Short-Term Health Insurance by State (2026 Duration Caps)

Short-term health insurance rules are set state by state, and the spread is enormous. Utah and Arkansas let coverage run to 36 months from the day the first policy issues. Delaware caps it at three months and bars renewal, which is tighter than the federal rule. Nevada stops at 185 days. Colorado allows six months and defines the plan as nonrenewable, and Ohio’s own bulletin still allows a one-time 364 days. Nebraska and Texas set no number of their own, so the federal definition decides. Five states prohibit the product completely. Use the box below: you get the duration cap, whether renewal is allowed, how long a pre-existing condition can be excluded, and the section of that state’s rulebook it comes from. Everything in it was read from the state’s own code, administrative rule or insurance-department bulletin, checked 7 to 10 October 2026. Where a state’s documents contradict each other, the tool shows the contradiction instead of picking a side.

The number in the ad and the number on the books

The federal definition of short-term, limited-duration insurance sits at 45 CFR 144.103. The version on the books is the 2024 final rule (89 FR 23338, published 3 April 2024, effective 17 June 2024): coverage of no more than 3 months between the effective date and the expiration date, and no longer than 4 months in total once you count renewals and extensions.

Most of what you see advertised says 364 days. That was the 2018 rule (83 FR 38212). It was superseded in 2024 and is still quoted by carriers, brokers and a lot of state rulebooks, because those rulebooks were written against it.

Then, on 7 August 2025, the Departments of Labor, Health and Human Services and Treasury issued a joint statement that they “do not intend to prioritize enforcement actions” for the 2024 rule while they write a new one, and that they are lenient where a state applies its own definition. The rewrite is still open. A proposed rule was due no later than summer 2026, and the law firm Mitchell Williams reported on 18 November 2025 that analysts expect the old 12-month initial and 36-month total standard to return. No final 2026 rule existed as of 9 October 2026.

Read those three facts together and you get the sentence nobody selling you a policy will say out loud: the duration limit that binds your policy is usually your state’s rule, because the federal agencies are not currently enforcing the federal text. Anyone offering you one number for the whole country is guessing. North Carolina shows what that guessing costs, since its own Department of Insurance spent August 2025 telling brokers the federal rule still applies there.

One federal requirement is never contested. Every short-term policy must print this on page one, in at least 14-point type: “IMPORTANT: This is a short-term, limited-duration policy, NOT comprehensive health coverage.”

Five kinds of state rule, and which one you live under

State rules are not one standard with local variations. They fall into four shapes, and the shape tells you what to expect when you apply.

1. Long-permitting states: Utah, Arkansas, Idaho

The Utah Insurance Department regulates these plans under Utah Admin. Code R590-286, reenacted effective 24 March 2025. R590-286-6(1) requires the contract to run less than 12 months from first issuance, caps the total including extensions at 36 months, and bars renewal. R590-286-4(1) also caps the pre-existing-condition exclusion at 12 months, which is rarer than the duration cap and worth more to you. Utah’s own filing says the 2025 rewrite changed no requirements, so the state did not move when the federal rule did.

Arkansas runs the same 12-and-36 structure off its statute (Ark. Code Ann. § 23-79-2002(5) and the Arkansas Short-Term Limited Duration Insurance Act, ch. 104), and its Insurance Department reopened selling in AID Bulletin 14-2025, dated 14 October 2025, five weeks after the federal non-enforcement statement. The bulletin prints the conflict itself: the federal rule, it notes, “had a limited duration of only four months.”

Idaho is the one to be careful in, because its own regulator has published three different answers. IDAPA 18.04.15.010.07 caps total coverage including renewals or extensions at 36 months and requires expiration less than 12 months after the original effective date. IDAPA 18.04.15.010.03 says nonrenewable short-term coverage has a duration of six months or less in total. The Idaho Department of Insurance consumer page dated 5 October 2026 says federal preemption makes the maximum “less than 12 months,” so plans may run “a maximum period of 364 days.” A department slide deck says six months, and the reissuance gap is 60 days on that page against 63 days in the rule. We are not printing one Idaho number, because Idaho has not printed one either. If you buy there, get the answer in writing and ask which document controls.

