What is catastrophic health insurance?

Catastrophic health insurance is a high-deductible health plan designed to provide coverage for major medical events while keeping monthly premiums low. It primarily covers emergency care, hospitalizations, and essential health benefits but requires individuals to pay most routine healthcare costs out-of-pocket until they reach the high deductible.

Who is catastrophic health insurance for?

• Younger or low-income individuals: These plans are typically available to those under 30 or those who qualify for a hardship exemption.
• People seeking low monthly premiums: They offer lower upfront costs but require paying more out-of-pocket before coverage kicks in.
• Those who need financial protection against major medical events: While routine care isn't fully covered, these plans help prevent financial ruin from unexpected hospitalizations or serious illnesses.

How does catastrophic coverage work with Medicare?

Medicare patients generally do not enroll in catastrophic health insurance, as Medicare provides comprehensive coverage options with out-of-pocket caps. However, Medicare does have a “catastrophic coverage” phase under Part D (prescription drug plans), which significantly reduces drug costs after a patient reaches a certain spending threshold.

How Solace can help

If you're a Medicare patient struggling with out-of-pocket costs for medications or medical care, a Solace advocate can help you navigate financial assistance programs, apply for Extra Help for prescription costs, and ensure you're enrolled in the right Medicare plan to minimize expenses. They can also assist with appealing high medical bills and finding resources to offset healthcare costs.

What to do next

Concerned about high out-of-pocket costs for prescriptions or medical care? A Solace advocate can help you explore cost-saving options. 

Find an advocate today.