Hardship exemption and how to apply

Health plans that meet all of the requirements applicable to other Health Connector plans but that don’t cover any benefits other than 3 primary care visits per year before the plan’s deductible is met. The premium amount you pay each month for health care is generally lower than for other health plans, but the out-of-pocket costs for deductibles, co-payments, and co-insurance are generally higher. To qualify for a Catastrophic plan, you must be under 30 years old OR get a “hardship exemption” because the Marketplace determined that you’re unable to afford health coverage.

Catastrophic health insurance plans have low monthly premiums and very high deductibles. They may be an affordable way to protect yourself from worst-case scenarios, like getting seriously sick or injured. But you pay most routine medical expenses yourself.

Only the following people are eligible:

• People under 30
• People of any age with a hardship exemption or affordability exemption (based on Marketplace or job-based insurance being unaffordable)

If you’re eligible to buy a Catastrophic plan, you’ll see them displayed when you compare plans on the Health Connector website.

• Monthly premiums are usually low, but you can’t use an Advance Premium Tax Credit to lower your cost. If you qualify for a premium tax credit based on your income, a Bronze or Silver plan is likely to be a better value. Be sure to compare.
• Deductibles—the amount you have to pay yourself for most services before the plan starts to pay anything—are very high. For 2017, the deductible for all Catastrophic plans is $7,150. After you spend that much, your insurance company pays for all covered services, with no copayment or coinsurance.

• Catastrophic plans cover the same essential health benefits as other Health Connector plans.
• Like other plans, Catastrophic plans cover certain preventive services at no cost.
• They also cover at least 3 primary care visits per year before you’ve met your deductible.