Catastrophic health insurance in Texas is an Affordable Care Act marketplace plan sold through HealthCare.gov that trades a lower monthly premium for a very high deductible. For 2026, you can buy one if you are under 30, or if you are 30 or older and your projected household income puts you outside the range that qualifies for premium tax credits or cost-sharing reductions. The deductible is $10,600 for an individual and $21,200 for a family, and premium tax credits cannot be applied to the premium.
Who Can Buy a Catastrophic Plan in Texas
Texas uses the federal marketplace, so the national eligibility rules apply here directly.1CMS.gov. Expanding Access to Health Insurance: Consumers Gain Access to Catastrophic Health Insurance Plans Three paths lead to a catastrophic plan for the 2026 plan year.
Anyone under 30 can enroll with no exemption or extra paperwork. The plan simply appears among the options on HealthCare.gov.
People 30 and older who do not qualify for marketplace savings can now enroll as well. Under CMS guidance issued September 4, 2025, a consumer whose projected annual household income falls below 100 percent or above 250 percent of the federal poverty level — and who is therefore ineligible for premium tax credits or cost-sharing reductions — qualifies for a hardship exemption to buy catastrophic coverage.2CMS.gov. Guidance on Hardship Exemptions Starting with the November 2025 open enrollment period, HealthCare.gov evaluates this automatically from the information on your application, so most people do not need to file a separate exemption request.1CMS.gov. Expanding Access to Health Insurance: Consumers Gain Access to Catastrophic Health Insurance Plans
A third path remains for people of any age who experienced a qualifying hardship: homelessness, eviction, domestic violence, bankruptcy, a natural disaster, and similar circumstances. These require a hardship exemption application, which can be submitted on paper under “Hardship 14” with a brief explanation.3HealthCare.gov. Health Coverage Exemptions: Forms and How to Apply2CMS.gov. Guidance on Hardship Exemptions
What the Plan Covers and What You Pay
A catastrophic plan is still an ACA-compliant plan. It must cover the same ten essential health benefits as every other marketplace plan, including hospitalization, prescription drugs, emergency services, maternity care, mental health treatment, and lab work.4HealthCare.gov. Catastrophic Health Plans Preventive services — screenings, check-ups, and immunizations — are covered at no cost before the deductible is met.
You also get at least three primary care visits per year before the deductible applies.5KFF. What Is a Catastrophic Health Plan Everything else is on you until spending reaches the 2026 deductible of $10,600 for an individual or $21,200 for a family.6KFF. Policy Changes Bring Renewed Focus on High-Deductible Health Plans Those figures are also the out-of-pocket maximum, so once you hit the deductible, the plan pays the rest of your covered costs for the year. There is no coinsurance layer in between.
What You’ll Pay Each Month
Premiums vary by age, county, and insurer. In the Houston area, the cheapest catastrophic plan for a 45-year-old without subsidies came in at about $507 per month for 2026, with other options in the same area reaching $647 per month.7HealthInsurance.org. Catastrophic Plan The cheapest bronze plan for the same profile in Houston started around $423 per month.
So catastrophic is not automatically the lowest-premium option in Texas. Insurers in some states raised catastrophic plan rates after CMS expanded eligibility, having been allowed to refile rates in late September 2025 to account for the broader pool of potential enrollees.7HealthInsurance.org. Catastrophic Plan Check both tiers before deciding.
One rule weighs heavily on the math: premium tax credits cannot be applied to catastrophic plans.8HealthCare.gov. HSA Options If you qualify for subsidies, a bronze or silver plan with tax credits applied will almost always cost less, both month to month and over the year.
The 2026 HSA Change
For 2026, every individual-market catastrophic plan qualifies as a high-deductible health plan for Health Savings Account purposes. Section 71307 of the Working Families Tax Cuts legislation (Public Law 119-21), signed July 4, 2025, treats catastrophic plans as HSA-eligible regardless of whether they meet the traditional IRS deductible and out-of-pocket thresholds.9IRS. Working Families Tax Cuts Before 2026, no catastrophic plan was HSA-eligible.6KFF. Policy Changes Bring Renewed Focus on High-Deductible Health Plans
The 2026 HSA contribution limits are $4,400 for self-only coverage and $8,750 for family coverage.10HealthCare.gov. High Deductible Health Plan Contributions are tax-deductible, grow tax-free, and come out tax-free for qualified medical expenses. Health economists have noted that HSAs help most when you have the disposable income to fund them, and much less when the unsubsidized premium already strains the budget.11Forbes. Oz Pushes Catastrophic Health Plans, Which Critics Call Junk Insurance
How to Enroll
Shop on HealthCare.gov, the same marketplace used for every other individual ACA plan in Texas. Create an account, complete the application with household and income details, and compare plans in your county. Catastrophic plans are available in at least some parts of 36 states plus the District of Columbia for 2026, but availability varies by county, and not every Texas county may offer one.7HealthInsurance.org. Catastrophic Plan
If you are under 30, catastrophic options appear automatically. If you are 30 or older, the application now checks your projected income against the subsidy thresholds and grants the hardship exemption if you fall outside them, which unlocks catastrophic plans in your results.12HHS. HHS Expands Access to Affordable Catastrophic Health Coverage Open enrollment for 2026 plans began November 1, 2025. Outside open enrollment, you need a qualifying life event to use a special enrollment period.
