Catastrophic Health Insurance: Who Qualifies and What It Covers

On this page

• What a catastrophic plan covers
• Who can buy a catastrophic plan
• Catastrophic vs. bronze plans
• Is a catastrophic plan right for you?
• Catastrophic plans vs. short-term plans
• Using an HSA with a catastrophic plan
• What’s new for 2027
• Frequently asked questions

What a catastrophic plan covers

A catastrophic plan is built to protect you from a very large bill, not to pay for everyday care. It still has to cover the ACA’s essential health benefits, and a few things are covered before you meet the deductible:

• Preventive care like checkups, screenings and recommended vaccines, at no cost in network.
• Three primary care visits a year before the deductible (you may owe a copay).
• Everything else, including ER visits, hospital stays, prescriptions and specialists, once you meet the deductible.
• Essential benefits such as maternity care and mental health care.

Because the deductible and the out-of-pocket maximum are the same number, you pay the full cost of most care until you reach it, then nothing for covered in-network care for the rest of the year.

Who can buy a catastrophic plan

• People under 30 when the coverage starts.
• People with a hardship exemption, for example after homelessness, eviction, bankruptcy, domestic violence, a death in the family or large unpaid medical bills.
• People with an affordability exemption, when the cheapest coverage available to them costs more than a set share of their income.
• For 2026, people who don’t qualify for premium tax credits because of their income, meaning below 100% or above 400% of the poverty level. HealthCare.gov checks this automatically when you apply, or you can request the exemption with the hardship form.

Young adults often weigh this against the other choices in health insurance for students.

Catastrophic vs. bronze plans

Catastrophic premiums are usually the lowest on the marketplace, but they aren’t always your cheapest option. Premium tax credits only apply to bronze, silver, gold and platinum plans, so if you qualify for help, a bronze plan may cost less each month and come with a lower out-of-pocket limit. Check both before you buy. See the difference between bronze, silver, gold and platinum plans and how subsidies work.

	Catastrophic	Bronze
Who can buy	Under 30, or with an exemption	Anyone
Premium tax credit	No	Yes, if eligible
Deductible	Equal to the out-of-pocket max	Varies, often several thousand dollars
Out-of-pocket maximum	$10,600 (2026), $12,000 (2027)	Up to the same limits, often lower
Covered before the deductible	Preventive care plus 3 primary care visits	Preventive care; some plans add visits or drugs
HSA-eligible	Yes, since 2026	Yes, since 2026

Is a catastrophic plan right for you?

It tends to fit if you rarely need care beyond a yearly checkup, want protection against a big accident or illness at the lowest monthly price, don’t qualify for much of a premium tax credit, and have savings to cover a large bill if something happens.

It’s a poor fit if you have a chronic condition, take regular medications, are planning a pregnancy, or couldn’t cover a five-figure bill. If you work for yourself or are between jobs, compare it with the options in health insurance for the self-employed and health insurance for the unemployed.

Catastrophic plans vs. short-term plans

Don’t mix these up. Catastrophic plans are ACA insurance that covers pre-existing conditions. Short-term health plans can refuse to cover them and can leave out essential benefits. Catastrophic plans also count as full coverage in states with their own insurance mandate.

Using an HSA with a catastrophic plan

Since January 2026, catastrophic plans count as HSA-compatible under the 2025 tax law. You can put in up to $4,400 for self-only coverage in 2026 ($4,500 in 2027) and spend it tax-free on medical costs, which is a good way to build a cushion toward that large deductible. See what an HSA is and how it works.

What’s new for 2027

A 2027 federal rule lets insurers sell multi-year catastrophic plans that can renew for up to 10 years, with some care covered before the deductible. Whether they’re offered in your area depends on local insurers.

Related guides: health insurance for a 26-year-old and health insurance for a 30-year-old.

See what catastrophic and bronze plans cost where you live: compare quotes by ZIP code.

Frequently asked questions

Can I get a catastrophic plan if I’m over 30?

Only with a hardship or affordability exemption. For 2026, that includes people whose income is below 100% or above 400% of the poverty level.

Do catastrophic plans cover prescriptions?

Yes, but you pay the full price until you meet the deductible, except for preventive medications that are covered at no cost.

Can a family buy a catastrophic plan?

Yes, as long as everyone on the plan qualifies, for example if everyone is under 30 or has an exemption.

Where can I buy one?

On HealthCare.gov or your state’s marketplace, where they appear if you’re eligible, or directly from insurers that sell them. Not every insurer or area offers one.

This article is general information, not legal or insurance advice. Plan availability and rules vary by state and year, so check HealthCare.gov, your state’s marketplace or a licensed agent for your situation. Last reviewed September 2026.