Major medical plans must also cover at least three visits to your primary care doctor before you meet your deductible. Other than those benefits, you’ll pay your medical expenses out of pocket until you meet your deductible. After that point, catastrophic insurance must cover the same essential health benefits as other health marketplace plans, including:
Ambulatory patient services Emergency services Hospitalization Pregnancy and maternity/newborn care Mental health/substance abuse Prescription drugs Rehabilitative services Laboratory services Preventive/wellness services Pediatric services Additional benefits, such as birth control or breastfeeding coverage Dental or vision coverage (based on your state’s requirements for minimum coverage)
Once you’ve reached your deductible, you’ll have no coinsurance or copay on any of these services.
How Do HSAs Fit In?
If you are employed and covered by only a high-deductible health plan, you can combine a catastrophic health care plan with a health savings account (HSA), which allows you to set aside tax-free money to apply toward medical costs. An HSA can help you pay for any of your out-of-pocket health expenses under a catastrophic health insurance plan.
How To Get Catastrophic Health Insurance
Many insurance providers offer catastrophic health care insurance. If you already have insurance, check with your provider to see its available plans and how much they cost. If you don’t want to use your provider, you can shop on the federal government’s health care marketplace or that of your state. Before you purchase a catastrophic plan, keep in mind that your deductible and out-of-pocket expenses will likely be higher than if you had a traditional plan. Whether you choose a catastrophic plan or something more, make sure you can afford it if you have to pay up to your maximum out-of-pocket amount. Like other health plans, you can only purchase catastrophic insurance during an open enrollment period or after a qualifying event. If you’d like more information about catastrophic health plans, visit HealthCare.gov, or call 800-318-2596.
