ACA plans are the right choice for most Arizonans. But for college students living out of state, healthy people between jobs, early retirees bridging to Medicare, and others in specific situations — short-term medical may be a smarter, more flexible fit. Understanding the difference is exactly what a licensed broker is for.
Not sure if short-term medical or an ACA plan is right for you? A licensed broker will walk you through both options — free, no obligation.
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Understanding the Landscape
Knowing when an ACA plan is the wrong tool for the job is just as important as knowing when it's the right one.
The ACA marketplace was built to ensure broad, comprehensive access to health coverage, and for the majority of Arizonans it does exactly that. Pre-existing condition protections, essential health benefits, and financial subsidies make ACA plans the correct starting point for nearly anyone evaluating their options.
However, one significant limitation affects a large and specific group of Arizonans: the majority of ACA marketplace plans are structured as HMOs. HMO plans tie your coverage to a defined local provider network. Outside that network — except in emergencies — your coverage is either severely limited or nonexistent. For people whose lives don't stay in one geographic place, that structure creates real, practical problems.
Short-term medical plans are not a replacement for ACA coverage in a general sense. They are a specific tool with real strengths and significant limitations. Used correctly, with professional guidance, for the right person and the right situation, they provide meaningful protection. Used incorrectly — or chosen without fully understanding what they don't cover — they can leave someone seriously exposed. That nuance is exactly what makes broker guidance so important with these plans.
With enhanced ACA subsidies having expired at the end of 2025, some Arizonans who previously found ACA plans affordable are now seeing significantly higher premiums. For healthy individuals in certain income brackets, short-term medical has become a more relevant conversation than it was a year ago — making it even more important to evaluate both options carefully with a licensed broker.
College students: An Arizona parent's HMO plan covers care in Arizona. It does not cover their child's doctor visits, urgent care, or specialist appointments in the state where the student actually lives and goes to school — only emergencies.
Frequent travelers: Someone who regularly travels for work and needs care outside Arizona while on the road will find most ACA HMO networks provide little practical coverage away from home.
Snowbirds in reverse: Arizonans who spend significant time in other states — whether for family, work, or lifestyle — may find a nationwide PPO more practically useful than an Arizona-network HMO.
Short transition periods: Someone starting a new job in 60 days who needs bridge coverage during the gap may find short-term medical a more cost-effective tool than COBRA or a full ACA plan for a brief window.
Who Short-Term Medical May Be Right For
These are the most common circumstances where short-term medical becomes a legitimate option worth considering. In every case, a broker comparison of both ACA and STM options is essential before deciding.
An Arizona parent's ACA HMO covers the student in Arizona but provides only emergency care in the state where the student actually lives. A short-term PPO plan with nationwide network coverage covers the student at doctors and urgent care in their college town — where they actually need it.
Strong Fit — Geographic CoverageSomeone leaving a job and starting a new position in 60–90 days faces a coverage gap. COBRA can be prohibitively expensive. For a healthy individual with no significant health needs, a short-term plan can provide meaningful protection during the transition at a fraction of the COBRA cost.
Possible Fit — Bridge CoverageArizonans who missed the open enrollment window without a qualifying life event cannot enroll in an ACA plan until November. For a healthy person facing months without coverage, a short-term plan can serve as a bridge — with clear understanding of its limitations.
Possible Fit — Enrollment GapSomeone who retires at 62 or 63 and needs coverage until Medicare at 65 may find short-term medical a cost-effective bridge — particularly if they're in good health, have no significant pre-existing conditions, and their income is too high for meaningful ACA subsidies.
Careful Evaluation RequiredWith enhanced ACA subsidies having expired in 2026, Arizonans above subsidy thresholds face full-price ACA premiums. A healthy person in their 30s or 40s with no pre-existing conditions may find short-term premiums significantly lower — but the coverage tradeoff must be fully understood.
Careful Evaluation RequiredA healthy person who regularly needs care outside Arizona and finds their ACA HMO's out-of-network limitations a practical problem may find a nationwide PPO short-term plan more useful for their lifestyle — provided they fully understand what the plan excludes.
