Benefits & Coverage
Costs for Medical Care
Prescription drug coverage
Access to doctors and hospitals
Medical Management Programs
Child Dental Coverage
Adult Dental Coverage
Exclusions and Limitations
Weight Loss Programs
Imaging (CT/PET Scans, MRIs)
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)
Outpatient Surgery Physician/Surgical Services
Urgent Care Centers or Facilities
Outpatient Rehabilitation Services
Routine Foot Care
Diabetes Care Management
Inherited Metabolic Disorder - PKU
Laboratory Outpatient and Professional Services
Rehabilitative Occupational and Rehabilitative Physical Therapy
Rehabilitative Speech Therapy
Treatment for Temporomandibular Joint Disorders
Well Baby Visits and Care
Congenital Anomaly, including Cleft Lip/Palate
Off Label Prescription Drugs
Port-Wine Stain Removal
Prescription Drugs Other
Residential Treatment for Children with Emotional Disabilities
Services to Ventilator-Dependent Persons
Treatment of Lyme Disease
Diethylstilbestrol Exposure Treatment
Routine Patient Cost for Clinical Trials
Testing for STD's
Treatment for STD's
Treatment for Lyme Disease
Inpatient Physician and Surgical Services
Home Health Care Services
Durable Medical Equipment
Dental Check-Up for Children
Long-Term/Custodial Nursing Home Care
Abortion for Which Public Funding is Prohibited
What To Know
- This is an ACA (Obamacare) compliant health plan.
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Types of Health Insurance
Health Insurance in 2018
Catastrophic plan frequently asked questions (FAQ)
What is the Catastrophic Plan?
Catastrophic health insurance is a type of medical coverage under the Affordable Care Act. This is a type of high-deductible health plan for people under 30 or those who qualify for a "hardship exemption."
How are Catastrophic Plans different than other Obamacare health plans?
The fundamental difference among the new Obamacare health plans is the percentage of covered medical costs paid by the health plan. There is no actuarial value associated with catastrophic plans but other Obamacare metal plans pay a higher percentage of these costs.
How much does a Catastrophic Plan cost?
The monthly premium for a Catastrophic Plan depends on the insurer from whom you purchase the plan, the number of people to be insured by the plan, your age, whether you smoke, and the region in which you live. You can use HealthPocket’s comparison tool to compare Catastrophic Plan premiums in your area.
When Can I Enroll in a Catastrophic Plan?
The first Open Enrollment period for the new Affordable Care Act health plans began October 1, 2013 and ended March 31, 2014. However, some individuals who qualified for a special enrollment period were allowed to enroll past the March 31st deadline. The 2015 open enrollment period will be from November 15, 2014 to February 15, 2015. See our Open Enrollment article for more information.