Catastrophic health plans: who qualifies and what they cover
A Catastrophic plan is a low-premium, very-high-deductible Marketplace plan meant to protect you from worst-case medical bills. You can buy one if you're under 30 or you qualify for a hardship or affordability exemption. It covers preventive care at no cost and at least 3 primary-care visits a year before the deductible. You can't use premium tax credits on it, so if you qualify for savings, a Bronze or Silver plan may cost you less.
Who can buy a Catastrophic plan
- People under 30.
- People of any age who qualify for a hardship exemption or an affordability exemption. The Marketplace's exemptions page lists the current types and how to apply. The rules for which exemptions qualify have changed in recent years and some were affected by court rulings in 2026, so check the current list before you count on one.
Catastrophic plans aren't sold in every area.
What they cover
- The same 10 essential health benefits as other Marketplace plans.
- Preventive services at no cost to you.
- At least 3 primary-care visits per year before you meet the deductible.
- After that, you generally pay costs until you reach the deductible; then the plan pays for covered services.
New in 2026: HSA-compatible
Starting January 1, 2026, Catastrophic plans available through an Exchange are treated as HSA-compatible under the One, Big, Beautiful Bill Act. That means an eligible person with a Catastrophic plan can contribute to a Health Savings Account and pay medical bills with pre-tax money. See HSA basics for 2027 contribution limits.
Catastrophic vs Bronze: the subsidy catch
Premium tax credits can't be applied to a Catastrophic plan. If you qualify for a premium tax credit, a Bronze plan could end up with a lower monthly premium than a Catastrophic plan, and HealthCare.gov notes that if you qualify for cost-sharing reductions, a Bronze or Silver plan may be a better value. Compare the after-subsidy prices side by side.
Pros and cons
| Pros | Cons |
|---|---|
| Usually the lowest full-price premium | Very high deductible: you pay most costs until you reach it |
| Protects against very large bills with an out-of-pocket limit | No premium tax credits |
| Free preventive care plus 3 primary-care visits before the deductible | Limited eligibility; not offered everywhere |
| HSA-compatible from 2026 | Can be costly if you need regular care or prescriptions |
Frequently asked questions
Can I get a Catastrophic plan if I'm over 30?
Only if you qualify for a hardship or affordability exemption. Check the current exemption types on HealthCare.gov's exemptions page.
Can I use a premium tax credit for a Catastrophic plan?
No. Premium tax credits can be used on Bronze, Silver, Gold and Platinum plans, but not on Catastrophic plans.
Are doctor visits covered before the deductible?
Catastrophic plans cover preventive services at no cost and at least 3 primary-care visits per year before you meet the deductible.
Can I pair a Catastrophic plan with an HSA?
Yes, starting in 2026, Catastrophic plans available through an Exchange are treated as HSA-compatible, provided you meet the other HSA eligibility rules.
Sources
- HealthCare.gov: Catastrophic health plans (accessed October 28, 2026)
- HealthCare.gov: Health plan categories (Bronze, Silver, Gold & Platinum) (accessed October 28, 2026)
- HealthCare.gov: Exemption types & forms (accessed October 28, 2026)
- IRS: Guidance on new HSA benefits under the One, Big, Beautiful Bill (Notice 2026-05) (accessed October 28, 2026)