2. States tighter than the federal rule: Delaware, Nevada, Maryland, Washington

Delaware is the strictest state found in this check, and it is stricter than Washington. 18 Del. Admin. Code Regulation 1320 § 4.0 defines the product as coverage expiring “less than or equal to 3 months after the original effective date“ with ”a duration of no longer than 3 months in total.” § 5.1.2 bars back-to-back terms, and § 6.3.4 requires the policy outline to state that the policy is not renewable. That is three months against the federal four, effective since January 2019.

Nevada does not use the 364-day standard either. Under NAC 689A.434 a plan stays outside Nevada health-plan regulation only if it covers “not more than 185 days” and is nonrenewable, with any extension keeping the total under 185 consecutive days in a 365-day period. Nevada sets no separate STLDI maximum by statute, and its rule dates to 1997. It does constrain what happens after you are sick: NRS 689A.075 limits mid-term cancellation to listed causes and requires 10 days’ written notice for non-payment, 20 for other permitted causes. Many states require nothing.

Maryland keys the product to less than three months with no extension or renewal (Md. Code, Insurance § 15-1301), and Washington to three months or less, non-renewable, and no more than three months of it in any 12 months (WAC 284-43-8000). Both were read at the rule section rather than the state consumer page, so treat those two as citation-level verification.

3. States that adopt the federal definition: North Carolina, Texas

North Carolina did the opposite of Arkansas. NCDOI Bulletin 25-B-11, dated 29 August 2025, states that the definition in 45 C.F.R. § 144.103 “remains the definition” in North Carolina and that no short-term product regulated by the Department may be offered there without complying with the current federal rule. The bulletin adds: “This statement of non-enforcement does not change what the current law is.” So in North Carolina the answer is 3 months, 4 months with renewals, and the state’s own regulator is the source, which contradicts what North Carolina brokers advertise.

Texas keys its definition to the federal rule through Tex. Insurance Code ch. 1509 and sets no state number. Do not publish a Texas 12-month cap from this page’s work: two Texas Department of Insurance consumer pages contradict each other, and the code section is the one we print.

4. The silent states: Nebraska

Nebraska has no short-term rule. The Department of Insurance rules index (210 NAC) contains no STLDI rule at all. The only statutory text found, Neb. Rev. Stat. § 44-787(5)(d)(iv)(D), mentions short-term insurance expiring within twelve months, but that clause is a carve-out from the state’s guaranteed-renewability requirement, not a maximum term, and a broker who reads it as permission for a 12-month policy is misquoting it. The department’s consumer alert quotes no day count. So in Nebraska the federal text on the books decides, and “my state has no cap” is worse news than a state cap, not better.

Two rulebooks that predate the current federal rule: Colorado, Ohio

Colorado allows six months, longer than the federal definition, but writes the plan as nonrenewable and allows one such policy per person in any twelve months (C.R.S. 10-16-102(60)). Ohio’s department still publishes a one-time term of no more than 364 days (Bulletin 2018-05, effective 24 October 2018), and its line calling the plan exempt from federal essential-benefit requirements was written against the 2018 rule. Above three months, neither state’s number makes the plan federally exempt, so a policy can be legal under the state rulebook and not be a short-term plan in federal terms.

Where you cannot buy one at all

KFF’s state brief of 15 October 2025 (updated 3 November 2025) lists California, Illinois, Massachusetts, New Jersey and New York as states where these plans are not sold, and counts 36 states where they are. Nine states plus the District of Columbia appear on that brief with no coverage available from any issuer. KFF publishes no state-by-state duration table, so it is the right source for availability and the wrong source for a cap: every number in the table below comes from the state’s own documents.

