Catastrophic health insurance is a low-premium Marketplace plan with a very high deductible. For 2027, that deductible equals the $12,000 out-of-pocket maximum. You can buy one if you're under 30, or if you're 30 or older and qualify for a hardship or affordability exemption. Every catastrophic plan still covers the ACA's essential health benefits, free preventive care and at least three primary care visits before the deductible. However, you can't use a premium tax credit on one, so a subsidized bronze plan is often the better deal.
- Catastrophic plans are for people under 30, or 30 and older with a hardship or affordability exemption.
- In July 2026, a federal court paused a rule that would have opened these plans to many more people.
- Premium tax credits can't be used on catastrophic plans.
- Catastrophic and bronze Marketplace plans are HSA-eligible, with 2027 limits of $4,500 for one person and $9,000 for a family.
What Catastrophic Health Insurance Covers
Catastrophic plans protect you from worst-case medical bills. Even so, they are full ACA plans, not stripped-down coverage. Each one includes:
- All 10 essential health benefits, such as hospital care, emergencies, maternity and prescriptions
- Preventive care, such as checkups and many screenings, at no cost in network
- At least three primary care visits a year before you meet the deductible
- Coverage for pre-existing conditions
After those visits, you pay the full cost of most care until you reach the deductible. For 2027, the deductible equals the $12,000 out-of-pocket maximum. In other words, once you've paid $12,000 for covered in-network care, the plan pays 100% for the rest of the year. For more on caps, see what an out-of-pocket maximum is.
Who Qualifies for a Catastrophic Plan
You can buy catastrophic health insurance if one of these applies:
- You're under 30. No exemption needed.
- You have a hardship exemption. This covers events that kept you from getting coverage, such as eviction, a disaster, domestic violence or large medical debt.
- You have an affordability exemption. This applies when the cheapest coverage available to you costs more than a set share of your household income.
To get an exemption, you apply through HealthCare.gov or your state Marketplace. Once approved, you receive an exemption number to use when you enroll. Questions about qualifying? Call 888-730-6001.
Lost your tax credit because of the subsidy cliff? Ask us to check the affordability exemption. If your cheapest bronze plan costs more than the allowed share of your income, a catastrophic plan may open up for you.
What Changed in Court
In September 2025, federal regulators expanded hardship exemptions. As a result, people who couldn't get tax credits because of their income could buy catastrophic plans. More than 20,000 people used that path in 2026.
Then, in July 2026, a federal court paused that expansion, along with other parts of the 2027 Marketplace rule. So for 2027, eligibility is back to the original rules: under 30, or a hardship or affordability exemption. We'll update this guide if the courts change course.
A licensed Vivna agent can check your age, income and exemption options, then compare catastrophic and bronze prices side by side.
Catastrophic vs. Bronze: Which Costs Less?
| Feature | Catastrophic | Bronze |
|---|---|---|
| Who can buy | Under 30 or with an exemption | Anyone during Open Enrollment |
| Premium tax credit | Not allowed | Allowed if you qualify |
| Deductible | Equals the $12,000 maximum for 2027 | Averaged about $7,200 in 2026 |
| Care before the deductible | Preventive care plus 3 primary care visits | Preventive care, sometimes copays for visits |
| HSA-eligible | Yes | Yes |
If you qualify for a tax credit, a bronze plan often costs less after the credit. In many areas, it can even be close to $0 a month. Compare the two in our bronze vs. silver plan guide, or see all tiers in how metal tiers compare.
Pairing a Catastrophic Plan With an HSA
Since 2026, all Marketplace catastrophic and bronze plans count as HSA-eligible. That means you can put money aside tax-free for medical bills. For 2027, the limits are $4,500 for self-only coverage and $9,000 for family coverage.
In addition, HSA contributions lower the income used for subsidies. That can help people near the subsidy cliff. Read more in our guide to the ACA subsidy cliff.
Alternatives If You Don't Qualify
- Bronze plan. Open to everyone, and tax credits apply if you qualify.
- Short-term health insurance. In approved states, healthy people may pay less. However, it excludes pre-existing conditions. See short-term vs. ACA.
- Medicaid. If your income is low, you may qualify any time of year. Check income-based health insurance.
- Job-based coverage. A spouse's plan may cost less than buying on your own.
Catastrophic Health Insurance: FAQs
Can I get catastrophic health insurance if I'm over 30?
Yes, with a hardship or affordability exemption from the Marketplace.
Is catastrophic health insurance cheaper than bronze?
Before tax credits, usually yes. After credits, a bronze plan often costs less.
Does a catastrophic plan cover prescriptions?
Yes. Prescriptions are an essential health benefit. Most costs count toward the deductible first.
Can a family buy a catastrophic plan?
Yes, if every person on the plan qualifies, either by age or exemption.
Is catastrophic coverage the same as short-term insurance?
No. Catastrophic plans are ACA plans that cover pre-existing conditions. Short-term plans are not.
We'll compare catastrophic, bronze and short-term options for you. Call Monday through Friday, 9am to 6pm.
Sources
- HealthCare.gov: Catastrophic health plans
- HealthInsurance.org: 2027 ACA open enrollment changes
- American Hospital Association: Court pauses 2027 rule provisions
- Milliman: 2027 out-of-pocket maximum limits
- Peterson-KFF Health System Tracker: Deductible trade-offs
Eligibility rules reflect federal guidance and court action as of October 2026 and may change. Short-term health insurance is not ACA-compliant coverage, excludes pre-existing conditions and is available only in approved states. This is general information, not tax advice. Vivna Insurance is a licensed, independent agency (NPN 19168641). We are not affiliated with HealthCare.gov or any government agency.