Hardship exemption and how to apply

Hardship exemption and how to apply

If you are over age 30 and have applied for and was approved for a federal hardship exemption, you may be able to shop for a Catastrophic plan. For information about the federal hardship exemption, including how to apply, go to the hardship exemption page on HealthCare.gov →

Were you already approved for a federal hardship exemption?

If you have a federal hardship exemption and want to shop for a Catastrophic health insurance plan through the Health Connector, please call Health Connector customer service at 1-877-MA-ENROLL (1-877-623-6765), or TTY 1-877-623-7773 for people who are deaf, hard of hearing, or speech disabled.

Health plans that meet all of the requirements applicable to other Health Connector plans but that don’t cover any benefits other than 3 primary care visits per year before the plan’s deductible is met. The premium amount you pay each month for health care is generally lower than for other health plans, but the out-of-pocket costs for deductibles, co-payments, and co-insurance are generally higher. To qualify for a Catastrophic plan, you must be under 30 years old OR get a “hardship exemption” because the Marketplace determined that you’re unable to afford health coverage.

Catastrophic health plans: For people under 30 or with certain exemptions

Catastrophic health insurance plans have low monthly premiums and very high deductibles. They may be an affordable way to protect yourself from worst-case scenarios, like getting seriously sick or injured. But you pay most routine medical expenses yourself.

Who can buy a Catastrophic plan

Only the following people are eligible:

  • People under 30
  • People of any age with a hardship exemption or affordability exemption (based on Marketplace or job-based insurance being unaffordable)

If you’re eligible to buy a Catastrophic plan, you’ll see them displayed when you compare plans on the Health Connector website.

How much Catastrophic plans cost

  • Monthly premiums are usually low, but you can’t use an Advance Premium Tax Credit to lower your cost. If you qualify for a premium tax credit based on your income, a Bronze or Silver plan is likely to be a better value. Be sure to compare.
  • Deductibles—the amount you have to pay yourself for most services before the plan starts to pay anything—are very high. For 2017, the deductible for all Catastrophic plans is $7,150. After you spend that much, your insurance company pays for all covered services, with no copayment or coinsurance.

What Catastrophic plans cover

  • Catastrophic plans cover the same essential health benefits as other Health Connector plans.
  • Like other plans, Catastrophic plans cover certain preventive services at no cost.
  • They also cover at least 3 primary care visits per year before you’ve met your deductible.

May 26, 2017    Individuals & Families    
Friday, May 26th, 2017|