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Catastrophic Health Plans in 2027: Who Can Buy One and Is It Worth It

Who can buy a catastrophic plan for 2027, what it covers before the $12,000 deductible, why tax credits do not apply, and when a Bronze plan costs less.

By All Blog Article Editorial Team · Published · 9 min read

You can buy a catastrophic health plan for 2027 if you have not turned 30 before the plan year starts, or if you are 30 or older and get a hardship or affordability exemption. The plan must also be offered where you live, and not every area has one.

Whether it is worth it depends heavily on your income. Catastrophic plans cannot be paired with the premium tax credit, so if your income qualifies you for that credit, HealthCare.gov advises comparing it with Bronze and Silver plans, which can be the better buy after the credit. If your income is too high for a credit and you rarely need care, a catastrophic plan's low premium can make it the cheapest option. Open enrollment for 2027 coverage on HealthCare.gov runs from November 1, 2026 to January 15, 2027.

Key takeaways

  • Eligibility for 2027: under 30 before the plan year begins, or 30 and older with a hardship or affordability exemption. Everyone on a family policy must qualify.
  • Before the deductible, a catastrophic plan covers preventive care at no cost and at least three primary care visits a year. Beyond those, it generally pays nothing until you reach the 2027 out-of-pocket limit of $12,000 for one person.
  • Premium tax credits and cost-sharing reductions cannot be used on a catastrophic plan, whatever your income.
  • Since January 2026, a catastrophic plan available through a Marketplace works with a health savings account.
  • A 2025 policy that let people who lost tax-credit eligibility because of their income buy catastrophic coverage, and a 2027 rule that expanded it, were stayed by a federal court on July 16, 2026.

Who can buy a catastrophic plan for 2027

Catastrophic plans are a fifth category of Marketplace plan, alongside Bronze, Silver, Gold and Platinum. Federal rules limit them to two groups.

People under 30

The rule looks at your age before the plan year starts: you qualify if you have not turned 30 before the first day of the plan year. For a 2027 plan that begins January 1, 2027, someone who is 29 on that date qualifies for all of 2027 even if they turn 30 in March. For 2028, they would need an exemption. You do not need an exemption if you are under 30.

People 30 and older with an exemption

If you are 30 or older, you need an exemption certificate number from the Marketplace before you can enroll. There are two kinds:

  • Affordability exemption. This applies when even the cheapest coverage open to you, whether a Marketplace plan or a plan through a job, would take more than a set percentage of your household income. CMS set that percentage, called the required contribution percentage, at 8.50% for 2027 and 8.05% for 2026. When checked on October 13, 2026, HealthCare.gov's exemption page listed 7.97%, which matches neither CMS figure, so it is worth confirming with the Marketplace which percentage it applies. An exemption that covers all of 2027 has to be requested before January 1, 2027.
  • Hardship exemption. This applies when a hardship kept you from getting coverage. Among the situations HealthCare.gov lists are homelessness, an eviction or foreclosure, a utility shut-off notice, domestic violence, a death in the family, serious property damage from a fire, flood or other disaster, bankruptcy, unpaid medical bills that left substantial debt, a Medicaid denial because the state did not expand Medicaid, and other hardships in getting insurance. The exemption normally runs from the month before the hardship to the month after it, and the Marketplace can extend it, up to a full calendar year.

California, Connecticut, the District of Columbia and Maryland run their own exemption processes, so residents apply through their state's site. Being unemployed does not, by itself, count as a hardship.

Family coverage

A catastrophic plan can cover more than one person only if every person on the policy meets the age or exemption rule. A family with a 28-year-old and a 34-year-old without an exemption cannot share one.

The 2026 expansion, and why it is on hold for 2027

On September 4, 2025, CMS said that people newly ineligible for the premium tax credit or cost-sharing reductions because their projected income was below 100% or above 400% of the federal poverty level could get a hardship exemption to buy a catastrophic plan for 2026. The guidance covered HealthCare.gov states and participating state exchanges. From November 1, 2025, HealthCare.gov and certified enrollment partners checked for this automatically during the application, or people could use the paper form, choosing "Hardship 14".

The 2027 payment rule then added an expanded version of that policy to the federal regulations. On July 16, 2026, a federal court in Maryland stayed both the new regulation and the September 2025 guidance while a lawsuit continues, and CMS said they did not or will not take effect as finalized. For 2027, that income-based route is on hold, so people 30 and older need to qualify under one of the hardships on HealthCare.gov's list or the affordability exemption.

As of October 13, 2026, we found no CMS statement on what the stay means for people who bought a catastrophic plan for the rest of 2026 under the September 2025 guidance. Anyone in that position can ask the Marketplace before open enrollment ends.

What a catastrophic plan covers

Like other Marketplace plans, a catastrophic plan has to cover all 10 categories of essential health benefits. What differs is when it starts paying:

  • Preventive services, such as screenings and checkups, with no deductible, copay or coinsurance.
  • At least three primary care visits a year before you meet the deductible.
  • Everything else only after you have paid costs up to the year's out-of-pocket limit. For plan year 2027 that is $12,000 for one person and $24,000 for a family; for 2026 it is $10,600 and $21,200. Once you reach it, covered in-network care costs you nothing more that year.

