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Is An Obamacare Catastrophic Plan For You?





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Is an Obamacare catastrophic plan for you?

Finding adequate health insurance coverage can be a challenge, especially if you're strapped for cash. If an Obamacare "metal level" health plan -- bronze, silver, gold or platinum -- busts your budget, you might consider a "catastrophic" plan.

The catastrophic option under the health care law allows Americans to enroll in a plan "with relatively cheap premiums, that is going to protect them in the worst-case scenarios," says Cheryl Fish-Parcham, deputy director of health policy at Families USA, a Washington, D.C.-based consumer group.

Slim coverage, fat deductibles

Primarily reserved for people younger than 30, the Affordable Care Act's catastrophic plans cover three annual primary care visits and preventive services at no cost, including disease screenings and vaccinations. Beyond that, the patient pays all medical expenses out of pocket up to a steep deductible, generally $6,350 for individuals and $12,700 for families.

More On Health Plans:

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People older than 30 who shop for health insurance in the Obamacare exchanges are usually required to choose a more comprehensive plan but may buy a catastrophic plan under one of the law's many exemptions.

For example, if the health coverage options available to you would cost more than 8 percent of your income or if your insurance plan was canceled because it didn't meet the law's new standards, you may ask for a hardship exemption to apply for catastrophic coverage.

Compare health insurance quotes to find the best plan for you.

Catastrophic plan pros and cons

Health Secretary Kathleen Sebelius told members of Congress that premiums for catastrophic plans are about 20 percent lower, on average, than prices for other health plans available in the Obamacare exchanges.

However, unlike the metallic plans, catastrophic plans don't offer potential discounts through tax subsidies. If you enroll in a catastrophic plan -- no matter how low your income is -- you won't qualify for a tax credit to lower your premium costs.

So, would the plan still give you enough bang for your buck? Maybe not.

Catastrophic vs. bronze

Consider how catastrophic plans compare with Obamacare bronze plans, which typically offer the lowest premiums but the skimpiest coverage of the four metallic plan levels.

In Missouri, the cheapest bronze plan would cost a 20-something consumer $157 per month, says Fish-Parcham, while the least expensive catastrophic plan would cost even less: $104. One insurer quotes a similar California bronze plan at $204 per month and a catastrophic plan at just $180 per month, says Craig Gussin, an insurance broker in San Diego.

But even though they seem more expensive, bronze plans may still be a better deal not only because of the potential financial assistance available through the subsidies, but also because those plans must cover "essential health benefits," including emergency services and prescription drugs, which catastrophic plans may not cover until the deductible is met.

"There isn't enough difference, in my opinion," Gussin says, referring to the lower premiums for catastrophic plans. Consumers who pony up the extra $20 or $30 can have a metallic plan with more coverage, he adds.

Sample rates for catastrophic plans

Average countywide catastrophic plan premiums, in select markets.




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