Catastrophic Insurance

What Is Catastrophic Insurance?

Catastrophic health insurance is a specialized insurance plan under the Affordable Care Act.  These plans are designed to be more affordable than other available Qualified Health Plans, which are plans that meet the Health Insurance Marketplace requirements.

Catastrophic health insurance plans allow you to pay a lower monthly premium by increasing your out-of-pocket costs such as deductibles, copayments, and coinsurance.  While these plans may seem appealing to those who consider themselves healthy, they are not available to everyone.   

What Does Catastrophic Health Insurance Cover?

Under the Affordable Care Act, all insurance policies are required to cover preventative services, and catastrophic health plans are no exception.  Along with your preventative health services, catastrophic health benefits also include 3 annual primary care visits.  All other medical services will only be covered once your annual deductible is met.

Who Qualifies for Catastrophic Coverage?

To qualify for a catastrophic insurance plan, you will need to be under 30 years of age. In addition, you will need to have job-based insurance that is unaffordable or have a hardship or affordability exemption based on the government insurance marketplace. Some of these exemptions include:

  • Being homeless
  • Filing for bankruptcy
  • The death of a family member
  • Facing eviction or foreclosure
  • Experience domestic violence
  • Receiving a shut-off notice from a utility company
  • Incurred medical expenses you couldn’t pay that created substantial debt
  • Experiencing a fire, flood, or other natural or human-caused disaster that caused severe damage to your own property

If you're curious to see if you qualify for catastrophic health insurance, give one of our agents a call at 858-771-4087, or enter your zip code here for free health insurance quotes!

Can I Get Catastrophic Health Insurance Over 30?

While people older than 30 do not qualify for catastrophic coverage, they may still be eligible for a hardship exemption based on the aforementioned circumstances and others. If you qualify for a hardship exemption, you will not be penalized for the hardship time periods when you did not have insurance coverage.

The Pros and Cons of Catastrophic Insurance


This type of insurance:

  • Can be an affordable alternative to traditional insurance with premiums that are about 20% lower
  • Offers protection for worst-case scenarios
  • Is much better than thousands upon thousands of dollars in medical expenses that you might face if you have no insurance at all in worst-case scenarios
  • Has many situations that could put you in a qualifying category


This insurance coverage:

  • May not cover important health care needs such as sick visits or prescription medication
  • Has high deductibles of $6,350 for individuals and $12,700 for families
  • Is not as good as some plans that are only $20 or $30 more per month
  • Has no tax credit available for people who enroll in catastrophic plans