A type of health insurance plan designed to provide coverage for major medical expenses resulting from severe illnesses or injuries. It typically has lower monthly premiums but higher deductibles compared to traditional health insurance plans.
The amount of money that the insured individual must pay out of pocket for covered medical expenses before the insurance company begins to cover costs. In catastrophic health insurance, deductibles are usually higher, which means the insured is responsible for a significant portion of their medical expenses before insurance kicks in.
The maximum amount of money the insured individual is required to pay for covered medical expenses during a policy period. Once this limit is reached, the insurance company typically covers 100% of the remaining costs for covered services.
Services aimed at preventing illness or detecting conditions at an early stage when treatment is likely to be more effective. Catastrophic health insurance plans often cover preventive care at no cost to the insured, even before the deductible is met.
Medical services provided in response to a sudden and serious medical condition, such as a heart attack, stroke, or severe injury. Catastrophic health insurance plans usually cover emergency services, even if the deductible has not been met, to ensure individuals receive prompt medical attention when needed.
Healthcare providers, such as doctors, hospitals, and clinics, that have contracted with the insurance company to provide services at negotiated rates. Catastrophic health insurance plans may have a network of preferred providers, and seeking care outside of this network may result in higher out-of-pocket costs for the insured.
A tax-advantaged savings account that individuals can use to pay for qualified medical expenses. HSAs are often paired with catastrophic health insurance plans, allowing individuals to save money for future medical costs while benefiting from lower monthly premiums.
The maximum amount of money that the insurance company will pay for covered medical expenses over the lifetime of the policy. Catastrophic health insurance plans may have a lifetime maximum benefit, although this limit is often quite high to provide adequate coverage for catastrophic events.
The percentage of covered medical expenses that the insured individual is responsible for paying after the deductible has been met. In catastrophic health insurance plans, coinsurance may apply once the deductible is reached, requiring the insured to pay a portion of the costs while the insurance company covers the rest.
Specific medical services or conditions that are not covered by the insurance policy. It’s essential for individuals to review the exclusions of their catastrophic health insurance plan to understand what services may not be covered and plan accordingly.