Catastrophic health insurance is an affordable option that provides major medical protection at the best possible rate. Premiums are typically 30%-60% lower than a standard comprehensive policy, and this type of plan is perfect for individuals or families that want affordable coverage, and are willing to assume some additional risk. Self-employed persons frequently utilize this option to maintain low premiums while paying large emergency medical costs.
Employer-provided group policies generally offer high-deductible plans, and a Senior Medicare Supplement Plan G (HD) contract is also offered. Larger employers typically offer a comprehensive (PPO or HMO) plan, along with a high-deductible/HSA option. The cost of a Group HSA is about 50% less than the comprehensive option, and often, employers will contribute funds into their employee’s plan. Obamacare plans offering these options are offered in all states.
“High Deductible Health Plans” (HDHP) are necessary if you are going to set up an HSA (Health Savings Account). If covering emergencies and hospital expenses, plus keeping premiums low are your main goal, then this type of option will be very suitable. Our instant comparisons will show you the policies from top-rated companies that provide the benefits you want at the best price. Several optional deductibles are offered.
HSA features were slightly enhanced for 2022 effective dates, once Administration proposed changes became effective. Minimum deductibles are $1,400 for individual plans and $2,800 for family plans. The maximum out-of-pocket limits are $7,050 for individuals and $14,100 for families. The maximum contribution amounts are $3,650 for individuals and $7,300 for families.
Additional tax incentives may be introduced in the future, along with a possible increase to the contributions limit, to where it matches the maximum out-of-pocket expenses limit. Currently, HSA plans can be purchased privately (off-Exchange), through the Marketplace, and from carriers offering qualified plans through large and small businesses. Often, larger employers will deposit funds into their employee’s HSA accounts. Amounts typically range from $500 to $3,000.
NOTE: Although there is a “catastrophic” tier, since most applicants don’t qualify (must be under age 30), Bronze tier plans are a suitable alternative. We have listed several of the cheapest options later in this article. Also, only Bronze, Silver, Gold, and Platinum plans are eligible for a federal subsidy. Applicants that receive group coverage from an employer are also unlikely to qualify for a subsidy and can not apply for Marketplace coverage outside of OE periods. When pandemics occur (COVID), often an Open Enrollment period is extended and subsidies temporally increase.
Available Through Your State Exchange
When the “Affordable Care Act” (Obamacare) legislation became effective, state marketplaces were created to offer five five tiers of coverage to consumers. They are known as Platinum, Gold, Silver, Bronze and Catastrophic. Platinum plans are the most expensive since they are designed to pay 90% of your expected medical bills. However, low deductibles, low copays, and high premiums are not the best combination for many applicants. Many carriers also no longer offer Platinum-tier options, since the cost is often prohibitive, and very few consumers choose the most expensive policies.
The “catastrophic” tier of policies are typically the cheapest available options since a deductible applies to most non-preventive expenses. Many policies have deductibles between $7,000 and $8,700, which, of course, keeps premiums fairly low. Also, there are several coinsurance options, usually ranging from 0%-50%. However, comparing the “maximum out-of-pocket expense” is always the best barometer when determining which plan to choose. For example, a policy with a $6,000 deductible and maximum out-of-pocket expenses of $6,000, may be a more cost-effective option than a policy with a $1,500 deductible and maximum out-of-pocket expenses of $8,700.
“Catastrophic” plans do not qualify for the federal subsidy, regardless of your income. However, they do contain 10 mandated essential health benefits (ER, Hospitalization, Pregnancy, Prescriptions etc…) so once the deductible is met, you have a respectable comprehensive plan. It’s also important to note that unless you are under age 30 or meet financial hardship qualifications, a different type of plan will have to be chosen (Bronze and Silver would be the most likely). 12-month short-term plans can also be considered, although they contain may limitations and are medically-underwritten.
What Do They Cover?
Typically, catastrophic healthcare plans are designed to cover large expenses and catastrophic illness, such as inpatient and outpatient hospital stays, emergency room bills and surgeon, assistant surgeon and facility charges. Other coverage include radiation, chemotherapy, organ transplant drugs, MRIs, CAT Scans and common inpatient expenses such as room and board, intensive care unit, operating and recovery room and physician visits. Prescription drugs and physician visits provided while you are in the hospital, are also covered. Inpatient therapy is also generally covered. Note: Pre-existing conditions are always covered on Exchange catastrophic-tier plans. However, temporary contracts typically exclude existing conditions (including medications).
