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Catastrophic Health Insurance Explained

by | Dec 25, 2024

Is Catastrophic Health Insurance Right for You?

If you have a tight budget and are researching affordable health insurance options, you have likely come across catastrophic health insurance. These policies have low monthly payments, making them an attractive option for budget-savvy shoppers, but they are not good options for everyone.

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Catastrophic Health Insurance Explained

What Is Catastrophic Health Insurance?

Catastrophic health insurance is a health insurance plan with a high deductible and low monthly premiums. These plans are primarily intended for young adults under age 30 who are less likely to experience an unexpected event. For those over age 30, catastrophic health insurance is available, but those who want this coverage must qualify for a hardship exemption.

Like major medical health insurance plans, catastrophic health insurance covers the 10 essential health benefits outlined in the Affordable Care Act. However, if you have this type of plan, your out-of-pocket costs for services are considerably higher than with regular health insurance. These plans typically have high deductibles, which is the amount that you must pay for any services you receive before coverage kicks in. For example, with a $8,550 deductible, your health insurance will not cover services such as lab tests, hospital stays or emergency care until you pay $8,550 out of pocket for medical care. Of course, you’ll be extended their network pricing which is tremendous help which lowers the bill substantially.

Depending on your health insurance plan, some services may be covered under catastrophic insurance even before you meet your deductible. In most cases, policyholders are covered for three primary care visits per year and free preventative services such as immunizations and certain screenings.​

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Is Catastrophic Health Insurance Good Coverage?

Catastrophic health insurance coverage may not be well-suited for everyone, but that does not mean that the coverage is not good. These plans provide the same scope of coverage that major medical health insurance does; it just has higher up-front costs until you’ve hit your “out of pocket maximum”.

If you are under age 30, you do not need a lot of medical care and rarely visit a doctor and you can handle high out-of-pocket medical costs, then catastrophic insurance may be a good option. It is much better than going uninsured.

However, if the primary reason that you are considering this coverage is that you cannot afford costlier health insurance, you’ll most definitely want to speak with one of our licensed agents. You may be eligible for Government assistance to help you afford a lower deductible lower cost plan. If the unexpected happens and you are suddenly facing a serious injury or illness, your out-of-pocket medical costs will only be a second thought, your health will be more important in the moment. Having a catastrophic plan even though it’s a higher deductible will still be a great blessing to have.​

What If I Need More Coverage?

Before signing up for a catastrophic health insurance plan, talk to one of our health insurance agents about options that are comparably affordable and provide more coverage. If you cannot afford high monthly premiums, you may qualify for federal subsidies that greatly reduce monthly out-of-pocket costs or Medicaid.

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