Exemptions & Catastrophic Coverage

If you’re 30 years old or older and want to enroll in a “Catastrophic” plan for 2020 or later, you must claim a hardship exemption to qualify. A Catastrophic health plan offers lower-priced coverage that mainly protects you from high medical costs if you get seriously hurt or injured. 

Catastrophic Plans & Hardship Exemptions
  • If you’re under 30, you can enroll in a Catastrophic plan whether you have an exemption or not. 
  • If you’re 30 or older, you can enroll in a Catastrophic health plan only if you qualify for a hardship exemption (this includes affordability exemptions)
  • To enroll in a Catastrophic plan if you’re 30 or older, you must submit a hardship or affordability exemption application and get an exemption certificate number. 
  • You’ll find out the Catastrophic plans available to you when you apply either with your preferred representative, broke, or by applying online. 

Need a hardship exemption form? Get instructions for downloading the exemption form and a link to the form itself.

Hardship Exemptions
  1. You were homeless.
  2. You were evicted or were facing eviction or foreclosure.
  3. You received a shut-off notice from a utility company.
  4. You experienced domestic violence.
  5. You experienced the death of a family member.
  6. You experienced a fire, flood, or other natural or human-caused disaster that caused substantial damage to your property.
  7. You filed for bankruptcy.
  8. You had medical expenses you couldn’t pay that resulted in substantial debt.
  9. You experienced unexpected increases in necessary expenses due to caring for an ill, disabled, or aging family member.
  10. You claim a child as a tax dependent who’s been denied coverage for Medicaid and CHIP, and another person is required by court order to give medical support to the child. In this case, you don’t have to pay the penalty for the child. 
  11. As a result of an eligibility appeals decision, you’re eligible for enrollment in a qualified health plan (QHP) through the Marketplace, lower costs on your monthly premiums, or cost-sharing reductions for a time period when you weren’t enrolled in a QHP through the Marketplace. 
  12. The exemption is for “grandfathered: individual insurance plans is no longer available. 
  13. You had another hardship. If you experienced another hardship obtaining health insurance, use this form to describe your hardship and apply for an exemption.