Short-term health insurance by state: the table

Short-term health insurance by state comes down to sixteen rulebooks we could read in primary form, plus the five states that prohibit the product. Every row carries its citation. Anything we could not read is left out rather than estimated.

State	Maximum term on the rulebook	Renewal	Citation
Utah	Initial term under 12 months; total coverage no more than 36 months from first issuance, counting extensions	No. The rule bars renewal outright.	Utah Admin. Code R590-286-6(1) and R590-286-4(1), reenacted effective 24 March 2025
Arkansas	Initial term less than 12 months; renewals may extend total coverage to 36 months	Yes, inside the 36-month total.	Ark. Code Ann. 23-79-2002(5) and 23-104-104 to 23-104-106; AID Bulletin 14-2025, 14 October 2025
Idaho	Three numbers from one regulator: the rule caps total coverage at 36 months, the DOI consumer page says 364 days, a DOI deck says 6 months	Nonrenewable short-term coverage may not be renewed, reissued or replaced; enhanced plans renew inside the 36-month total.	IDAPA 18.04.15.010.07 and .010.03, amended effective 2 April 2026; Idaho Code 41-5203(13) and 41-5214
Delaware	3 months or less at issue, and no longer than 3 months in total	No. The policy outline must state that the policy is not renewable, and successive terms are barred.	18 Del. Admin. Code Regulation 1320, sections 4.0, 5.1.1, 5.1.2, 6.3.4 and 6.5, effective January 2019
Nevada	Not more than 185 days, and not more than 185 consecutive days in any 365-day period	No. The Division of Insurance answers the renewal question with one word: No.	NAC 689A.434, effective 14 November 1997; NRS 689A.075 requires 10 days notice to cancel for non-payment and 20 days for other permitted causes
Maryland	Less than 3 months, with no extension or renewal	No.	Md. Code, Insurance 15-1301
Washington	3 months or less, no renewal, and no more than 3 months of this coverage in any 12 months	No.	WAC 284-43-8000
North Carolina	3 months at issue and 4 months total counting renewals and extensions – the federal rule, applied by name	Only inside the federal 4-month total.	NCDOI Bulletin 25-B-11, 29 August 2025; G.S. 58-3-178(1)(m); 45 CFR 144.103
Texas	No state number of its own; the code adopts the federal definition, so 3 months at issue and 4 months total	Only inside the federal 4-month total.	Tex. Insurance Code chapter 1509, which keys the state definition to the federal rule
Nebraska	The state sets no number, so the federal text on the books decides: 3 months at issue, 4 months total	No state renewability standard for these plans.	No short-term rule appears in the Department’s rules index (210 NAC); Neb. Rev. Stat. 44-787(5)(d)(iv)(D) is a carve-out from guaranteed renewability, not a duration cap
Florida	Initial term under 12 months; counting renewals and extensions, total coverage is not to exceed 36 months	Yes. The statute counts renewals and extensions inside the 36-month total.	Fla. Stat. 627.6426, amended by ch. 2024-139; companion group provision 627.6525
Arizona	The statute allows under 12 months and no more than 36 months in total; the federal rule still on the books says 3 months and 4 months	Yes, inside the 36-month total the statute allows.	A.R.S. 20-1384, with DIFI Regulatory Bulletin 2025-12 saying the department will not enforce the 2024 federal duration limits but will enforce the federal notice
Michigan	185 days or less per policy, and no more than 185 days of this coverage in any 365-day period	No. The statute says the coverage is nonrenewable.	MCL 500.2213b(8) to (12), amended by 2023 Act 162, effective 13 February 2024
Tennessee	The state sets no number, so the federal text on the books decides: 3 months at issue, 4 months total	No state renewability rule for these plans.	Tenn. Comp. R. 0780-01-93-.01(3) leaves short-term limited duration insurance outside the definition of individual health insurance coverage; effective 20 February 2012
Colorado	Not more than six months, and the plan has to be written as nonrenewable	No. The definition says nonrenewable, and only one such policy may be issued to a person in any twelve months.	C.R.S. 10-16-102(60), 2025 edition
Ohio	The department’s bulletin allows one term of no more than 364 days; the federal definition on the books allows 3 months at issue and 4 months in total	No. Ohio’s exception is written for a one-time policy.	Ohio Department of Insurance Bulletin 2018-05, effective 24 October 2018, One-Time-Limited-Duration Policies
California, Illinois, Massachusetts, New Jersey, New York	Not sold. These states prohibit the product.	Not applicable	KFF state brief, 15 October 2025, updated 3 November 2025