Supplemental plans are different and are designed to simply “add on” to existing benefits. An “AFLAC” contract is an example that would add to, but not replace an in-force policy. The duck would be optional! Typically, this specific brand must be payroll-deducted since it is generally offered through your employer benefit package. Private critical illness policies can also be purchased from many reputable carriers. Additional lines of coverage include accident, cancer, vision, dental, life, and short-term disability.
A popular “add-on” contract is a policy that simply pays your out-of-pocket expenses that are not covered on your primary plan. For example, if you enroll in a “Bronze” tier contract, it’s likely that your deductible and out-of-pocket maximum may be as high as $8,700 per person and more than $17,400 for your family (if applicable). Although these types of “add on” options won’t pay 100% of your expenses, they can potentially pay a significant amount. Some supplemental plans pay a “per day” amount and others will pay a specified amount towards specific surgeries and illnesses.
For persons that are Medicare-eligible, a similar option is Medigap or Medicare Advantage plans. Fortunately, these contracts are much more closely regulated by the government, which makes comparison of plans much easier, and the enrollment process much simpler and quicker. A Plan G high-deductible Medicare Supplement option is offered by many companies. Although many expenses must be paid out-of-pocket, premiums are lower, and it is a very cost-efficient option for healthy Seniors. The deductible is $2,490 (not including premiums), with 100% coverage after it has been met. Also, the customary cost of three pints of blood also must be paid as an out-of-pocket cost on this plan.
The monthly premium on High Deductible (HD) Plan G coverage is also much less expensive than other plans. For example, monthly rates for a non-smoking 65 year-old male in Indianapolis are only $29 (United American), $31 (Medico), $31 (New Era Life), $32 (United World Life), $37 (Bankers Fidelity), $40 (United States Fire), and $44 (Elips Life). However, the least expensive monthly rates for Plan F are $108 (Prosperity), $109 (Accendo), $109 (Medico), $115 (Great Southern Life), $131 (Central States and Cigna), $132 (Manhattan Life, New Era Life, and Elips Life), and United States Fire ($135).
Other Under-65 coverage varies, depending on the type of policy and company. Most plans in this category will have a cap that limits your out of pocket expenses for the calendar year. It may be a few thousand dollars or possibly more. You can purchase short-term contracts with extremely high caps of $20,000 or more. Of course, the price will be very inexpensive since you are inheriting more risk.
Where Do You Buy Catastrophic Medical Insurance?
We specialize in low cost high-deductible healthcare plans. With soaring medical insurance rates in most states, recent healthcare reform and state and federal Exchanges have increased costs, not decreased them. However, there are still several individual and family options that offer reasonable pricing, especially if you qualify for a subsidy. For higher-income households that receive no state or federal financial aid, higher deductible plans may return in 2023.
We research all of the top companies with state-of-the art software to provide you with the lowest quote provided by every carrier. With our application-direct links, the enrollment process is drastically reduced, federal subsidies are quickly calculated, and if you are eligible for Medicare or Medicaid, you are instantly notified. Dependents can be issued separate policies if cost-effective. It’s also possible to place members of the same household on different Exchange plans.
In less than two minutes, our website will make it possible for you to view affordable coverage from the top-rated health insurers. We never use any type of “discounted” plan and only recommend policies that meet your personal needs. Of course, rates from one company could vary quite a bit in different parts of the country. Important: If you currently are prescribed an expensive non-generic or specialty drug, a more comprehensive plan with a lower prescription deductible should be strongly considered.
Is This The Best Type Of Option For You?
If you are in good health and are rarely hospitalized, then high deductible coverage might be your best option. Typically, you will save hundreds of dollars per month compared to a comprehensive medical plan. If you have substantial assets to pay for your out-of-pocket costs (up to the deductible), you may be a good candidate for this type of policy. If you can afford paying a large deductible for a significant claim, but maintain excellent health, these plans should be considered. During Open Enrollment, new Exchange plan options may be purchased without evidence of insurability.
Choosing the right deductible will be important since you are required to pay that amount (plus any applicable coinsurance) if you have a major claim. The most popular catastrophic policies often feature deductible options ranging from $5,000 to $8,700. Occasionally, you will find a company that will quote a deductible as high as $25,000, although this will be an “off-Marketplace” plan, and will not comply with current legislative guidelines. Since hospitals will often negotiate a bill with you, increased risk is growing in popularity. For example, if your final hospital bill is $20,000, you may be able to negotiate a settlement that reduces your liability. Costs of expensive procedures, including CT Scans and MRIs can also substantially reduce when using network repricing.
