Catastrophic Health Plan are health insurance plans intended for people who are very health, have few medical needs. They are intended to protect healthy individuals only from worst-case scenarios, like getting seriously sick or injured. But you pay most routine medical expenses yourself, like testing. These plans meet all of the requirements of the typical ACA-compliant plans, except
- they do not cover any benefits other than 3 primary care visits per year until the plan’s deductible is met.
- You do get free vaccinations and an annual physical included,
- The monthly premiums are generally lower than for other plans,
- The deductibles are very high. For 2017, the deductible for all Catastrophic plans is $7,150.
- out-of-pocket costs for deductibles, copayments, and coinsurance are much higher.
Who qualifies for a catastrophic plan?
Since Obamacare was enacted, to qualify for a Catastrophic plan, you must
- be under 30 years old OR
- are over 30 and get a “hardship exemption”. This includes people whose plan was canceled by their insurer or small group employer.
Costs of Catastrophic plans
Monthly premiums are usually low, but you are not eligible for a subsidy! If you do qualify for a premium tax credit based on your income, you’ll probably find that a Bronze or Silver plan is likely to be a better value. After you meet the annual deductible, your insurance company pays for all covered services, with no copayment or coinsurance.
Catastrophic health coverage is different from other specialty insurance plans, like accident, critical illness, or short-term plans.