Oscar Health Catastrophic (Secure) vs. Oscar Simple Bronze - Which one is best?

As the year draws toward the fall open enrollment period, it‚s an excellent time to reassess your health insurance options for 2021. As you may already be aware, there are four different metal tiers of insurance coverage for individual and family plans starting with bronze before progressing to platinum-level coverage. If you are under the age of 30 you also have the option to choose a catastrophic plan.

What do Catastrophic and Bronze Plans Cover?

Catastrophic plans have higher deductibles compared to other metal tiers, after which the insurer will pick up the remaining costs with no co-pay or coinsurance contributions thereafter. They are specifically designed for healthy young adults under the age of 30.

By contrast, bronze plans offer similar amount of coverage, and under the Affordable care act they cover around 60% of your medical costs on average.    

It is often a good idea to pair a catastrophic or bronze plan with a supplemental plan like Mira. Having a health insurance helps cover the high cost medical events and adding Mira helps you access basic and routine everyday healthcare without having to pay full price out of pockets for things like urgent care, lab tests, and prescriptions.

Can everybody get a Catastrophic plan?

No. Catastrophic plan provides minimal coverage against serious medical risk. They are lower in monthly premium, but not free in most cases. You may be eligible to purchase a catastrophic plan if:

• You are under 30 years old.
• Are over 30 and meet the guidelines for a hardship exemption.

Is a Catastrophic or Bronze plan the right fit for me?

If you‚re considering a catastrophic plan, you must first make sure that you are eligible. There are only two ways to qualify, either by being under the age of 30 or by qualifying through a financial hardship exemption (based on Marketplace or job-based insurance being unaffordable).

If you‚re over 30 then the Simple Bronze Plan offered by Oscar Health works is almost exactly the same way as a traditional catastrophic plan. Rather than covering around 60% of your medical expenses, you cover the costs of pretty much everything before the deductible (bar a few co-pays), before receiving 100% coverage thereafter. Perfect if you‚re in good shape and rarely make use of any medical services.

You can learn more about the metal tiers, and other important information regarding your health insurance eligibility here.