Learn about catastrophic health insurance plans in Madison, WI before purchasing one.

What to Know About Catastrophic Health Insurance Plans

Catastrophic health insurance generally offers the least expensive premiums of any type of plan. The Affordable Care Act (ACA) has made this type of plan available to people younger than 30 and those with “hardship exemptions.” 

Hardship exemptions are granted to people based on income or other factors that prevent them from getting coverage. If you had an individual insurance plan that was cancelled and you believe other plans aren't affordable, you may qualify for a hardship exemption. If you do, you can buy a catastrophic health insurance plan.


What is a catastrophic health insurance plan?

Catastrophic health insurance plans generally require you to pay all of your medical costs up to a certain amount, usually several thousand dollars. This limit is known as a deductible. After you reach your deductible, costs for essential health benefits* are generally paid by the catastrophic plan. Catastrophic plans usually have lower monthly health insurance premiums than metal level plans. But they may only cover your costs after you’ve used a lot of care. These plans basically help protect you financially from worst-case scenarios like serious accidents or illnesses.


Services that catastrophic health insurance plans cover

Catastrophic insurance plans cover three primary care visits per year at no out-of-pocket cost, even before you’ve met your deductible. They also cover certain preventive services at no out-of-pocket cost.

If you’re under 30 or think you may qualify for a hardship exemption, Unity can help you find a plan that’s right for you.  



*Essential health benefits must include items and services within at least the following 10 categories: ambulatory patient services; emergency services; hospitalization; maternity and newborn care; mental health and substance use disorder services, including behavioral health treatment; prescription drugs; rehabilitative and habilitative services and devices; laboratory services; preventive and wellness services and chronic disease management; and pediatric services, including oral and vision care.