In practice the deductible and the out-of-pocket maximum are the same number. A rule finalized in May 2026 would raise that threshold to 130% of the limit starting with plan year 2028, but the same July 16, 2026 court order stayed that change while the lawsuit continues. Federal surprise-billing protections still apply.

The 2027 rule also allows catastrophic plans with terms of up to 10 consecutive plan years. A plan with a term of two years or more may cover some services before the deductible through value-based insurance designs. This part of the rule is being challenged in the same lawsuit, but it was not among the provisions the court stayed. Whether any insurer offers such a plan in your area is something to check when you compare 2027 plans.

Why tax credits do not apply, and what that means

The premium tax credit lowers your monthly premium on a Bronze, Silver, Gold or Platinum plan. It cannot be used on a catastrophic plan, at any income, and catastrophic plans do not come with cost-sharing reductions either.

That matters because for 2027 coverage the credit is generally available with household income between 100% and 400% of the poverty level. That upper limit is $63,840 for one person in the 48 contiguous states and DC, and the temporary credits above 400% ended after the 2025 tax year. If you are under 30 with income in that range, compare the after-credit price of the cheapest Bronze plan before choosing a catastrophic plan. If your income is between 100% and 250% of the poverty level, also look at a Silver plan with cost-sharing reductions.

Above 400% of the poverty level, there is no credit on any plan, so you compare full prices. HealthCare.gov describes catastrophic plans as having low monthly premiums, and at full price that difference counts in full.

Worked example: catastrophic or Bronze at 27

Example: A 27-year-old expects 2027 income of $70,000, above the $63,840 limit, so no plan comes with a tax credit. The two plans below are illustrative. The catastrophic plan costs $3,000 a year and pays nothing beyond preventive care and three primary care visits until the 2027 limit of $12,000 is reached. The Bronze plan costs $3,900 a year, with a $7,500 deductible, 40% coinsurance after that and a $10,500 out-of-pocket maximum. The bills below exclude preventive care and the first three primary care visits.

Covered bills in 2027Catastrophic: premium plus out-of-pocketBronze: premium plus out-of-pocket
$500 (low use)$3,500$4,400
$12,000 (medium use)$15,000$13,200
$60,000 (high use)$15,000$14,400

The catastrophic plan saves $900 in a quiet year. It stays cheaper until covered bills reach $9,000; above that, Bronze costs less, by up to $1,800 in this example. At $12,000 of care, the catastrophic plan holder pays the full $12,000, while the Bronze holder pays the $7,500 deductible plus 40% of the remaining $4,500, or $9,300.

Two points can shift the result. If the Bronze plan's maximum were also $12,000, the catastrophic plan would cost $900 less in the worst case, though Bronze would still cost less for covered bills between $9,000 and $16,500. And both plans now work with a health savings account, so that no longer separates them. Our guide to choosing a metal tier runs the same kind of comparison across all four tiers.

Health savings accounts since 2026

Before 2026, a catastrophic plan could not be paired with a health savings account (HSA), a tax-advantaged account for qualified medical expenses, because it did not count as a high-deductible health plan: it had to cover three primary care visits before the deductible, and its out-of-pocket limit was above the HSA rules' maximum. Under the 2025 federal tax law, for months beginning after December 31, 2025, a catastrophic plan available as individual coverage through a Marketplace counts as an HSA-qualified plan, even though it does not meet the usual high-deductible plan rules. The same plan bought directly from the insurer also qualifies if it is available through a Marketplace. IRS Notice 2026-5 sets out these rules. The 2027 HSA contribution limit is $4,500 for self-only coverage. Our guide to 2026 and 2027 HSA rules covers the details.

Frequently asked questions

Can a premium tax credit be used on a catastrophic plan?

No. Catastrophic plans are not eligible for the premium tax credit or cost-sharing reductions, whatever your income. If you qualify for a credit, compare a Bronze or Silver plan's after-credit price.

What happens to someone who turns 30 during 2027?

They can keep a catastrophic plan for all of 2027 if they had not turned 30 before the plan year began, because eligibility is checked against age before the first day of the plan year. For 2028 they would need a hardship or affordability exemption.

How is an affordability exemption for 2027 obtained?

Apply to the Marketplace with the exemption application and, if approved, you receive an exemption certificate number to use when you enroll. To cover the whole year, request it before January 1, 2027. Residents of California, Connecticut, the District of Columbia and Maryland apply through their state.

Do catastrophic plans cover anything before the deductible?

Yes: preventive care at no cost and at least three primary care visits a year. Other care counts toward the deductible, which for 2027 equals the $12,000 out-of-pocket limit for one person.

Does a catastrophic plan work with an HSA?

Yes, starting in 2026, if the plan is available as individual coverage through a Marketplace. The 2027 contribution limit is $4,500 for self-only coverage. The other HSA rules still apply; for example, no new contributions can be made once Medicare coverage starts.

Sources

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