How to buy catastrophic health insurance: Catastrophic health insurance or high deductible health plans (HDHP) are low-premium and high-deductible policies that you can purchase for health insurance coverage.
Catastrophic insurance is a qualified health insurance plan that follows Obamacare guidelines. A catastrophic plan is a form of emergency health insurance designed to provide coverage in the event of a significant medical emergency, while you pay for day-to-day health expenses yourself.
You are eligible for catastrophic health insurance if you are under the age of 30 or are currently approved for a hardship waiver.
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What is catastrophic health insurance?
Catastrophic health insurance plans are designed for people who are under the age of 30 or meet hardship requirements.
The maximum deductible and out-of-pocket costs for catastrophic plans are $8,700. You pay for most routine medical expenses yourself, but the plans provide coverage for serious emergencies that require significant medical attention.
Catastrophic plans cover essential health benefits like other health insurance marketplace plans, which cover preventive services at no additional cost.
Who Should Get Catastrophic Health Insurance?
Non Catastrophic health insurance policies are affordable, but they’re not for everyone. They are best for people who are young and without healthy health conditions and who need regular care.
If you can’t afford a traditional health insurance plan, catastrophic plans are a low-cost option that provides coverage in the event of an accident or critical illness that you would otherwise have to pay for yourself.
If you have other options — such as employer-provided coverage or a traditional plan through the Affordable Care Act — those insurance plans will offer more comprehensive coverage with much lower deductibles.
Require regular doctor visits or treat a chronic health condition, catastrophic health plans will be expensive because the deductibles are so high. You’ll be better off with a bronze or silver plan purchased through the Health Insurance Marketplace.
What does catastrophic health insurance cost?
This amount (plan is $195 per month) is much less than the cost of a bronze plan purchased through the health insurance marketplace. As of 2022, the lowest level Bronze plan costs an average of $329 per month.
Short-term insurance plans are another option that can be cheaper as they are in the form of temporary coverage and do not cover pre-existing conditions. Short-term policies typically cost around $124 per month.
Catastrophic Health Insurance
- Rehabilitative and habilitative services and devices
- Laboratory services
- Preventive and wellness services
- Hospitalization
- Pregnancy, maternity, and newborn care
- Outpatient care services
- Emergency services
- Mental health and substance use disorder services
- Prescription drugs
- Pediatric services
The 4 Best Catastrophic Health Insurance
(1): Blue Cross Blue Shield
Blue Cross Blue Shield (BCBS) is chosen as the best catastrophic health insurance provider due to its vast provider network and benefits.
Founded in 1929, BCBS is one of the nation’s largest insurance companies, insuring three Americans. The BCBS structure is made up of 34 separate independent, community-based BCBS companies.
Because each BCBS company operates independently, they can provide customized options to the communities they serve.
BCBS has a large provider network of companies, with more than 96% of hospitals and 95% of doctors and specialists contracted with BCBS.
They offer a range of non-deductible PPO plans, so you can choose the doctors of your choice and don’t need referrals for specialist care.
Through BCBS’s Blue365 program, you can get valuable discounts at national and local retailers, including dental and vision services, fitness gear and apparel, gym memberships, and healthy eating options.
However, BCBS plans, options, and prices can vary widely by location. And, since decommissioning plans are so low cost, you are not eligible for premium tax credit Each BCBS chapter is independent, so each has its own National Association of Insurance Commissioners (NAIC) rating, and the level of customer service may vary by location.
(2): Oscar
Oscar is a top choice for health insurance with added benefits. You can earn rewards for healthy habits like walking and yours to help manage your health and access a care team nearby.
This is a relatively new company that was launched in 2012. It offers unique features like both virtual emergency care and virtual prima care at $0
You can earn $1 per day for reaching your step goal. In California, members can also earn rewards for reaching their gold goals.
You’ll also have access to a care team – a team of guides and nurses who will help you find the best and cheapest care near you.
Oscars are not available everywhere. Common health plans are available in 22 states. Only five locations have Catastrophic plans: New York, Los Angeles, Orange County (CA), San Francisco, and San Antonio.
Because Oscar is so new and only available in certain regions, it has a smaller provider network than some other insurance companies.
And it has some growing pains as it expands. In 2021, the National Association of Insurance Commissioners Complaint Index for one of Oscar’s larger regional subsidiaries was 5.81, meaning it received five times more complaints than a company its size.
Kaiser Permanente
Kaiser Permanente Insurance Company has been in business since 1945, starting as an insurance company for shipyard and steel mill workers. Now, it is a large nonprofit provider of health insurance with 12.5 million members.
With Kaiser Permanente’s catastrophic plan, you can talk to a health care professional without coming to the office in person. You can schedule same-day visits with doctors or nurses to address issues like sore throats, bladder infections, or allergies.
Appointments are available by phone or video, and you can contact a health care provider by email if you have non-urgent health questions. Kaiser Permanente can also connect you with specialists through telehealth appointments.
With a catastrophic plan, kids can get an annual eye exam and a set of glasses at no extra charge and no deductible applies.
A Kaiser catastrophic plan may cover some additional health services, including acupuncture and chiropractic care, but this varies with the specific plan.
Some services and drugs may require prior authorization, which means you may have to try other treatments before your desired treatment is covered by the insurer.
(4): Pivot Health
Pivot Health is a short-term insurance marketplace that connects consumers with policies written by insurers such as The North River Insurance Company and Companion Life.
Short-term coverage is different from catastrophic health plans sold through the health insurance marketplace, and they are much less expensive.
While other plans make you wait a few weeks before you’re covered, Pivot Health plans are usually effective the day you apply for insurance.
Most plans are PPO networks, so you can choose your own health care provider and see specialists without a referral.
Because short-term coverage is different from catastrophic plans offered on Healthcare.gov, they have higher deductibles and may exclude pre-existing conditions.
There are also limits to how much your insurance company will cover; For lower-level plans, the limit is $100,000
In addition to the monthly premium, you will also pay an enrollment fee of $19.95. Because Pivot Health is an insurance marketplace, it is not included in the NAIC Complaint Index.
Difference Between Major Medicare and Catastrophic Coverage?
Major medical insurance is a term used to describe plans sold in the health insurance marketplace that meet the requirements of the Affordable Care Act.
Although the major Medicare plans have different tiers — with different premiums and deductibles — they cover the same preventive services and essential benefits.
Catastrophic plans are also sold through the health insurance marketplace but have much higher deductibles than larger medical plans.
You will usually pay for routine medical care out of your own pocket; A catastrophic plan only provides coverage if you pay thousands and have a deductible.
Is the bottom line
Catastrophic health plans provide basic insurance with the same minimum coverage as other market plans. But not everyone is eligible for catastrophic insurance.
If you qualify, you may conclude that having a plan is better — and potentially cheaper — than having no insurance.
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