Cheapest Catastrophic Exchange Plans
Listed below are several of the least expensive policies offered through State or Federal Marketplaces in selected states. It’s important to note that not all policies are available in every state. Catastrophic-tier plans are available to applicants under age 30. Bronze-tier plans are offered to all applicants.
California – Anthem Minimum Coverage HMO, Oscar Minimum Coverage Select EPO, Kaiser Minimum Coverage HMO, Kaiser Bronze 60 HDHP HMO, Health Net Of California Minimum Coverage Ambetter PPO, Health Net Minimum Coverage Ambetter HSP, LA Care Minimum Coverage HMO, LA Care Bronze 60 HMO, Sharp Health Plan Minimum Coverage HMO, Sharp Health Plan Bronze 60 Performance HMO, Molina Minimum Coverage HMO, Western Health Minimum Coverage HMO, Blue Bronze 60 HDHP PPO, and Blue California Minimum Coverage PPO.
Colorado – Bright Catastrophic 8700, Bright Bronze 8700 Limited Direct, Friday Catastrophic, Oscar Secure, Kaiser KP Select CO Catastrophic, Oscar Secure, Cigna Connect Flex Bronze 8700, and Anthem Catastrophic Pathway Essentials HMO 8550.
Florida – Florida Health Care Plans GYM Access IND Essential Plus Catastrophic, AdventHealth GYM Access Catastrophic HMO, Oscar Secure, Bright Catastrophic, AvMed Entrust Catastrophic 100, Health First GYM Access Catastrophic HMO, Ambetter Essential Care 1, and Molina Core Care Bronze 1.
Georgia – Anthem Catastrophic Pathway X Guided Access HMO 8700, Kaiser KP Ga Signature Catastrophic 8700/0, Friday Health Plans Catastrophic, Oscar Secure, and Alliant SoloCare Catastrophic No Referral HMO.
Illinois – Oscar Secure, BCBS Blue Choice Preferred Security PPO 200, Bright HealthCare Catastrophic 8700, Health Alliance 2022 HMO 8700 Elite Catastrophic, and WellFirst Catastrophic Safety Net.
Michigan – Blue Cross Select HMO Value, McLaren Young Adult/Catastrophic, BCBS Premier PPO Value, Physicians Health Plan Sparrow PHP Healthy Exclusive, Physicians Health Plan Sparrow PHP Healthy HMO, and Oscar Secure.
New Jersey – Horizon BCBS EPO Essentials, Horizon BCBS Omnia Bronze, IHC Bronze EPO HSA AmeriHealth Advantage $25/$50, IHC Bronze EPO HSA AmeriHealth Hospital Advantage $50/$75, IHC Local Value Simple Saver, Oscar Secure, and Oscar Bronze Classic.
New York – Oscar Secure DP FP, Fidelis Care Catastrophic, Fidelis Care Bronze, Fidelis Care Bronze HSA, Empire HealthPlus Gatekeeper Catastrophic, Healthfirst Green Leaf DP FP, EmblemHealth Catastrophic, and MetroPlus B2 DP FP.
North Carolina – Bright Health Catastrophic 8700 Direct, Bright Health Bronze 8700, Bright Health Bronze 7200, Bright Health Bronze 5300 HSA, Bright Health Bronze $0 Medical Deductible, BCBS Blue Home Catastrophic, BCBS Blue Home Bronze 7000 HSA Eligible, Aetna CVS Bronze, and Ambetter Essential Care 1.
Ohio – CareSource Marketplace Bronze, CareSource Marketplace Bronze First, Anthem Catastrophic Pathway X HMO 8700, Anthem Bronze Pathway X HMO 8700, Anthem Bronze Pathway X 6000, Ambetter Balanced Care 2, Ambetter Essential Care 1, Ambetter Essential Care 10, Medical Mutual Market HMO Young Essentials, Oscar Secure Select, Oscar Bronze Simple, Aultcare Catastrophe Select, Aultcare Bronze 8550 Select, SummaCare Value, and SummaCare Bronze 8000.
Oregon – KP OR Bronze 6500/50, KP OR Bronze 5000/50, Providence HSA 6000, Providence Connect 7150, BridgeSpan Bronze HDHP 6000 RealValue, BridgeSpan Standard Bronze Plan RealValue, Pacific Source Oregon Standard Bronze Plan LHN, Moda Health Oregon Standard Plan Bronze, ATRIO Bronze Saver 6850, and ATRIO Bronze 6350 HSA.
