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Catastrophic Health Insurance

Catastrophic health insurance is a form of medical coverage under the Affordable Care Act. This is a kind of high-deductible health plan for persons under 30 or those who qualify for a “hardship exemption.”

Catastrophic health insurance plans are designed to protect you in a worst-case scenario; for instance, if you get into a medical emergency and your medical expenses sum thousands of dollars. Monthly plan premiums tend to be lower, but you will generally require to pay for all health-care costs out of pocket until you attain the health insurance plan’s annual deductible, which is typically at least a couple thousand dollars.

Here is an overview of catastrophic coverage works, including benefits, costs, and whether this kind of health insurance may work for your situation.

Catastrophic Plan Benefits

Catastrophic health insurance covers the same minimum health benefits as other health plans under the Affordable Care Act, including prescription drugs, emergency services, preventive services, and more. The difference with a catastrophic plan is that you must pay for all health-care expenses until you attain a high annual deductible. Only after your out-of-pocket spending reaches the deductible does your insurance company begins to pay for most covered health-care services.

The deductible does not apply to all benefits. Catastrophic health plans cover the following benefits, even if you have not met your annual deductible yet:

• Three primary care visits each year
• Free preventive services needed under the Affordable Care Act, including individual screenings and immunizations.

You’ll pay the entire cost for all other health-care services until you meet your annual deductible. Other cost-sharing expenses, like copayments and coinsurance, are usually higher with this type of plan. Nonetheless, monthly premiums tend to be lower compared with major medical plans.

Catastrophic health coverage varies from accident, critical illness, or short-term plans; these coverage types tend to protect the insured in specific, limited situations. For instance, critical illness plans insure the policyholder against specific health illnesses. Short-term health insurance provides limited, temporary coverage when an individual is not qualified to enroll in a major medical health plan or is waiting for coverage to begin. For instance, you might enroll in a short-term plan to fill a coverage gap before you are qualified for Medicare.

In contrast, catastrophic plans cover the same essential health benefits like medical plans, after you’ve met the yearly deductible.

Enrolling in a Catastrophic Health Insurance

To enroll in a catastrophic health insurance 2020, you must meet one of the following eligibility requirements:

• Be under 30 years old, or
• Be eligible for a “hardship exemption” (a situation that prevents you from being able to afford health coverage).

If you and all other persons covered by your health plan are under 30, you may be eligible to buy a catastrophic health plan.

If you are over 30 and interested in catastrophic health coverage, you must be eligible for a hardship exemption. Some examples of hardship exemptions comprise if you were homeless in the last three years or if you were found unqualified for Medicaid because your state didn’t expand its Medicaid program.

If you think you may qualify for an exemption due to financial hardship, you’ll require to apply for a hardship exemption at the Marketplace. If you receive a notice indicating that you qualify for a hardship exemption, you can choose to buy a catastrophic insurance plan, and licensed insurance agents would be happy to help you find a plan that may work for you. Or you can opt to enroll in a significant medical plan instead.

Bear in mind that if you qualify for lower health-care costs because of income (also known as a subsidy), you cannot apply these savings towards a catastrophic health plan. This consists of premium tax credits and cost-sharing subsidies. So you will pay the standard premium amount for your catastrophic insurance plan, irrespective of your income level.

Is A Catastrophic Insurance Plan Appropriate For Me?

A catastrophic plan may be appropriate for you if:

• You need lower premiums or can’t afford more costly coverage.
• You are generally healthy and hardly see the doctor.
• You don’t mind having high out-of-pocket expenses.
• You require to be prepared against high medical bills in a “worst-case scenario.”
• You do not qualify for Medicaid.
• You are not eligible for a subsidy based on your income.

Every situation is different, and you will have to carefully consider your health requirements, priorities, and cost of catastrophic health insurance to determine what’s right for you. If you have questions regarding catastrophic coverage or other plan options, please contact Health Insurance Plans to discuss your requirements with a licensed insurance agent.

Call for your Quote Today

Stop waiting around! The right insurance provider is out there and we’re going to make sure you’re covered for the foreseeable future. Accidents can happen any time whether it’s day, night, workdays, or holidays. Insurance is the best way to prepare for the unpredictable, and a great way to secure your peace of mind. Give us a call today or fill out the form for a quote – you’ll be glad you did!

Resources and References:

• Preventive Care Services
• Medicaid Eligibility Requirements
• How to Enroll in Catastrophic Health Insurance Plans