One little discussed aspect of ACA is the coverage option for a household that doesn’t qualify for a subsidy but still finds coverage unaffordable. That point is where the lowest cost bronze plan costs more than 8% of income but total household income is above the 400% of FPL. This would be a household of two with $75K income and a bronze policy premium of $600 per month. Consumers in areas with lots of competition may have better options, but many live in less competitive marketplaces and face this reality.
Does catastrophic coverage satisfy this need? It has the same 10 essential health benefits and the same deductible as a bronze policy. It also has the same structure as a high deductible policy (without the HSA benefit) where the insured pays the entire charge up to the deductible, then the plan pays 100% of all subsequent costs.
The differences between the two are not readily apparent or easy to identify, other than the catastrophic plan is not subject to an actuarial value limit. Here’s a US News article comparing the two http://health.usnews.com/health-news/health-insurance/articles/2013/08/28/aca-obamacare-bronze-tier-vs-catastrophic-health-insurance
So, is there something about the catastrophic plan that makes it a less appealing policy? Comparing certificates of coverage for both options would help, but they aren’t readily available. There may be network differences, but the higher value bronze plans already have network restrictions. Catastrophic coverage might be an option not just for young invincibles but also people on lower cost underwritten plans that are subject to cancellation this year or next.
Can anyone share any thoughts, experience, links, or informed sources of information on this? Has anyone contacted an insurer to apply or get more information?
This thread would make a nice addition to the FAQ section, so in the interest of keeping it helpful, let’s keep it on topic.
Does catastrophic coverage satisfy this need? It has the same 10 essential health benefits and the same deductible as a bronze policy. It also has the same structure as a high deductible policy (without the HSA benefit) where the insured pays the entire charge up to the deductible, then the plan pays 100% of all subsequent costs.
The differences between the two are not readily apparent or easy to identify, other than the catastrophic plan is not subject to an actuarial value limit. Here’s a US News article comparing the two http://health.usnews.com/health-news/health-insurance/articles/2013/08/28/aca-obamacare-bronze-tier-vs-catastrophic-health-insurance
So, is there something about the catastrophic plan that makes it a less appealing policy? Comparing certificates of coverage for both options would help, but they aren’t readily available. There may be network differences, but the higher value bronze plans already have network restrictions. Catastrophic coverage might be an option not just for young invincibles but also people on lower cost underwritten plans that are subject to cancellation this year or next.
Can anyone share any thoughts, experience, links, or informed sources of information on this? Has anyone contacted an insurer to apply or get more information?
This thread would make a nice addition to the FAQ section, so in the interest of keeping it helpful, let’s keep it on topic.
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