Quick Catastrophic Plan Rate Calculator
What the new rules mean for adults over 30
For a long time, Catastrophic health plans were mostly limited to young adults. Unless you were under 30 or qualified for a hardship exemption, you simply couldn’t choose one, even if the lower premiums made the most sense for your situation. That’s finally changing. Starting in 2026, the federal rules expand who can enroll, giving more people access to a simpler, more affordable type of coverage.
Who can enroll in a Catastrophic plan in 2026?
Beginning in 2026, adults over 30 can enroll in a Catastrophic plan if their income is above 400 percent of the federal poverty level. This is the same point where premium tax credits end, since the subsidy cliff returns for 2026. If you’re no longer eligible for savings, Catastrophic plans open up as an option.
For people who qualify for subsidies, Catastrophic plans are still available in two cases:
• You qualify for a hardship exemption
• You qualify for an affordability exemption
People under 30 never need an exemption.
This change is meaningful because many adults in their forties, fifties, and sixties have asked for lower-premium options without needing to jump through paperwork. In 2026, a big part of that barrier finally drops.
How Catastrophic plans work
Catastrophic plans follow a simple structure designed to protect you from worst-case medical bills:
• Preventive care is covered at no cost, even before the deductible
• You pay the full cost of most non-preventive care until you reach the deductible
• After that, the plan begins paying for covered services
• You’re always protected by an out-of-pocket maximum
Catastrophic plans also include at least three primary-care visits per year before the deductible, which is a small but meaningful difference from a traditional Bronze plan.
If you receive premium tax credits, a Bronze or Silver plan will almost always be a better value. But for households above the subsidy cutoff, Catastrophic plans can offer a more budget-friendly alternative while still providing major medical protection.
A related update for 2026: All Bronze and Catastrophic plans will be HSA-qualified
This is another big shift. Beginning in 2026, every Bronze and Catastrophic plan will qualify for a Health Savings Account. For people who prefer lower monthly premiums and want the option to save pre-tax dollars for medical expenses, 2026 brings much more flexibility.
When exemptions still matter
Even though the tax penalty is long gone, exemptions still play a role for people over 30 who do qualify for savings on a Marketplace plan.
Hardship exemptions
These apply when something destabilizing made it difficult to maintain health coverage. Examples include:
- Eviction or foreclosure
- Utility shutoffs
- Domestic violence
- Death of a family member
- Bankruptcy or significant medical debt
- A natural disaster that damaged your home
- Caring for an ill, disabled, or aging family member
- Being denied Medicaid because your state didn’t expand it
- Other serious life circumstances that prevented coverage
Hardship exemptions generally cover the month before the event, the months during it, and the month after. In some cases, the Marketplace can extend them up to a full year.
Affordability exemptions
These apply when the lowest-cost Marketplace or job-based plan available to you would require more than a set percentage of your income. For 2025, that threshold is 7.97 percent. If the cheapest available plan costs more than that, you can qualify.
Affordability exemptions usually last through the end of the calendar year.
How to apply
If you need an exemption, you must apply and receive an Exemption Certificate Number before you can enroll in a Catastrophic plan. Forms and instructions are available here:
https://www.healthcare.gov/health-coverage-exemptions/forms-how-to-apply
What this means for 2026
With rising premiums and the subsidy cliff returning, Catastrophic plans will become a useful option for people over 30 who don’t qualify for savings. For some households, the ability to choose a lower-premium plan without extra paperwork will bring much-needed breathing room.
If you’re not sure whether a Catastrophic plan makes sense for you, or you want help comparing your options for 2026, feel free to reach out. I’m always happy to walk through the numbers with you so you can find something that fits both your needs and your budget.
