Catastrophic health insurance plans are low-cost health plans geared toward people under age 30 and those who qualify for a hardship or affordability exemption.
Although premiums for catastrophic health plans are low, these plans have very high deductibles.
Reading: How much is catastrophic insurance
Catastrophic plans offer the same coverage as all Affordable Care Act plans, including preventive care at no cost, but most other care is subject to the deductible. Read on to find out how a catastrophic health plan works and who qualifies.
what is catastrophic insurance?
A catastrophic health insurance plan is a plan that offers low monthly premiums with a high deductible. is designed to provide a low-cost alternative for people who don’t anticipate a lot of regular health care costs.
what does catastrophic insurance cover?
These plans cover up to three doctor visits each year, as well as routine immunizations and preventive care. catastrophic health insurance also covers the 10 essential services required by the aca:
- emergency services
- ambulatory care and doctors
- pregnancy, maternity and newborn
- mental health and substance abuse disorder
- prescription drugs
- rehabilitation services
- lab work
- preventive, wellness and chronic disease management
- pediatric services, including dental and vision services
- people under 30 years old
- people over 30 who qualify for hardship and affordability exemptions
- facing eviction or foreclosure
- domestic violence
- damage to your home in a disaster
- a sudden need to care for a disabled or elderly family member
- lowest cost bronze plan: $329
- lowest cost silver plan: $428
- lowest cost gold plan: $462
- medicaid. medicaid is a federal/state health insurance program for low-income Americans.
- other plans here. Subsidies are available if you meet income requirements, which may make other plan options here more affordable.
- short-term medical insurance. short-term health plans have low premiums but are limited and only a temporary solution.
- Cobra. If you recently lost your job, you may be eligible for Cobra, which allows you to keep health insurance from your previous employer, but is very expensive.
all other medical care is covered once you meet the deductible.
What does catastrophic health insurance not cover?
A catastrophic plan will not cover anything more than the requirements listed above until you meet your deductible.
In addition, the exclusions for catastrophic plans are similar to those for any other health insurance plan. plans may vary by provider, but most do not cover elective procedures, such as cosmetic surgery. experimental treatments are also commonly excluded.
who qualifies for a catastrophic plan?
Unlike other health plans, the ACA limits catastrophic health insurance to just two groups of people:
Possible reasons for hardship exemptions include:
Go to your state health insurance exchange to see if you qualify for a hardship waiver. catastrophic health plan quotes should appear when you search for plans if you are eligible. If you don’t see the option, you can apply for a hardship waiver.
catastrophic health insurance costs
an ehealth analysis of 2022 found that the average cost of catastrophic insurance is $173 a month.
However, catastrophic plans have a much higher deductible, $8,700 in 2022, according to the Kaiser Family Foundation. only preventive care and three office visits per year are exempt from the deductible.
compared to the monthly rates of the other plans here, a catastrophic plan is very affordable:
One of the benefits of a catastrophic medical plan is that, unlike other medical plans, catastrophic medical insurance has no coinsurance. will cover you 100% after you meet the deductible.
how to get a catastrophic health plan
If you qualify, you can get a catastrophic health plan through your state’s marketplace, also called an exchange. You can start by going to healthcare.gov, which will help you find the page for your state.
If you are applying based on hardship, you can complete a hardship waiver application and submit it to your state.
is catastrophic health insurance worth it?
Catastrophic health insurance is not for everyone. Even if you are eligible, this type of plan may not be right for you.
Catastrophic medical insurance offers preventive care and protects you in case of emergencies. however, if you have prescriptions or have a condition that requires regular doctor visits, catastrophic health insurance may not be a good option for you.
There are other options to consider, some of which are inexpensive:
Catastrophic plans are one way to get affordable health insurance, but you may not qualify. Even if you do, out-of-pocket costs are high when you need care, so be sure to weigh the pros and cons of catastrophic health insurance before you buy.
- Catastrophic Health Insurance: Definitions and Costs
- what is a catastrophic health plan?
- average market premiums by metal tier, 2018-2022