Situational — Broker Review EssentialThe PPO Advantage
One of the most significant practical differences between short-term medical and most ACA marketplace plans is the provider network structure — and for certain Arizonans, it's the deciding factor.
The majority of ACA plans available on the Arizona marketplace are structured as HMOs — Health Maintenance Organizations. HMO plans restrict your coverage to a defined network of providers within a specific geographic service area. If you receive non-emergency care outside that network, you're typically responsible for the full cost. For a person whose life stays within the Phoenix or Tucson metro, this rarely presents a problem. For anyone else, it's a significant limitation.
Short-term medical plans from carriers like Allstate Health Solutions use large national PPO networks — most commonly MultiPlan and PHCS — that include hundreds of thousands of physicians, specialists, urgent care centers, and hospitals across all 50 states. When you see an in-network provider, the plan's negotiated rates apply and your cost-sharing kicks in. This structure provides meaningful, practical coverage wherever you are in the country.
For a college student in Colorado, a traveling contractor working a job in Texas, or a retiree spending summers in Michigan — a nationwide PPO delivers coverage that an Arizona HMO simply cannot. That practical reality is why, for the right person in the right situation, short-term medical isn't just a cheaper alternative. It's genuinely a better-fitting product.
Most major short-term medical carriers use MultiPlan or PHCS networks — among the largest PPO networks in the United States with over 900,000 provider locations nationwide. Chances are your doctor and local hospital are already in-network, wherever you are. A broker can verify network participation for your specific providers before you enroll.
Unlike Arizona ACA HMO plans that restrict coverage to the state or metro area, short-term PPO plans provide in-network access to providers nationwide — critical for students, travelers, and those splitting time between states.
PPO plans don't require a primary care physician referral to see a specialist. You can go directly to the specialist you need, anywhere in the network — a flexibility that HMO plans don't offer.
Short-term medical plans cover emergency care regardless of network status — just like ACA plans. If you're in an emergency anywhere in the country, you're covered. The PPO advantage is that routine and specialist care is also covered nationwide, not just emergencies.
When you use an in-network PPO provider, the carrier's negotiated rates apply — significantly reducing what you pay even before you hit your deductible. This network discount applies at providers across the country, not just in Arizona.
Most short-term medical carriers provide online provider search tools so you can verify network participation before you enroll or before you seek care. A broker can also verify your specific doctors and hospitals are in-network during the application process.
This section is not a footnote — it is central to making an informed decision. Short-term medical plans provide real value for the right person, but they exclude categories of coverage that ACA plans are required to include. Every person considering a short-term plan must fully understand these exclusions before enrolling. A licensed broker will walk through each of these with you.
This is the most significant exclusion. Short-term medical plans do not cover conditions you had before the policy began. If you have diabetes, heart disease, cancer history, asthma, or virtually any ongoing health condition, treatment related to that condition will not be covered. ACA plans are prohibited from this exclusion. Short-term plans are not.
Pregnancy, prenatal visits, labor, delivery, and postpartum care are explicitly excluded from short-term medical plans. If there is any chance of pregnancy during the coverage period, a short-term plan is the wrong choice. ACA plans cover maternity as an essential health benefit.
Mental health services — therapy, psychiatry, inpatient behavioral health, substance use disorder treatment — are typically excluded from short-term plans or very severely limited. ACA plans are required to cover mental health with parity to physical health coverage.
Annual physicals, cancer screenings, immunizations, and other preventive services covered at no cost under ACA plans are generally not covered under short-term medical. You will typically pay out of pocket for routine preventive visits.
Most base short-term medical plans do not include prescription drug coverage. Some plans offer Rx riders that can be added for additional premium, but coverage is limited compared to ACA Part D-equivalent benefits. If you take regular medications, this is a critical factor to evaluate.
Short-term plans are not required to cover the ten essential health benefits mandated under the ACA — which include pediatric services, rehabilitative care, laboratory services, and more. Coverage is focused on major medical events rather than comprehensive care.
