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 some preventative care benefits as outlined in the Affordable Care Act. At least 3 visits to a primary care physician (PCP) are covered. You are responsible for all other medical costs until the $6,850 deductible is met. Medical costs after that are covered at 100% by the insurance company.

Catastrophic Health Insurance Plans are not eligible for the Premium Tax Credit.

Who is Eligible for Catastrophic Health Insurance Plans?

Catastrophic plans are limited to:

  • Individuals under 30 years of age whether they qualify for a hardship exemption or not.
  • Individuals 30 and older 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.