Catastrophic coverage is a category of coverage primarily for individuals under the age of 30, who may not use a lot of healthcare services during the year, but want to be protected from serious illness or an accident. Catastrophic plans cover the same essential health benefits as other Virginia's Insurance Marketplace plans, and also cover certain preventive services at no cost.
While premiums are generally lower for catastrophic coverage, those enrolled in these plans are not eligible for financial assistance to lower the cost of coverage and care. These plans feature very high deductibles, before the plan starts to pay anything. However, after you meet the deductible, your insurance company will pay for all covered services, with no copayment or coinsurance.
If you're 30 or older and want to enroll in a Catastrophic plan for 2021, you must claim a hardship exemption or affordability exemption (if your job-based coverage offer is not affordable) to qualify. If you’re eligible to buy a Catastrophic plan, you’ll see them displayed when you compare plans on Virginia's Insurance Marketplace.
How do I apply for a Hardship Exemption to enroll in Catastrophic coverage?
If you are 30 or older and want to buy a Catastrophic health plan, you must apply for a hardship exemption to qualify. There are two types of hardship exemptions you can submit, choose the one that fits your circumstances:
- Hardship exemption for circumstances like homelessness, bankruptcy, eviction, or foreclosure. Click here and follow the instructions for completing and submitting the form.
- Affordability exemption if you cannot afford coverage for the upcoming year. Click here and follow the instructions for completing and submitting the form.
- You will need to receive an exemption certificate number from healthcare.gov and enter your exemption information on the Virginia's Insurance Marketplace eligibility application to see catastrophic plans in plan shopping.
- Please call healthcare.gov at 1-800-318-2596 for assistance with completion and status of your hardship exemption. Healthcare.gov is only processing your exemption application. You will need to shop and enroll in coverage through Virginia's Insurance Marketplace once you have your exemption certificate number from healthcare.gov.