The bottom line: Short-term medical plans are designed to protect healthy people from major, unexpected medical events — hospitalizations, surgeries, accidents, sudden serious illness. They are not designed to be comprehensive health coverage. If you have ongoing health conditions, take regular medications, are pregnant or planning to become pregnant, or rely on mental health services, a short-term plan is likely the wrong choice regardless of the premium savings. A licensed broker will tell you this honestly — because their job is to put you in the right plan, not just any plan.
Side-by-Side Comparison
This comparison is intentionally honest in both directions. Neither plan type is universally better — the right choice depends entirely on your health situation, your life circumstances, and your budget. A broker reviews both options against your specific profile before making a recommendation.
| ACA Marketplace Plan healthcare.gov — Arizona | Short-Term Medical Plan Non-ACA Compliant | |
|---|---|---|
| Pre-Existing Conditions | ✓ Fully covered — cannot be denied or charged more based on health history | ⚠ Excluded first 12 months — pre-existing conditions are not covered during the initial exclusion period; coverage begins month 13 on multi-year plans |
| Essential Health Benefits | ✓ All 10 required — maternity, mental health, Rx, preventive care, and more | ✗ Limited — covers major medical events; essential benefits are not required |
| Monthly Premium | Moderate to high — significantly reduced by subsidies for qualifying income levels | Lower — often 30–60% less than ACA for healthy applicants who qualify |
| Provider Network | Usually HMO — Arizona network; limited or no coverage outside the state except emergencies | Nationwide PPO — large national networks (MultiPlan, PHCS) accepted across all 50 states |
| Maternity Coverage | ✓ Fully covered — prenatal, labor, delivery, and postpartum care included | ✗ Excluded — maternity is explicitly not covered on short-term plans |
| Mental Health Coverage | ✓ Covered with parity — mental health treated same as physical health | ✗ Limited or excluded — mental health typically not a covered benefit |
| Prescription Drugs | ✓ Covered — formulary-based Rx coverage included in all plans | Limited — Rx riders available at added cost; base plans often exclude |
| Preventive Care | ✓ Free — annual exams, screenings, and vaccines at $0 cost | ✗ Not covered — preventive services are not included in base plans |
| Term Length | Annual — aligned with calendar year and open enrollment | Flexible — 1 to 12 months depending on state rules; ideal for bridge coverage |
| Enrollment Timing | Open enrollment only — or qualifying life event SEP | Enroll anytime — no enrollment windows; coverage can start within days |
| Subsidy Eligibility | Yes — premium tax credits available for qualifying income levels | No — not eligible for ACA premium tax credits |
| Out-of-Pocket Maximum | Federally capped — $9,450 individual / $18,900 family in 2026 | Varies by plan — limits set by carrier, not federal regulation; review carefully |
| Best For | Anyone with pre-existing conditions, ongoing prescriptions, planning pregnancy, or who qualifies for subsidies | Healthy individuals needing bridge coverage, out-of-state coverage, or coverage outside enrollment windows |
Featured Carrier
Our broker network works with Allstate Health Solutions as a primary short-term medical carrier for Arizona residents. Here's what sets their plans apart.
Allstate Health Solutions brings the Allstate brand's reputation for stability and customer service to the short-term medical market. Their plans are available to Arizona residents and offer two large PPO networks: the Aetna Open Choice PPO and the Cigna PPO — both among the largest physician and hospital networks in the country, giving enrollees broad access whether they're in metro Phoenix, rural Arizona, or anywhere else in the United States.
In Arizona, AHS offers plan durations up to 3 years, with rate guarantees available for the duration of the plan term. This is a meaningful advantage over competitors who cap durations at 12 months — a longer term locks in your rate and, critically, your pre-existing condition exclusion clock. HSA-compatible plan options are also available for enrollees who want to pair short-term coverage with a Health Savings Account.
Next-day effective dates are available on AHS plans — a significant practical benefit for anyone in an unexpected coverage gap who needs protection quickly. Application approval can result in coverage beginning as soon as the following day.
