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What is a Catastrophic Health Insurance Plan?

Serious Businesswoman

Health insurance is a crucial way to protect your health and comes in many forms, one of which is called a “catastrophic health insurance plan.” These plans have a significant advantage – they are affordable and protect you in worst-case scenarios. These plans do not cover everything that many other health insurance plans cover, but for people who rarely visit a physician and are generally healthy.

How Does a Catastrophic Health Insurance Plan Work?

A catastrophic plan is not available to everyone. The criteria include:

  • People 30 years old or younger
  • People who have a “hardship exemption” of any age.

The monthly premiums are low, but you pay a higher deductible. Once you have met your deductible, the health insurance company pays for all the covered services, and you will not be required to pay copayments or coinsurance out of pocket.

What Does a Catastrophic Health Plan Cover?

These high deductible health insurance plans cover the required essential health benefits and preventative services of other plans, as mandated by the Affordable Care Act, which includes three primary care visits per year :

  • Outpatient services
  • Emergency services
  • Hospitalization
  • Pregnancy, maternity, and newborn baby care
  • Mental health and substance abuse treatments
  • Prescriptions
  • Rehabilitative care
  • Lab services
  • Pediatric services
  • Specific health screenings
  • Diet counseling
  • Falls prevention
  • Immunizations
  • Statins
  • Birth control coverage
  • Many others
  • Catastrophic Health Insurance Plans

Catastrophic health plans can be the right choice for young, healthy people, as the premiums are more affordable. However, you need to be aware that should you need extensive medical care, the deductible is higher, and so are your copays. These plans are covered if you develop a medical condition requiring more extensive medical care or have an accident and are hospitalized, require surgery, or other “catastrophic” event – after your deductible is met. Note that premium tax credits cannot be used to pay for this type of insurance.

Catastrophic Insurance Coverage

Some other coverage includes critical illness insurance, accident insurance (other than your auto insurance), and “fixed-benefit indemnity medical insurance,” which provides cash payouts for specific illnesses or injuries, as listed in your policy.

An Affordable Option for Health Insurance

The advantage of one of these plans is that you are covered for more severe illnesses and accidents after meeting your deductible. When you consider the cost of hospitalization, surgeries, and ongoing treatments, this option is an affordable way to protect yourself – and your family – when an unexpected health issue arises. Rather than depleting your savings or needing financial assistance from your family to cover your medical costs, your treatments are covered once you have paid the deductible.

Find Out More About Catastrophic Health Insurance

If you are age 30 or younger, you are eligible for health insurance. People over 30 could be qualified if they apply and are approved for a hardship exemption, such as the death of a family member or having incurred medical expenses you could not afford to pay, and some other types of hardships.
If you are young and healthy and need health insurance, talk to one of our friendly local agents who can show you the types of plans available to you and explain how these plans work.

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