Health Insurance

What is catastrophic health insurance?

Catastrophic health insurance is a type of health plan that offers coverage in emergency times and preventive care. Catastrophic health plans generally have low monthly premiums and a high deductible. You pay for any emergency medical care you receive until you meet the deductible, and most preventive care is covered at 100%. Catastrophic health coverage is available to people under age 30 who are looking for minimal coverage and low monthly premiums and those of any age eligible due to financial hardship.

What do catastrophic health plans cover?

Catastrophic health insurance coverage can help you pay for unforeseen emergency medical expenses that could otherwise turn into medical bills you can’t pay. It also covers essential health benefits, including preventive services like health checkups, most immunizations, annual checkups, and specific birth control methods.

What do catastrophic health plans not cover?

Your catastrophic health plan does not cover emergency care until you have met your deductible. And depending on the project, there may be certain limits on preventive care and the number of visits to the primary care provider (PCP) covered.

You must understand what your specific plan does and does not cover.

What type of medical care does catastrophic health insurance cover?

Once you’ve met your plan’s deductible, catastrophic coverage would pay for accidents, unforeseen injuries, sudden emergency illnesses, etc. These plans also offer 100% coverage for some preventive care services, annual checkups, flu shots, some types of routine checkups, and more.

Most catastrophic plans also cover at least three visits to a primary care doctor.

Do I qualify for catastrophic insurance?

It would help if you were under 30 or qualified for a hardship exemption. Generally, an exemption means you can’t afford health care insurance because you’ve recently become homeless, filed for bankruptcy, or qualify under other criteria.

How do I qualify for an exemption to get catastrophic health coverage?

Two types of waivers could help you qualify for catastrophic insurance: personal hardship waivers and accessibility waivers. You could be eligible for either exemption depending on the details of your specific situation.

Some of the most common difficult situations are the following:

  • homelessness
  • Bankruptcy
  • domestic violence
  • Death of a family member
  • Interruption of public services
  • eviction
  • Foreclosure
  • A natural or human-caused fire or disaster that results in substantial property damage

There are also affordability exemptions, which means your income isn’t enough to pay for regular health care coverage. If you qualify for an exemption, you can claim it on your annual tax return and get your money back.

How do I request an exemption?

You must complete an application and submit it to the Exchange to request an exemption. You can get the form at You will receive a notice in the mail from the Exchange notifying you whether or not you qualify for the exemption.

If you want insurance with a low monthly rate, catastrophic insurance might be right for you. You must be under 30 or train for a hardship waiver to qualify for devastating insurance. Your request will be approved or denied based on the details of your specific circumstances.

If I qualify for an exception, can I get catastrophic health insurance?

If you’re approved for a hardship or accessibility waiver, it means you can get a catastrophic health insurance plan if you want.

Catastrophic health insurace plans may help protect you from the high costs of medical emergencies and cover essential health benefits like annual checkups, some preventive services, and at least three primary care visits before you meet your deductible. However, if you anticipate the costs associated with managing a chronic condition, you may be able to save more with another type of health plan.

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