Catastrophic plan

Catastrophic plans are a special type of health insurance plan that is similar to a Bronze plan but a lot less expensive. Since young people are generally healthier than older people, the ACA (opens in new tab) created this more affordable health insurance plan for people under 30 years old.

Keep in mind, however, that while you’ll pay the lowest monthly premium (opens in new tab), other plan options may actually be better for you, depending on the costs of care you expect to need in the year ahead. Here's how it all nets out.

What is a catastrophic plan?

Catastrophic health insurance is the cheapest health insurance plan for people under 30 unless you qualify for financial subsidies. The plan caps your financial exposure to big medical bills if you were to unexpectedly become seriously sick or injured. People who are young and healthy often prefer these plans because they have low monthly premiums.

As with all qualified health insurance plans, you pay for the care you need during the year. If your spending reaches the max, the plan will pay 100% of your health care costs for the rest of the year. Catastrophic plans guarantee coverage for certain minimum essential health benefits. These include some free preventive care, like certain vaccinations, your annual physical, a well woman exam, and certain forms of birth control.

If you purchase Oscar's catastrophic plan (Secure plan), you’ll also get at least three visits to your primary care doctor every year for free, as well as access to the same doctors and tools as all other Oscar plans. That said, with all catastrophic plans, your out-of-pocket costs for deductibles (opens in new tab), coinsurance, and copayments on your medical bills are generally higher than with other plans.

Do I qualify?

Not everyone can sign up for a catastrophic plan. To qualify, you must either:

• Be under 30 years old.
• Qualify for a hardship exemption. These are difficult situations that make buying health insurance unaffordable to you, like homelessness, foreclosure of a home, bankruptcy, being the victim of domestic violence, and a few other special circumstances. You must fill out a hardship exemption form, which will be reviewed by the marketplace administrators and approved or denied.

How much does a catastrophic plan cost?

Oscar offers catastrophic health insurance plans to individuals in New York, Los Angeles, Orange County, San Francisco, and San Antonio. Prices vary by state, so the best way to find out what a plan will cost you is to get a free personalized quote (opens in new tab).

Note, if you qualify for financial aid, another plan may actually be less expensive than a catastrophic plan. So just be sure to check out all your options. Also keep in mind that if you qualify for Medicaid (opens in new tab), that’s likely the best option for you.