Catastrophic Health Insurance 2027: Who Qualifies, Costs and How to Enroll

A catastrophic health plan is a low-premium Marketplace plan with a very high deductible: $12,000 for one person in 2027. Anyone under 30 can buy one. For 2027, people 30 and older also qualify if their projected income is below 100% or above 250% of the federal poverty level, or about $39,900 for a single adult, in every state. You can’t use premium tax credits on a catastrophic plan, so compare it with a bronze plan after your credit before you choose.

Catastrophic Health Insurance at a Glance

Who Qualifies for a Catastrophic Plan in 2027?

Catastrophic plans are not open to everyone. You need to meet one of these tests.

You Are Under 30

If you are under 30 when your coverage starts, you can buy a catastrophic plan without any exemption. This has been the rule since the ACA Marketplaces opened. If you are in this group, also see our guide to the best health insurance for young adults.

You Are 30 or Older and Your Income Is Above 250% of FPL

This is the big change. In September 2025, CMS began granting a hardship exemption to people who lost tax credit eligibility because of their income, which let them buy catastrophic plans for 2026 in some states. The 2027 payment rule, finalized May 15, 2026, goes further. It covers anyone who does not qualify for premium tax credits or cost-sharing reductions because their projected income is below 100% or above 250% of the federal poverty level, and it applies in all states.

Cost-sharing reductions stop at 250% of FPL, so in practice most adults with income above that line now qualify. Here is where 250% of FPL falls for 2027 coverage, which uses the 2026 poverty guidelines for the 48 contiguous states and D.C.:

You Have Another Hardship or Affordability Exemption

Other exemptions still apply. These cover situations such as the lowest-cost coverage available to you costing more than a set share of your income, or other hardships you can document on the Marketplace exemption form. HealthCare.gov lists the current exemption types and forms.

What a Catastrophic Plan Covers

Catastrophic plans cover the same 10 essential health benefits as other Marketplace plans, including hospital care, emergency care, prescriptions, maternity care and mental health care. Preventive services such as checkups, screenings and many vaccines are covered at no cost. The plan must also cover at least 3 primary care visits a year before you meet the deductible.

For most other care, you pay the full cost until you reach the deductible. After that, the plan pays 100% of covered care for the rest of the year. Like all ACA plans, a catastrophic plan cannot turn you down or charge you more for a pre-existing condition.

How Much Does a Catastrophic Plan Cost in 2027?

Premiums vary by state, age and ZIP code. CMS says the average premium for the lowest-cost catastrophic plan in 2027 is nearly 10% cheaper than the next lowest-cost plan at other coverage levels.

The trade-off is the deductible. A catastrophic plan’s deductible is set at the ACA out-of-pocket maximum, which rises to $12,000 for one person in 2027, up from $10,600 in 2026. That is the most you would pay for covered in-network care in a year, but you could pay all of it before the plan pays for anything beyond preventive care and 3 primary care visits. For context, see our look at the average health insurance deductible in 2027.

There is also no tax credit. Federal law does not allow premium tax credits to be used for catastrophic plans, so you pay the full premium.

Catastrophic Plan vs. Bronze Plan: Which Costs Less?

If you qualify for a premium tax credit, a bronze plan often costs less than a catastrophic plan after the credit. CMS says more than 75% of HealthCare.gov shoppers can find a plan for $50 a month or less in 2027 after tax credits. Bronze plans are also HSA-compatible now, and their deductibles are usually lower than a catastrophic plan’s.

A catastrophic plan tends to make more sense if you don’t get a tax credit, for example if your income is above 400% of FPL, and you mainly want protection against a large medical bill. HealthCare.gov’s own advice is that a bronze or silver plan may be a better value if you qualify for savings.

For a step-by-step look at how the credit is figured, read how to calculate ACA subsidies.

Can You Pair a Catastrophic Plan With an HSA?

