How to choose Marketplace insurance

Catastrophic health insurance plans

People under 30 and people with “hardship exemptions” may buy a "catastrophic" health plan. This type of plan has lower monthly premiums and mainly protects you from very high medical costs.

Protection from worst-case scenarios

A catastrophic plan generally requires you to pay all of your medical costs up to a certain amount, usually several thousand dollars. This limit is known as a deductible. After you reach your deductible, costs for essential health benefits are generally paid by the catastrophic plan.

Catastrophic plans usually have lower monthly premiums than a comprehensive plan. But they cover your costs only after you’ve used a lot of care. These plans basically protect you from worst-case scenarios like serious accidents or illnesses.

Catastrophic plans cover prevention and some primary care

In the Marketplace, catastrophic plans cover 3 primary care visits per year at no cost, even before you’ve met your deductible. They also cover free preventive services.

If you buy a catastrophic plan in the Marketplace, you can’t get premium tax credits or lower out-of-pocket costs based on your income. Regardless of your income, you pay the standard price for the catastrophic plan.

Catastrophic plans with a hardship exemption

  • People 30 and over with a “hardship exemption” may buy a catastrophic plan. Hardship exemptions from paying the fee are granted to people based on income or other factors that prevent them from getting coverage. Learn about the 14 types of hardship exemptions.
  • If you had an individual insurance plan that was cancelled and you believe other Marketplace plans aren't affordable, you may qualify for a hardship exemption. If you do, you can buy a catastrophic plan.

Learn if you qualify for a catastrophic plan in the Marketplace

After you fill out a Marketplace application you'll get an eligibility notice. It will tell you what programs and savings you’re eligible for, including catastrophic plans. If you’re eligible to enroll in a catastrophic plan, you’ll see these plans listed when you compare your coverage options.

You can then choose to enroll in a catastrophic plan or any other plan available to you.