Catastrophic Health Insurance: Who Qualifies for 2027
For 2027, catastrophic health insurance is open to people under 30 — and to people 30 and older only with a hardship or affordability exemption. The income-based shortcut some sites still describe was stayed by a federal court on July 16, 2026, and isn't available as of CMS's August 4, 2026 statement. Here's who qualifies, what it covers, and when bronze or silver is the smarter buy.
Get a Free 2027 Quote ↓What Is Catastrophic Health Insurance?
Catastrophic health insurance is an ACA Marketplace plan with a very high deductible, built as a safety net against worst-case medical bills. For 2027 it's open to people under 30 and to people 30 and older with a hardship or affordability exemption. Premium tax credits can't be used on it.
You choose it in the same window as bronze, silver, and gold: November 1, 2026 through January 15, 2027 on HealthCare.gov, with December 15, 2026 as the last day to enroll for a January 1 start. For the full season plan, see our 2027 open enrollment guide.
FreedInsure LLC (NPN: 20230457) is an independent brokerage licensed in 42 states. We price catastrophic, bronze, and silver side by side and enroll you free — carriers pay us, not you. Call (844) 788-3733.
Quick answer: Catastrophic health insurance is a high-deductible ACA plan for people under 30, or 30 and older with a hardship or affordability exemption (for 2027, lowest-cost coverage above 8.50% of household income). It covers the 10 essential health benefits, free preventive care, and at least 3 primary care visits before the deductible. Premium tax credits can't be used on it.
Who Qualifies for Catastrophic Health Insurance in 2027?
You qualify if you're under 30, or if you're 30 or older and get a hardship exemption or an affordability exemption. Those three paths define catastrophic plan eligibility under federal law (42 U.S.C. §18022(e)), and as of CMS's August 4, 2026 statement they're the only ones open for 2027 coverage.
| Eligibility Path | Who It Fits | What You Need | 2027 Status |
|---|---|---|---|
| Under 30 | Anyone under age 30 | A regular Marketplace application; no exemption | Available |
| Hardship exemption | 30+ facing eviction, foreclosure, homelessness, a utility shut-off notice, domestic violence, a death in the family, disaster damage, bankruptcy, unpaid medical debt, or another hardship obtaining coverage | Mailed exemption application → Exemption Certificate Number (ECN) | Available |
| Affordability exemption | 30+ whose lowest-cost coverage would cost more than 8.50% of household income | State-specific affordability form, requested before January 1 to cover the full year → ECN | Available |
| Income-based hardship (under 100% or over 400% FPL for 2026; the 2027 rule would have used over 250%) | 30+ shut out of tax credits or cost-sharing reductions by income alone | Was a streamlined online check for 2026 | Stayed by a federal court July 16, 2026; not available as of CMS's Aug 4, 2026 statement |
Under 30 is the simple path: no exemption, just a normal Marketplace application. Aging off a parent's plan? See our turning 26 health insurance guide.
Can you get catastrophic health insurance if you're over 30?
Yes, but only with an approved exemption. The affordability exemption applies when your lowest-cost coverage would cost more than 8.50% of household income, CMS's 2027 required contribution percentage. To cover a whole calendar year, you must request it before January 1 — so for 2027, ask in 2026. A hardship exemption turns on what happened to you, not your income, and usually covers the month before, the months of, and the month after the hardship. Approval gets you an ECN, which you use to enroll.
Does Earning Over 400% FPL Qualify You for a Catastrophic Plan?
No — not for 2027, as of CMS's August 4, 2026 statement. The income-based hardship route that opened catastrophic plans to people above 400% or below 100% of the federal poverty level was stayed by a federal court on July 16, 2026. Unless you're under 30 or hold a traditional exemption, high income alone doesn't get you in.
How the income route started — and stopped
On September 4, 2025, CMS said people newly ineligible for tax credits or cost-sharing reductions because of their income (below 100% or above 400% FPL) could get a hardship exemption for 2026 catastrophic coverage, with a streamlined HealthCare.gov check starting November 1, 2025. CMS later told the court that 20,025 consumers ineligible for advance tax credits enrolled in catastrophic plans on the federal exchange between November 1, 2025 and January 15, 2026 (2026 coverage).
The 2027 Payment Notice, published May 20, 2026, would have made the route permanent and widened it to income below 100% or above 250% FPL. On July 16, 2026, the U.S. District Court for the District of Maryland (City of Columbus v. Kennedy) stayed it, along with the 2025 guidance, as likely contrary to law. CMS's July 31 and August 4, 2026 statements list it among provisions that "didn't or won't go into effect as finalized." The litigation is ongoing.
