QUESTION

What is a Catastrophic Health Plan?

Individuals with no coverage | Comparing Plans: Benefits and Costs
ANSWER

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 2019, under a “catastrophic policy,” the annual deductible for covered services is $7,900 for an individual ($15,800 for a family policy.) 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, and for older people who can’t find any other marketplace policy that costs less than 8.05 percent of their projected income in 2018 (8.16 percent in 2017). (45 C.F.R. § 156.155; 81 Fed. Reg. 94058, Dec. 22, 2016).

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