Short term health insurance (short term limited duration insurance, or STLDI) can last far longer in some states than others. In a handful of states you can buy a single short term policy and renew it toward a 36-month total, roughly three years of continuous coverage. In others it's capped at a few months, and in six states it isn't realistically available at all.
Quick answer: As of mid-2026, about 19 states allow short term coverage to reach a 36-month total, and one more (South Carolina) allows up to 33 months. Whether that long duration rests on a state statute or only on a paused federal rule matters a lot, because the federally contingent states could revert to much shorter limits if federal enforcement resumes.
States that allow up to a 36-month total (2026)
Close, but not 36: South Carolina allows an 11-month initial term and up to a 33-month total (per DOI Bulletin 2024-13), not the 36 months some comparison sites list.
The distinction that matters most: state law vs. a paused federal rule
Not all "36-month states" are equally durable. There are two very different reasons a state allows long duration short term coverage:
1. A state statute or rule sets the 36-month ceiling. In Arizona, Arkansas, Florida, Iowa, Indiana, Kentucky, Oklahoma, Texas, and Utah, the 36-month total is written into state law or regulation. That footing doesn't depend on federal policy.
2. There's no state cap, so the state defaults to the federal framework. In Alabama, Georgia, Louisiana, Mississippi, Nebraska, Tennessee, West Virginia, and Wyoming, there is no state duration cap. Their up-to-36-month availability exists only because the 2024 federal rule, which would cap short term plans at a 3-month initial term and a 4-month total, is currently not being enforced. If federal enforcement resumes, the durations available in these states could revert to those much shorter federal limits. Treat their 36 months as currently available, not permanently guaranteed.
Idaho is its own category: its Enhanced Short Term Plan runs up to 36 months, is guaranteed issue, and covers a near-full set of essential health benefits, while a traditional Idaho short term plan is capped at a 6-month total.
Important: "36 months available" is not "36 months guaranteed to you"
Even in the strongest states, a few realities apply:
- These plans are generally not guaranteed renewable, the total duration is a ceiling, not a promise. Renewal terms depend on the specific plan.
- Short term coverage is medically underwritten in most of these states, so you can be turned down or have preexisting conditions excluded.
- It is not ACA minimum essential coverage. It doesn't have to cover the essential health benefits, and it won't qualify you for premium subsidies.
- In Florida, the specific carrier's approved form controls the term you can actually buy, some may still follow the shorter federal template.
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Which states do NOT allow long duration short term coverage?
Sixteen states cap short term coverage well below 36 months or don't offer it at all. Ten restrict it to a short window (for example, roughly 3–4 months in Maryland, North Carolina, Oregon, Pennsylvania, and Virginia; about six months per year in Michigan and Nevada). Six more, California, Colorado, Illinois, Minnesota, New Mexico, and Rhode Island, effectively don't have a short term market at all. See our companion guides on short term duration limits by state and where short term medical is banned or unavailable.
Key takeaways
- About 19 states currently allow short term coverage up to a 36-month total; South Carolina allows 33 months.
- In roughly half of those, the 36-month total rests on state law; in the other half it rests on a paused federal rule and could change.
- Long duration short term coverage is still not comprehensive coverage, for a genuinely long term need, an ACA marketplace plan is usually the better fit.
Get help comparing your options
Duration rules change, and the right choice depends on your health, budget, and how long you actually need coverage. As an independent, carrier neutral brokerage, we can help you compare what's genuinely available in your state, at no cost and with no obligation.
Sources
- 1Federal Register — Short-Term, Limited-Duration Insurance and Independent, Noncoordinated Excepted Benefits Coverage (final rule, 89 FR 23338, April 3, 2024)
- 2U.S. Department of Labor — Short-term, limited-duration insurance: the 2024 final rule, fact sheet and the August 7, 2025 tri-agency statement
- 345 CFR § 144.103 — Definitions, including “short-term, limited-duration insurance” (eCFR)
- 4NAIC — State insurance departments (find and contact your state regulator)
This article is general information, not insurance or legal advice. Regulatory details reflect state law and guidance as of the last updated date and can change; confirm current terms before you enroll. Last updated: 2026-07.
