Catastrophe Insurance

When things go wrong, your attention to your health should matter most—not figuring out how to cover the costs.

What is Catastrophe Insurance?

As a private health plan, catastrophe health plans are designed for people who want to be able to cover high emergency expenses but do not want to have to pay for their routine medical treatment through higher monthly premiums.

Since these plans tend to have very high deductibles, they are ideal for folks who tend to have relatively low medical expenses and do not anticipate high medical bills outside of a catastrophic circumstance such as an unexpected severe illness or injury.

A group catastrophe health plan is a type of catastrophic insurance plan offered through a larger group health insurance plan from an organization or employer.

This type of plan is usually available for individuals who are under the age of thirty years old or able to demonstrate a hardship for exemption such as homelessness or inability to buy other types of health insurance.

What Does Catastrophe Insurance Cover?

A group catastrophe health plan covers essential health benefits that most health insurance plans on the marketplace would cover.

These essential health benefits include:

  • the services of doctors
  • hospital care both in inpatient and outpatient settings
  • coverage for prescribed medications
  • mental health services
  • childbirth and pregnancy services
  • and certain other services

Group catastrophe health plans also cover certain preventative services.

These preventative health benefits include:

  • the necessary immunizations
  • screenings such as alcohol misuse screenings
  • blood pressure screenings
  • depression screenings
  • and diet counseling for adults who have a greater risk for chronic disease than the general population

These may include emergency room visits, three primary care visits prior to meeting a deductible, and more.

Once you have met your deductible, which is admittedly very high on the group catastrophe plans, you will be able to use your group catastrophe health plan to cover all services at no out-of-pocket cost and free from co-pay charges.

What does it NOT cover?

Group catastrophic plans do not cover or include contributions to health savings accounts, also known as HSAs.

While high deductible health plans tend to allow users to contribute to an HSA, group catastrophic plans do not meet the definition for HDHPs.

This is because they do cover some care before the deductible is met such as three primary health provider visits. Although they have a high deductible, they do not have the same benefits as certain HDHPs for this reason.

What are the limitations?

Limitations of group catastrophe plans include the age range for who can participate in these plans and the circumstances of participants over the age of 30.

If someone is over thirty years old, they will not be eligible for this plan. These plans are also limited in that they do not allow users to contribute to a HSA.