Last verified against primary sources on August 17, 2026. Rules
change; this page is re-checked before each open enrollment.
The rule that changed in August 2025, and what almost nobody has updated
Short-term health plans — the medically underwritten policies people buy when
they are between jobs, or when an unsubsidized marketplace premium is simply out
of reach — used to be governed by a single federal cap. A 2024 federal rule
limited them to three months, extendable to four.
On August 7, 2025, the Departments of Labor, Health and Human
Services, and the Treasury announced they “do not intend to prioritize enforcement
actions” against that rule while new rulemaking is pending, and encouraged states
to take the same approach.
The practical effect: your state’s own law now decides how long you can
keep one of these plans. And state law varies enormously — from three
years in one state to a product that is effectively unavailable in another.
Most national websites still quote the four-month federal number. That number
is not what governs in most of these states.
These plans go by several names and they all mean the same product: short-term health insurance, short term medical insurance, temporary health insurance, or simply short term insurance. Whatever it is called on the application, the duration limit below is the one your state enforces.
Maximum short-term plan duration, by state
| State | Maximum duration under state law | Marketplace | Medicaid expanded | 2026 approved rate change |
|---|---|---|---|---|
| Utah | 12 months initial, 36 months total | HealthCare.gov | Yes | +14.2% |
| Tennessee | No state cap — follows the federal default | HealthCare.gov | No | +37.5% |
| Indiana | 364 days initial, 36 months total | HealthCare.gov | Yes | +26.5% |
| Ohio | 364 days, one-time policy | HealthCare.gov | Yes | +19.8% |
| Michigan | 185 days in any 365-day period, same insurer | HealthCare.gov | Yes | +20.2% |
| North Carolina | 3 months initial, 4 months total | HealthCare.gov | Yes (Dec 2023) | +28.6% |
| Maryland | 3 months, no renewal | Maryland Health Connection | Yes | +13.4% |
| Colorado | Effectively unavailable — 6 months non-renewable by statute, and no insurer currently sells them | Connect for Health Colorado | Yes | +21.2% |
State guides
Detailed guides for individual states, with the local rules, deadlines and options spelled out:
- Utah — the most permissive short-term rule of the eight, at 36 months
- Tennessee — steepest rate increase in the group, no Medicaid expansion, and a real coverage gap
- North Carolina — lost more enrollees than any state, and caps short-term plans at four months by choice
The remaining five states in the table above are being written now and will be linked here as each is published.
How to read that table
A healthy self-employed person in Utah can hold a short-term
plan for three years. The same person in Colorado cannot buy one
at all. In North Carolina they get four months — because the
North Carolina Department of Insurance issued a bulletin on August 29, 2025
stating it will keep enforcing the federal standard regardless of the federal
non-enforcement policy. Michigan’s Department of Insurance and Financial Services
did the same thing on October 1, 2025, holding its own 185-day limit.
Two states decided the federal government stepping back changed nothing
locally. Two others already allowed three years. That is the whole spread, and it
is the reason “how long can I keep a short-term plan?” has no national answer.
Why premiums jumped everywhere in 2026
The enhanced premium tax credits created in 2021 expired on December 31,
2025. Nationally the average net premium people actually pay rose
58%, from $113 to $178 a month, and the average deductible rose
37% to a record $3,786.
Enrollment fell accordingly. Effectuated marketplace enrollment is projected to
drop from 22.3 million in 2025 to about 17.5 million in 2026.
North Carolina alone lost roughly 214,000 enrollees, the steepest decline in the
country.
Two of these eight states softened the blow with their own money.
Maryland replaced 100% of the lost federal subsidy below 200% of
the federal poverty level and 50% between 250% and 400%. Colorado
replaced roughly 40% through its Premium Assistance program. Maryland was the only
state in this group where enrollment grew in 2026, by about 3%.
The other six — Utah, Tennessee, Indiana, Ohio, Michigan, North Carolina —
replaced none of it.
Open enrollment for 2027
November 1, 2026 through January 15, 2027 in all eight states,
including Colorado and Maryland, which run their own exchanges. Enroll by
December 15, 2026 for coverage that starts January 1.
One caveat worth stating plainly, because a lot of pages have it wrong: a
federal rule would have shortened this window to December 15. A court
vacated that rule in June 2026, and CMS confirmed in August 2026 that the
January 15 deadline stands. An appeal was argued in late October 2026. If that
changes, this page changes.
Before you buy a short-term plan, read this part
These plans are not a cheaper version of real insurance. They are a different
product, and for a lot of people they are the wrong one.
- They are medically underwritten. You can be declined, or have
a condition excluded. Marketplace plans cannot do either. - Pre-existing conditions are generally not covered.
- Maternity care is generally not covered.
- They are not ACA-compliant and are not required to cover
essential health benefits. - They are not guaranteed renewable.
If you qualify for a premium tax credit, take it — a subsidized marketplace
plan will almost always beat anything I can sell you. If your income is under 138%
of the federal poverty level and you live in one of the seven expansion states
above, check Medicaid first. If you have a chronic condition, buy a marketplace
plan. I would rather tell you that here than waste your time on a call.
Where a short-term plan genuinely fits: you are healthy, you are between
coverage or newly self-employed, and you do not qualify for a meaningful subsidy —
so the realistic alternative is an unsubsidized premium you cannot absorb, or
going uninsured.
Related
Self-employed or paid on a 1099? Start here: health insurance for the self-employed and 1099 workers — the subsidy cliff, the tax deduction, and mid-year enrollment.
Sources
- U.S. Departments of Labor, HHS and the Treasury, statement on short-term,
limited-duration insurance, August 7, 2025. - North Carolina Department of Insurance, Bulletin 25-B-11, August 29, 2025.
- Michigan Department of Insurance and Financial Services, Bulletin 2025-22-INS,
October 1, 2025. - Utah Code §31A-1-301(180); Utah Administrative Code R590-286.
- Indiana Code §27-8-5.9-3; Indiana Department of Insurance Bulletin 244.
- Ohio Department of Insurance, Bulletin 2018-05.
- Colorado Revised Statutes §10-16-102; Division of Insurance Regulation
4-2-59. - State insurance department approved rate filings for plan year 2026 (Utah,
North Carolina, Michigan, Ohio, Indiana, Colorado, Maryland, Tennessee). - KFF, 2026 ACA Marketplace enrollment, premiums and deductibles.
- CMS, 2025 Marketplace Integrity and Affordability final rule, and the June 2026
order vacating the shortened open enrollment period.
Scott Binsack — licensed health insurance agent, National
Producer Number 20492859. Licensed in 31 states. I am paid a
commission by the insurance company when you enroll, at no additional cost to you.
I have told you above which options I am not paid for, because you should hear
that from me rather than find it out later.
