Tag: catastrophic plan

No. Catastrophic health plans are not eligible for premium tax credits or cost sharing reductions.

In general, only young adults under the age of 30 are eligible to buy a catastrophic plan. However, older adults can buy a catastrophic plan if no other qualified health plan offered through the Marketplace in 2019 would cost less than 8.3% of income.

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 (twice that amount for a family policy.) After you have satisfied the deductible, the plan will pay 100% for covered essential health benefit services that you receive from in-network providers for the remainder of the year. “Catastrophic policies” may also be sold by insurers outside of the health insurance Marketplace.

Insurers can also offer “Catastrophic” plans. Catastrophic plans have the highest cost sharing. In 2019, Catastrophic plans will have an annual deductible of $7,900 ($15,800 in family plans). You will have to pay the entire cost of covered services (other than preventive care) until you’ve spent $7,900 out of pocket; after that your plan will pay 100 percent of covered in-network services for the rest of the year. 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 8.3 percent of their income.