Catastrophic vs. Bronze: The Real Decision
For most Texans weighing a low-premium plan, the honest comparison is catastrophic against bronze.
- Bronze plans cover roughly 60 percent of average healthcare costs. Catastrophic plans cover less; HHS has estimated their actuarial value at about 55 percent under updated 2027 rules, and they carry no formal actuarial value requirement.13Health Affairs. HHS Finalizes Sweeping Marketplace Changes
- Bronze plans accept premium tax credits. Catastrophic plans do not.8HealthCare.gov. HSA Options
- Both cover preventive care at no cost. Catastrophic adds three pre-deductible primary care visits; bronze generally applies a 60/40 cost split to a broader range of services.
- Anyone can buy a bronze plan. Catastrophic requires being under 30 or qualifying for an exemption.
- Both are HSA-eligible for 2026.14HealthCare.gov. Plans and Categories
If you qualify for premium tax credits, a subsidized bronze or silver plan almost always wins on total cost. A catastrophic plan tends to fit a narrower profile: you earn too much for subsidies, you are generally healthy, you want a safety net against a major medical event, and you plan to pair the coverage with an HSA.
The Risk, and Why It Matters More in Texas
The core risk is simple. If you get sick, you pay thousands before coverage pays anything. A $10,600 individual deductible is more than many households have in savings, and a chronic diagnosis or an unplanned hospitalization can produce a bill at or near that figure quickly. Critics in Congress and among health economists have called the expansion a push toward “junk insurance,” arguing that pulling healthy people into high-deductible plans leaves sicker enrollees in the comprehensive risk pool and raises their premiums.11Forbes. Oz Pushes Catastrophic Health Plans, Which Critics Call Junk Insurance CMS, under Administrator Dr. Mehmet Oz, said the expansion gives consumers “real choices” and protects people facing hardship from devastating costs.15CMS.gov. HHS Expands Access to Affordable Health Insurance
Texas has the highest uninsured rate in the country. According to 2024 Census data, 21.6 percent of Texas adults and 13.6 percent of Texas children lack health insurance, roughly double the national average.16Texans Care for Children. Texas Has the Worst Uninsured Rate in the US Once Again Texas has not expanded Medicaid under the ACA, so most low-income adults do not have access to state-sponsored coverage unless they are pregnant, severely disabled, or in a nursing home. The enhanced ACA premium tax credits created by the American Rescue Plan Act and extended by the Inflation Reduction Act expired at the end of 2025 and were not renewed.17Brookings Institution. Why Are Expiring ACA Subsidies Raising Health Insurance Premiums Research from the Mosbacher Institute at Texas A&M projected that between 665,000 and 1.45 million Texans would lose marketplace coverage, with out-of-pocket premiums rising an average of 115 percent for 2026.18Bush School – Texas A&M University. Expiring Federal Health Subsidies Catastrophic plans fit a specific niche in that environment: a lower-premium ACA-compliant option for Texans priced out of subsidized coverage who can carry the deductible risk.
A Note on Texas Farm Bureau “Catastrophic” Plans
Outside the marketplace, Texas Farm Bureau Health Plans sells a Major Medical product marketed as “catastrophic protection.” These plans are authorized under Texas Insurance Code § 1682 as nonprofit agricultural organization health benefits and are explicitly not insurance under state law.19Texas Farm Bureau Health Plans. Major Medical They do not meet ACA minimum requirements, they use medical underwriting that can affect eligibility and rates, and they can impose waiting periods for pre-existing conditions.20Texas Farm Bureau Health Plans. Individual and Family Plans Enrollment requires Texas Farm Bureau membership, and coverage runs through the UnitedHealthcare ChoicePlus network.21Texas Farm Bureau. TFB Health Plan FAQ Premiums can be lower for healthy applicants than comparable ACA plans, but applicants can be denied, and the ACA protections for guaranteed issue, pre-existing conditions, and essential health benefits do not apply. If you are comparing a Farm Bureau product to a marketplace catastrophic plan, you are comparing two different things.