Yes. Under the 2025 budget law, bronze and catastrophic plans available through an Exchange count as HSA-compatible starting January 1, 2026. The IRS confirmed this in Notice 2026-05 and said the plan does not have to be bought through the Exchange to qualify. That means you can put money into a health savings account tax-free and use it toward your deductible. CMS says eligible HealthCare.gov shoppers have 35 HSA-eligible plans to choose from on average in 2027. See our guide to HSA-eligible Marketplace plans for 2027.

Multi-Year Catastrophic Plans

The 2027 rule also lets insurers offer catastrophic plans with terms of up to 10 consecutive plan years, and it allows these plans to cover some care before the deductible. Not every area will have them, so check the plans listed for your ZIP code. CMS also plans changes to catastrophic plan cost-sharing starting in plan year 2028.

How to Enroll in a Catastrophic Plan

1. Apply at HealthCare.gov or your state’s Marketplace. Enter your projected 2027 household income. On HealthCare.gov, the hardship exemption based on income is checked automatically from your application.
2. Look for catastrophic plans in your results. If you are under 30 or qualify for an exemption, they appear alongside bronze, silver and gold plans.
3. Compare the price after any tax credit. A bronze plan with a credit may cost less.
4. Enroll by the deadline. Open enrollment runs November 1, 2026, to January 15, 2027. Sign up by December 15 for coverage that starts January 1. Some state-run Marketplaces have later deadlines.

You can also apply for a hardship exemption on paper with the Marketplace exemption form, which HealthCare.gov provides.

What CMS Has Said About 2027 Marketplace Plans

CMS released a Plan Year 2027 Marketplace fact sheet on October 30, 2026. It says that on average, shoppers can choose from about 100 plans from five to six insurers, and that people who qualify for tax credits will have a plan with nearly 90% of the lowest-cost premium paid by the federal government. CMS has not yet released detailed 2027 premium data, such as the change in benchmark silver premiums. We will update this page when it does.

Frequently Asked Questions

Who qualifies for catastrophic health insurance in 2027?

People under 30 can buy a catastrophic plan. People 30 and older qualify with a hardship or affordability exemption. For 2027, that includes anyone whose projected income is below 100% or above 250% of the federal poverty level, which is $39,900 for one person, in every state.

Can I get catastrophic health insurance if I’m over 30?

Yes, if you qualify for an exemption. In 2027, people 30 and older with projected income above 250% of the federal poverty level qualify for a hardship exemption. HealthCare.gov checks this automatically from the income you enter on your application.

What is the deductible for a catastrophic plan in 2027?

A catastrophic plan’s deductible equals the ACA out-of-pocket maximum, which is $12,000 for one person in 2027. Preventive care and at least 3 primary care visits a year are covered before you meet it.

Can I use premium tax credits on a catastrophic plan?

No. Federal tax law does not allow premium tax credits for catastrophic plans. If you qualify for a tax credit, a bronze or silver plan may cost you less after the credit.

Are catastrophic plans HSA-eligible?

Yes. Since January 1, 2026, catastrophic and bronze plans available through an Exchange count as HSA-compatible, so you can open and contribute to a health savings account.

When can I sign up for a 2027 catastrophic plan?

During open enrollment, November 1, 2026, to January 15, 2027, on HealthCare.gov. Enroll by December 15 for coverage that starts January 1. Some state-run Marketplaces have different dates.

Sources

• HealthCare.gov, Catastrophic Health Plans
• HealthCare.gov, Out-of-Pocket Maximum/Limit
• CMS, HHS Notice of Benefit and Payment Parameters for 2027 Final Rule (May 15, 2026)
• CMS, Expanding Access to Catastrophic Health Insurance Plans for 2026 (September 4, 2025)
• CMS, Plan Year 2027 Marketplace Plans and Prices Fact Sheet (October 30, 2026)
• IRS, Guidance on New HSA Tax Benefits (Notice 2026-05)
• 26 U.S.C. 36B, Refundable Credit for Coverage Under a Qualified Health Plan
• HHS ASPE, Poverty Guidelines