Pennsylvania – UPMC Advantage Bronze $6,950/$35, UPMC Advantage Silver $3,250/$10, Highmark Alliance Flex Blue PPO 2300, Geisinger Marketplace HMO 30/60/3500, Capital BlueCross Silver PPO 4500/0/10, Independence Blue Cross Personal Choice Bronze Basic, and Independence Blue Cross Personal Choice PPO Bronze Reserve.
Tennessee – Humana Basic 7150, Cigna US-TN Connect 6650, Cigna Connect 6400, Humana Bronze 4800, Cigna Connect HSA 5000, and BCBS Bronze B07S, BCBS Silver S04S,
Texas – BCBS Blue Advantage Bronze HMO 105, Molina Marketplace Choice Bronze, Community Health Choice HMO Bronze 003, Molina Marketplace Choice Silver, Ambetter Essential Care 1, Ambetter Essential Care 4, Sendero Health Plans IdealCare Essential, FirstCare Health Bronze HSA (100%), CHRISTUS Health Plan CHP TX Bronze, CHRISTUS Health Plan CHP Texas Silver HD, Prominence HealthFirst Bronze 7, and Prominence HealthFirst HSA 1.
Virginia – Cigna Connect 5750, Cigna US-VA Connect 6650, Aetna Leap Basic Secours, Anthem HealthKeepers Bronze X 6350, Anthem HealthKeepers Bronze X 5900, Innovation Health Leap Bronze, Kaiser KP VA Bronze 6500/50, Aetna Leap Basic Coastal VA HP, OptimaFit Bronze 6850 30 M, and CareSource Federal Simple Choice Bronze.
Washington – Ambetter Essential Care 1, Kaiser Bronze Plan 17, Kaiser Core Bronze HSA 17, Kaiser Flex Bronze 17, LifeWise Essential Bronze EPO 6350, BridgeSpan HDHP 6000, Kaiser Core Silver HSA 17, BS Bronze HDHP 5000, Ambetter Balanced Care 4, and Ambetter Balanced Care 2
What Is A “High Deductible Health Plan” (HDHP)?
An HDHP is a catastrophic health insurance plan that features high deductibles for individuals and families. The minimum is $1,300 for individuals and $2,600 for families. It is combined with a Health Savings Account (HSA) to provide an option to traditional medical coverage. You can pay for qualified health care expenses on a tax-free basis and retain greater control and flexibility of how you use your benefits.
NOTE: The HSA contribution limit is $3,500 per person and $7,000 per family. An additional $1,000 “catch-up” (if you are age 55 or over) is available. The out-of-pocket amounts are now $7,900 for single plans and $15,800 for family contracts. Every state offers at least one HDHP plan through the Marketplace and Open Enrollment. Non-subsidized HSA plans are also offered to higher-income households.
You pay no federal income tax on the funds you deposit and there is no penalty on the earnings once you use the account for those expenses. Once you have enrolled in an HDHP, you may qualify for the HSA; however, it is important to check with the insurer to verify it is an HSA-eligible plan. Often, carriers will remove or replace plan options, and you may have to change companies.
HSAs are widely available and rates will vary, depending on the state where you live. When you request a quote from us, you will be able to view many types of options from multiple carriers with various deductible options. They provide preventive benefits without having to meet the deductible. We’ll be happy to review your specific situation and recommend the option that will save you the most money. If you are reasonably healthy, the higher deductible options may save you the most money, the longer you keep the policy.
At age 65, an HSA may still be purchased, if you qualify for eligibility guidelines. However, once eligible for Medicare, additional contributions are not permitted. However, if your eligibility date, for example, is April 1, you can make contributions for each month prior to April. Spouses that are under age 65 may continue to make contributions into their own contract. Existing funds inside of the HSA can be used for many qualified expenses, including deductibles, coinsurance, copays, diabetic and insulin supplies, and prescribed drugs.
Can I Purchase Temporary Catastrophic Coverage
There are many available options if your need is temporary. Many insurers offer “short term” plans which are typically used when less than 12 months of coverage is required. This type of policy works best if you are without coverage, unemployed, just graduated from college, or are considering COBRA. Premiums are substantially lower than a typical plan, and policies are normally issued within 1-2 days. In many states, UnitedHealthcare, Blue Cross, and several smaller carriers offer extremely competitive rates. Annual liability caps are generally between $250,000 and $2 million.
If you need help with obtaining prices on this page, please let us know. We help you protect what’s important, but at a low cost. We believe in shopping to pay less for your major medical benefits, as long as you retain quality.