What the plan will not pay for, and how the exclusion works

These plans take a full health history and can refuse any condition that existed before your start date. The carrier maps the excluded conditions from your application and pays nothing for their treatment while the exclusion window is open.

Some states cap that window. Utah caps it at 12 months. Where no state cap exists, the exclusion can run as long as the policy does. Delaware’s required notice has to spell the exclusions out before you sign, which is the only protection in that clause.

The second exposure comes after you are sick. The plans are not guaranteed-issue or guaranteed-renewable, and the term can end with a hospital bill still open.

Utah’s own required notice states the coverage gap plainly: this coverage “is not required to comply with certain federal market requirements for comprehensive health insurance, principally those contained in the Affordable Care Act” (R590-286-5(9)). Maternity, mental health treatment and prescriptions are whatever the carrier’s document says they are.

The money: what the discount is and what it buys

The premium runs below an unsubsidized Marketplace plan because the product is cheap to run: it screens out sick applicants, excludes known conditions, caps payouts, and can let you go when the term ends. Whether that discount is worth anything depends on which of the four options you actually qualify for.

Option for a gap	What it costs	How long	Who qualifies	The catch
Short-term plan	The quoted premium. No credible per-state dollar average exists that we could source, so none is printed here	Your state’s cap, which is three months to 36 months in the sixteen states read	Anyone who passes screening	Pre-existing conditions excluded, and none of the ACA rules apply
Marketplace with a subsidy	CMS: “$50 per month … for the lowest cost plan in 2026 for eligible enrollees,” a $13 increase from 2025. KFF puts the average benchmark premium at $625 for 2026, up from $497, which is KFF’s own calculation	A full calendar year	The enhanced credits lapsed after 2025, so the 100%-of-FPL floor and the 400% cap are restored for 2026	You need a window. 2026 enrollment ran 1 November 2025 to 15 January 2026
COBRA from your last hospital or agency job	The full group premium plus an administrative load	Usually up to 18 months	Anyone leaving employer coverage	You pay the employer’s share too, and the election window is 60 days
A spouse’s or partner’s plan	Payroll deduction at their employer’s rate	Continuous	Dependents under that plan’s rules	Your loss of coverage usually opens an enrollment window; ask their HR how long
Going bare	$0	Until the first ER visit	Everyone	Every bill lands on you at self-pay rates

Losing coverage starts clocks. A Marketplace Special Enrollment Period runs 60 days around a loss of coverage, and COBRA’s election window is 60 days. Medicaid has no window; apply any time, and a low-earnings gap month can qualify you in a Medicaid state even after high-earning contract months.

Whether any of this is your problem or your agency’s depends first on how you are hired. A W-2 travel nurse usually gets employer-sponsored coverage that a 1099 contractor does not, and the difference is worked through in our 1099 versus W-2 guide. The gap weeks are a cash problem before they are an insurance problem: how your agency pays between contracts decides what you can afford in the month you buy, and that is in the housing stipend guide.

How to read a quote: the six lines that decide everything

Ignore the monthly price until you have read these lines on a sample policy. Each one costs more than the premium does.

1. Total duration, counted the way the rule counts it: the expiration date including every renewal or extension, measured from first issuance.
2. The deductible, and whether it resets per policy period or per condition. A $2,000 deductible per condition is two car accidents deep before one payment.
3. Coinsurance after the deductible, and whether an out-of-pocket maximum exists at all.
4. The benefit maximum per period, per condition, and lifetime.
5. The exclusion list and its window: every mapped condition and the date each exclusion expires. Utah caps that window at 12 months by rule; ask where yours sits.
6. Renewability and the claim cutoff: can you renew, and what happens to an open claim when the term ends.

