Catastrophic Health Insurance Plans

The Affordable Care Act (ACA) provides not only 4 Metallic levels of benefits (Bronze, Silver, Gold, and Platinum), but a fifth level called Catastrophic.

Catastrophic plans cover the Essential Health Benefits (EHB) as outlined in the Affordable Care Act, but generally have a higher deductible than Metallic plans. The out of pocket maximum (OOP) for an individual is limited to $6,600 and $13,200 for a family (in 2015). Premiums for Catastrophic plans may be slightly lower than Bronze plans.

Who is Eligible for Catastrophic Health Insurance Plans?

Catastrophic plans are limited to:

  • Individuals under 30 years of age who satisfy certain financial requirements
  • Individuals who would qualify for a hardship exemption to the requirement to obtain an Affordable Care Act policy

The Centers for Medicare and Medicaid Services (CMS) continues to change the eligibility rules for Catastrophic plans.