Catastrophic health plans, which HealthCare.gov offers to people under 30 and to people with an exemption, are opening to more older shoppers in the Obamacare marketplace. A federal rule from the Department of Health and Human Services lets people 30 and older buy one if they get a hardship exemption because their income puts them outside premium subsidies, including incomes above 250 percent of the federal poverty level. The same rule lets some catastrophic plans run for up to 10 years.

The rule is the 2027 Notice of Benefit and Payment Parameters, published in the Federal Register on May 20, 2026 and effective July 20, 2026. It describes people “ineligible for APTC or CSRs due to projected household income below 100 percent or above 250 percent of the FPL,” APTC being the advance premium tax credit and CSRs the cost-sharing reductions. The expanded exemption “will allow individuals aged 30 and older who receive this hardship exemption to enroll in catastrophic coverage, if otherwise eligible.” The Centers for Medicare & Medicaid Services says in its final rule fact sheet that the policy applies “to individuals in all states.”

That leaves shoppers 30 and older with a real choice for 2027 coverage. The rule’s group is people who cannot get the premium credit or the cost-sharing reductions because their projected income is below 100 percent or above 250 percent of poverty. For them, a catastrophic plan with a low monthly premium and a high deductible becomes a possible pick, and the decision turns on how much care they expect to use.

The next date to know is Nov. 1, when HealthCare.gov opens applications for 2027 coverage.

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Who could buy one before

HealthCare.gov’s catastrophic plan page still lists two groups: “people under 30 years” and “others who qualify for a hardship exemption or affordability exemption.” The page has not yet been rewritten for the 2027 changes. Under 30, no exemption is needed. For everyone else, HealthCare.gov’s exemption page says an application must be submitted first, and the shopper has to “get an Exemption Certificate Number (ECN)” before enrolling.

The affordability exemption on that page has its own test: the lowest-priced coverage available would cost more than 7.97 percent of household income. The hardship exemption names no income threshold and covers “a financial hardship or other circumstances that prevented you from getting health insurance.” The new rule adds the income-based hardship category on top of those two.

What up to 10 years means

The Federal Register text says that, for plan years beginning on or after Jan. 1, 2027, “a catastrophic plan has a plan term of either 1 plan year, or of multiple consecutive plan years not to exceed 10 plan years.” CMS’s fact sheet describes it as plans that “may have terms of multiple consecutive plan years of up to 10 plan years.”

Plans with terms of at least two consecutive years can use value-based insurance designs for benefits before the deductible, under guidelines from HHS, Labor and the Treasury. CMS did not finalize a proposal that would have let multi-year catastrophic plans adjust their index rates to reflect the whole term. Separate changes to the cost-sharing requirements for catastrophic plans begin with plan year 2028.

What a catastrophic plan covers

HealthCare.gov says catastrophic plans “cover the same 10 essential health benefits as other Marketplace plans,” pay for preventive services at no cost and cover at least three primary care visits a year before the deductible is met. The trade is “very high deductibles” for low monthly premiums, and the page warns that “catastrophic plans might not be available in all areas.” It also says that a shopper who qualifies for the premium tax credit may find a bronze or silver plan “a better value” and should compare.

Comparing a catastrophic plan with bronze and silver

The free route starts at HealthCare.gov. The dates and deadlines page says applications for 2027 coverage start Nov. 1 and that Dec. 15 is the last day to enroll in or change plans for coverage starting Jan. 1. A shopper 30 or older who wants a catastrophic plan should start the exemption application before then, since the certificate number comes first.

Gather last year’s care costs, the list of regular prescriptions and the doctors who matter, then price each plan type for the same year. A catastrophic plan carries a low monthly premium, but the high deductible means the first dollars of nearly all care other than preventive visits and three primary care visits come out of pocket. For a multi-year catastrophic term, check the plan’s own terms before signing.

Anyone with income above 250 percent of poverty should price a silver plan too and look at what the premium credit does at their income, since the rule’s wording turns on being ineligible for the credits or the cost-sharing reductions.

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This article was produced with AI assistance and edited for accuracy against the sources linked above.