The primary short-term medical carriers offering plans to Arizona residents are Allstate Health Solutions, UnitedHealthcare, and Pivot Health. Note: Philadelphia American Life, North American Company, Freedom Life, and LifeShield/National General do not currently offer short-term medical plans in Arizona. A licensed broker confirms current availability and compares plan structures across all carriers writing business in the state.
Short-Term Medical Plans — Arizona
Real-World Scenarios
These scenarios represent situations where a licensed broker might legitimately recommend evaluating a short-term plan. Each situation is specific — and each requires a broker's individual assessment.
A family in Scottsdale has a daughter starting her sophomore year at the University of Colorado in Boulder. The family's ACA marketplace plan is an BCBS Arizona HMO — comprehensive coverage in the Phoenix metro, but only emergency coverage in Colorado. When the daughter gets strep throat, sees a dermatologist, or needs urgent care for a sprained ankle, the Arizona HMO leaves her on her own for those costs.
A healthy 38-year-old marketing professional in Tempe leaves his job at a tech company and is starting a new role in three months. COBRA to continue his former employer's coverage would cost $680/month. He has no pre-existing conditions, takes no regular medications, and is in excellent health. He needs 90 days of coverage before his new employer's plan kicks in.
A 63-year-old retired teacher in Tucson is two years away from Medicare eligibility. She retired early and her income is above the threshold for meaningful ACA subsidies. Full-price ACA premiums for someone her age in Arizona are substantial. She's in good health, has no significant pre-existing conditions, and simply needs coverage for a defined bridge period.
A 42-year-old general contractor in Mesa earns $85,000 net annually from his business — above the subsidy threshold for meaningful ACA credits in 2026 after the enhanced provisions expired. Full-price ACA premiums for his age bracket are around $650/month. He's healthy, exercises regularly, has no medications, and no significant health history.
The Broker's Role
Short-term medical is one of the insurance decisions where professional guidance isn't just helpful — it's genuinely important. Here's why.
A licensed broker compares both ACA and short-term options against your actual health situation and budget. Their job is to put you in the right plan — not to steer you toward the higher commission. If an ACA plan is the better fit, a good broker will tell you so.
Short-term medical underwriting involves health questions. A broker who regularly places these plans knows which conditions are likely to cause exclusions or declinations, and can advise you before you apply — so there are no surprises after you've already made a decision.
Every short-term carrier defines exclusions slightly differently. A broker reads the actual policy language — not just the marketing summary — and flags anything that could affect you specifically based on your health history and anticipated needs.
Short-term plans are by definition temporary. A broker helps you think through what comes next — whether that's ACA open enrollment, an employer plan, Medicare, or another coverage option — so you don't find yourself in a gap when the short-term plan ends.
If a claim issue arises during your short-term coverage period, a broker is your advocate with the carrier. That ongoing relationship is something you don't have when you buy directly from a website without professional representation.
The right answer — ACA, short-term, COBRA, AHCCCS, or something else entirely — depends on your specific situation. A licensed Arizona broker will evaluate all of your options honestly and help you make an informed decision. Free service, no obligation.
Connect With a Broker Now → Or try our AI Coverage Advisor first →Common Questions
Short-term medical plans can be the right solution for a specific person in a specific situation. They can also be the wrong solution — and choosing incorrectly can result in unexpected medical bills, denied claims, and significant financial hardship.
Please do not purchase a short-term medical plan based on price alone. Understand every exclusion. Know your health history and how it will be treated during underwriting. Know what happens when the plan ends and how you will transition to other coverage. Have a licensed broker walk through the policy language with you before you enroll.
Our broker network is here to provide exactly that guidance — honestly, at no cost to you, with no pressure to choose any particular plan or carrier. The right answer for your situation may be an ACA plan, a short-term plan, AHCCCS, COBRA, or something else entirely. A licensed Arizona broker will help you find out which.
A licensed Arizona broker will compare your ACA and short-term medical options side by side, honestly and at no charge — so you can make a fully informed decision.
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