Is catastrophic health insurance right for me?
A catastrophic plan may be right for you if you:
- Want lower premiums or can’t afford more expensive coverage.
- Are generally healthy and rarely see the doctor.
- Don’t mind having high out-of-pocket costs.
In this blog, we break down catastrophic insurance to help you figure out if it’s the right health insurance choice for you.
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Key takeaways:
- Catastrophic insurance is available to people under 30.
- People 30 or older can also enroll in these plans if they qualify for a hardship exemption (unable to afford health coverage).
- Catastrophic health insurance plans have low monthly premiums and very high deductibles.
- You pay for any emergency medical care you receive until you meet your deductible, and most preventive care is covered at 100%.
- Subsidies can’t be used with catastrophic plans.
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Need assistance now? Contact my office for one-on-one consulting to help determine the best plans suited for you, your family, and your budget.
What is catastrophic health insurance?
Catastrophic health insurance is a type of health plan that offers coverage in times of emergencies as well as coverage for preventive care.
It may be an affordable way to protect yourself from worst-case scenarios, like getting seriously sick or injured. But you pay most routine medical expenses yourself.
What does catastrophic health insurance cover?
Catastrophic plans cover the same essential health benefits as other Marketplace plans, but with very high deductibles, equal to the annual limit on out-of-pocket costs under the Affordable Care Act (for 2022, this is $8,700 for a single individual).
Like other plans, catastrophic plans cover certain preventive services—like shots and screening tests—at no cost to you. They also cover at least three primary care visits per year before you’ve met your deductible.
Who is eligible for catastrophic coverage?
Catastrophic plans are available to people under age 30, looking for minimal coverage with lower premiums, or people 30 and older who qualify for a hardship (or affordability) exemption.
A hardship/affordability exemption usually means that you can’t afford health insurance coverage due to economic hardship or certain other hardships—such as the death of a family member.
How much is catastrophic health insurance?
Catastrophic health insurance plans generally have lower premiums. However, deductibles—the amount you have to pay yourself for most services before the plan starts to pay anything—are very high.
In 2022, under a catastrophic policy, the annual deductible for covered services is $8,700 for an individual (twice that amount for a family policy.)
After you have satisfied the deductible, the plan will pay 100% for covered essential health benefit services that you receive from in-network providers for the remainder of the year.
Catastrophic Health Insurance: No Subsidies
Premium subsidies are not available for catastrophic plans (nor are cost-sharing subsidies, which are only available on Silver plans).
Depending on your income, you may be eligible for a subsidy that you could apply towards a metal-rated plan (Bronze, Silver, Gold, or Platinum). This will likely make a metal-level plan more affordable than a catastrophic plan. I can educate you on your options and help you choose the best plan for your needs.
Let Me Help You Choose the Best Catastrophic Health Plan
Choosing a plan is about finding the right balance between coverage, cost, and access to care.
As your independent insurance agent, I will help you determine if you’re eligible to buy a catastrophic plan and if it’s right for you. I represent numerous carriers in Georgia, South Carolina, Florida, Pennsylvania, and Alabama.
Get started today by requesting a free, no-obligation instant quote!