What is a Catastrophic Health Plan?

Individuals with no coverage | Comparing Plans: Benefits and Costs

A “Catastrophic Plan” is a qualified health plan offered through the marketplace that covers essential health benefits and requires the highest level of cost-sharing allowable for essential health benefits. In 2022, under a “catastrophic policy,” the annual deductible for covered services is $8,700 for an individual. After you have satisfied the deductible, the plan will pay 100 percent for covered essential health benefit services for the remainder of the year. “Catastrophic policies” may also be sold by insurers outside of the health insurance marketplace. Not everybody will be allowed to buy Catastrophic Plans. They are only for adults up to age 30, although adults of any age can buy a Catastrophic Plan if they receive an affordability exemption (either marketplace coverage or employer-sponsored coverage is determined unaffordable) or they receive a hardship exemption from the marketplace. (45 C.F.R. § 156.155, 42 USC §18022(e), FAQs About Affordable Care Act Implementation Part 46, June 4, 2021).

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