency care and that provider is not in the UnitedHealthcare network, you may receive limited or no benefits, depending on the state where you live.

As of 2019, there is no longer a federal tax penalty for not having ACA insurance, but there may still be penalties at the state level. Consult your tax advisor for more information.



Want to learn more about TriTerm Medical insurance?

Learn About Golden Rule Insurance Company TriTerm Medical Plans

Looking for temporary insurance with a shorter term?

Learn About Golden Rule Insurance Company Short Term Plans

In SC, plans are three 11-month terms. These plans are medically underwritten and do not cover preexisting conditions. 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. Also, this coverage is not “minimum essential coverage”. 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. 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.



1 UnitedHealth Group Annual Form 10-K for year ended 12/31/18.

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