If you're over the 400% cliff
Under current law, unless Congress acts, 2027 premium tax credits stop at 400% FPL: $63,840 single, about $132,000 for a family of four. Above that, see our private health insurance guide and ACA income limits. Under 100% FPL? Check Medicaid income limits by state first. Got a 2026 catastrophic plan through the income route? We haven't seen CMS guidance on how those plans renew for 2027, so don't assume yours carries over — re-shop by December 15 for a January 1 start.
What Does Catastrophic Health Insurance Cover?
The same 10 essential health benefits as any other Marketplace plan, plus free preventive care and at least 3 primary care visits a year before you meet the deductible. For most other care, you pay the full cost until the deductible is met. That's the trade: real protection against a huge bill, little help with routine ones.
🩺 10 Essential Health Benefits
Emergency care, hospitalization, prescription drugs, maternity, mental health, and the rest of the ACA's core list. "Catastrophic" doesn't mean stripped down.
💉 Free Preventive Care
Covered preventive services cost $0, even before you touch the deductible — the same rule as every Marketplace plan.
🏥 3 Primary Care Visits
At least 3 primary care visits per year are covered before the deductible, on top of free preventive care.
🏦 HSA-Eligible
Under IRS Notice 2026-5, Exchange-available catastrophic plans count for HSA purposes. The 2027 limit is $4,500 self-only.
Your yearly costs for covered in-network care are capped by the ACA out-of-pocket maximum: $12,000 for self-only coverage in 2027 (premiums don't count toward it). Catastrophic deductibles are tied to that limit, so expect to pay for most non-preventive care yourself until you reach it.
Is a catastrophic plan HSA eligible?
Yes. Under IRS Notice 2026-5, a catastrophic plan available as individual coverage through an Exchange counts as a high-deductible health plan for months beginning after December 31, 2025, even if it misses the usual HDHP tests; off-exchange versions count too. Add $1,000 to the $4,500 limit at 55 or older. Details: our 2027 HSA contribution limits guide (confirm with a tax professional).
Multi-year catastrophic plans: allowed, not confirmed
Starting with plan years on or after January 1, 2027, insurers may offer catastrophic plans lasting up to ten consecutive plan years, and plans of two years or more may cover some services before the deductible. That rule wasn't stayed, but whether any insurer will actually sell a multi-year catastrophic health plan for 2027 isn't confirmed — treat it as a possibility, not a product.
How Much Is Catastrophic Health Insurance — and Can You Use a Tax Credit?
Catastrophic premiums depend on your age, ZIP code, and insurer, and no tax credit can lower them. So the real question isn't the sticker price — it's whether a subsidized bronze or silver plan costs you less.
What usually decides it is the credit math. Under current law, unless Congress acts, between 100% and 400% FPL ($15,960 to $63,840 for one person in 2027), your expected contribution toward the benchmark silver plan is 2.15% to 10.22% of income, and the credit covers the rest — or you can apply it to a bronze plan instead.
Below 250% FPL, silver gets better still. Cost-sharing reduction silver plans cap out-of-pocket costs at $4,000 for one person between 100% and 200% FPL, and $9,600 between 200% and 250% FPL — versus the $12,000 ceiling on catastrophic coverage.
Straight talk: if you qualify for a tax credit, catastrophic is usually the wrong buy. The credit can't touch a catastrophic premium, but it can pull a bronze or silver premium down hard — so a subsidized bronze or silver plan usually costs less than catastrophic. HealthCare.gov itself says bronze or silver "may be a better value" if you qualify for savings. Catastrophic earns its place when you get no credit at all. We'll price both for free: (844) 788-3733.
Run your numbers in our 2027 ACA subsidy calculator, then compare metal tiers with our guide on how to choose a health insurance plan.
How Do I Get Catastrophic Health Insurance for 2027?
Under 30, you pick a catastrophic plan when you apply during open enrollment, November 1, 2026 through January 15, 2027 on HealthCare.gov. At 30 or older, get an exemption first, then enroll using your Exemption Certificate Number. Either way, enroll by December 15 for coverage that starts January 1, 2027.
(1) Confirm your path using the table above. (2) Apply for an exemption (30+ only): download the application from HealthCare.gov, print it, and mail it to the Health Insurance Marketplace at the address shown on the form. Affordability forms differ by state, and the forms need Adobe Reader on a desktop computer. (3) Get your ECN if you're approved; mail takes time, so apply well before December 15. (4) Enroll with the ECN: by December 15, 2026 for a January 1 start, or December 16 through January 15 for February 1. Miss January 15 and you'll generally need a Special Enrollment Period.
Stuck on the form? The Marketplace Call Center is 1-800-318-2596 (TTY 1-855-889-4325), and our HealthCare.gov phone number guide covers hours and what to have ready; lines get busiest near December 15 and January 15. Or let us check whether catastrophic even beats your subsidized options: (844) 788-3733.
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