HHS has announced new guidance for consumers seeking catastrophic health coverage. Beginning November 1st, catastrophic plans will be available to all consumers approved for a hardship exemption. These plans were already available to purchasers under the age of 30 but CMS is now extending hardship exemptions to anyone who earns more than 250% or less than 100% of the poverty level who is newly ineligible for tax credits under the Health Insurance Exchanges. These policies will be available on the Exchanges in every jurisdiction except California, Connecticut, Maryland and the District of Columbia.   

Catastrophic plans cover all the essential health benefits required under the Affordable Care Act at a lower premium. However, patients with these plans often end up paying more in the long run. Enrollees face higher out-of-pocket costs — plans could carry a $10,600 deductible for individual policies and a $21,200 deductible for family coverage in 2026 under a final rule CMS published in June. This year, the average deductible for an individual Bronze plan is $7,186, according to federal data analyzed by the Kaiser Family Foundation. For more information, view HHS’ fact sheet and the full guidance.