Then find the page-one “IMPORTANT … NOT comprehensive health coverage” sentence. Its absence is a red flag about the seller, not about the page layout.

If your state says not verified: the 15-minute check

Thirty-six entries in that dropdown answer “not verified” rather than guessing. Here is how to finish the job yourself, which is also how we verified the ten that are listed.

1. Search “[your state] department of insurance short-term limited duration rules” and open the state’s own domain, not a broker comparison site.
2. Find the administrative-code section that defines the product and read the duration clause. The phrase you need counts “renewals and extensions,” measured from first issuance.
3. Read the pre-existing-condition clause in the same rule and note whether it caps the exclusion window or leaves it to the carrier.
4. Compare the rule’s last amendment date against the federal timeline: the 2018 standard was superseded on 17 June 2024, and the non-enforcement statement came on 7 August 2025. A rule last touched in 2019 is quoting a dead number.
5. Call the insurance department’s consumer hotline and ask for the controlling rule number rather than a summary. Consumer pages and rule text disagree; ask which one a hearing officer would apply.
6. Ask what document you must receive at application. Utah’s is a named disclosure form and Delaware’s is a 14-point statement; knowing yours exists means you can demand it before you pay.

When to buy one, and when to skip it

Buy when the arithmetic lines up:

• The gap is fixed and short, with the next contract signed.
• No chronic condition under active management, and no surgery or pregnancy in the planning window.
• Your state sells them and the six lines above pass.
• You clear 400% of the federal poverty level, so the restored caps leave you little subsidy, and COBRA costs a multiple of the short-term quote.

Skip it when:

• A condition is being actively treated. The exclusion window means you prepay a deductible for care the plan will deny.
• The gap is open-ended. A term that ends mid-search turns a coverage problem into a bill.
• A low-income gap month could make you Medicaid-eligible, or your income dips under the subsidy thresholds.
• You are in one of the five ban states, where the product does not legally exist.
• Your own state’s tool answer above says not verified and you do not have 15 minutes. Guessing here costs more than the premium.

The cash side of the decision is the part you control. The emergency fund target for a nurse between contracts is what keeps a denied claim from becoming a credit-card balance, and the budget spreadsheet has a line for the premium.

Questions people ask after reading this

The site I quoted from says 364 days. Is that legal?

364 days was the 2018 federal standard, superseded in 2024 and not enforced by the federal agencies since August 2025. Whether you can actually buy one that long depends on your state’s definition, which is what the box above answers for sixteen states. Ohio’s own 2018 bulletin still publishes the 364-day term.

My gap could run four months. Do I buy two short policies back to back?

Read the state rule’s counting method first. Utah bars renewal and caps the total from first issuance. Delaware bars successive terms outright. Nevada’s 185-day cap is nonrenewable by design. Idaho’s rule converts anything totaling more than six months, counting renewals or reissuance, into a regulated enhanced plan. Stacking two policies can make you one contract under the rule, not two.

Is a health care sharing ministry the same thing?

No. A sharing ministry is not insurance, has no regulated benefit schedule, and has no state duration rule to cite. It belongs in the going-bare column of your risk math.

Does the federal 3-month rule still matter if my state allows more?

Yes, in states with no definition of their own, which default to the federal one still on the books. It also matters if you buy across state lines or your tax home and work state differ, since the state where the policy is issued writes it.

What is the highest-risk answer on this page?

Idaho’s. One regulator has published 36 months, 364 days and six months, and the difference between those numbers is the difference between a plan you finish and a plan that terminates on you mid-treatment. That is why the tool prints the conflict instead of resolving it.

