What are Catastrophic Plans?

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In Addition to the Bronze, Silver, Gold and Pltinum Plans, issuers in the Individual market can offer catastrophic plans. Eligibility for catastrophic plans is limited to:

(a) Individuals under age 30 before the plan year begins

(b) Individuals age 30 or older who have a certification from the Marketplace that they qualify for a hardship or affordability exemption. The required contribution percentage is used to determine whether individuals age 30 and older qualify for an affordability exemption that would enable them to enroll in catastrophic coverage.

There is no specific AV for catastrophic plans. Catastrophic plans have specific cost-sharing requirements related to the annual cost-sharing limit that do not apply to plans in the four plan categories. Nevertheless, catastrophic plans have several benefit. They:

(1) Offer Lower Premiums, on average than Bronze, Silver, Gold, or Platinum plans

(2) Cover atleast three primary care visits before reaching the deductible

(3) Cover recommended preventive services without cost sharing

(4) Protect enrollees with a maximum out-of-pocket cost limit (The limit changes annually; for 2023, the maximum annual out-of-pocket limitation on cost sharing is $9100 for an individual and $18200 for a family.