What this page leaves out

Four things, on purpose: per-state premium dollar averages, since the only figures circulating come from broker pages with no published methodology; any single Idaho duration number, since the Idaho regulator has not published one; the 30 states whose rule text this site has not read yet, which the tool marks rather than guesses; and whether your agency contract requires coverage, which is a question for your recruiter.

Sources, checked 7 to 10 October 2026

• 45 CFR 144.103 (eCFR): the federal definition of short-term, limited-duration insurance.
• 89 FR 23338 (final rule, published 3 April 2024, effective 17 June 2024): the 3-month and 4-month limits and the page-one 14-point disclaimer. 83 FR 38212 (2018): the superseded 364-day standard.
• Joint DOL/HHS/Treasury statement, 7 August 2025: non-enforcement pending rulemaking, and leniency where a state applies its own definition.
• Mitchell Williams client alert, 18 November 2025: proposed rule due no later than summer 2026; analysts expect a 12 and 36-month standard.
• KFF state brief, 15 October 2025, updated 3 November 2025: availability by state and the five ban states.
• Utah Admin. Code R590-286, sections 4(1), 5(9), 6(1), 7(1), 7(2)(c), reenacted effective 24 March 2025, via the Utah Insurance Department rule filing.
• IDAPA 18.04.15, sections .010.03, .010.05, .010.07, .040, amended effective 2 April 2026; Idaho Code 41-5203(13) and 41-5214; Idaho DOI consumer page dated 5 October 2026 and the DOI short-term deck.
• NAC 689A.434 and NRS 689A.075; Nevada Division of Insurance consumer page.
• Ark. Code Ann. 23-79-2002(5), 23-79-2003 and 23-104-104 to 23-104-106; Arkansas Insurance Department Bulletin 14-2025, 14 October 2025.
• NCDOI Bulletin 25-B-11, 29 August 2025; N.C. Gen. Stat. 58-3-178(1)(m).
• 18 Del. Admin. Code Regulation 1320, sections 4.0, 5.1.1, 5.1.2, 5.1.5, 6.3.4, 6.5, effective January 2019; Delaware DOI limited-benefit page.
• Nebraska Department of Insurance rules index (210 NAC) and consumer alert OUT16285, revised February 2019; Neb. Rev. Stat. 44-787(5)(d)(iv)(D).
• Md. Code, Insurance 15-1301; WAC 284-43-8000; Tex. Insurance Code ch. 1509.
• Fla. Stat. 627.6426 and 627.6525, read on the Florida Legislature site, and A.R.S. 20-1384, read on azleg.gov, with DIFI Regulatory Bulletin 2025-12 read from an archived copy of the department PDF.
• MCL 500.2213b(8) to (12), as amended by 2023 Act 162 effective 13 February 2024, read from an archived copy of the Michigan Legislature page because the host blocks automated fetches.
• Tenn. Comp. R. 0780-01-93-.01(3), effective 20 February 2012, read from the Tennessee rule text and its public mirror.
• C.R.S. 10-16-102(60), 2025 edition, read from a full-text mirror of the Colorado Revised Statutes because the official host refuses automated fetches, and compared with the 2024 edition.
• Ohio Department of Insurance Bulletin 2018-05, effective 24 October 2018, read from the department PDF, plus the department’s bulletin index, which still lists it as substantive.
• CMS and HealthCare.gov 2026 materials: the $50 lowest-cost-plan figure, the 1 November 2025 to 15 January 2026 enrollment window, the 60-day Special Enrollment Period, the lapsed enhanced credits and the restored 100% and 400% FPL bounds. KFF benchmark premium analysis ($497 to $625, +25.8%, KFF’s own calculation). US Department of Labor COBRA summary (18 months, 60-day election).

General insurance information, not advice about your situation or your state. Duration rules are mid-flight, and I would not print a number I could not source to a current rule text, which is why the tool above says “not verified” for most states instead of a figure. Michael Chen, CPA. Written for nurses with four to twelve weeks between contracts and no four hours to spend finding out what their state requires.