SEE UPDATES AT THE BOTTOM OF THE POST
Yesterday, while running quotes for a client who turned 30 a few months ago, we noticed that Catastrophic plans were showing up for him in the quoting tool on Connect for Health Colorado. Catastrophic plans are a provision of the ACA, and are an extra level of available coverage beyond the “metal” plans (Bronze, Silver, Gold, and Platinum plans). But they are only available for people for people under the age of 30, which means up to age 29. Once you turn 30, you’re no longer eligible for a Catastrophic plan unless you’ve got a hardship exemption.
In Colorado, the Catastrophic plans are called Colorado Young Adult (CYA) plans, and the exchange website explains that they are available for people age 18 – 29. There is no ambiguity in terms of who’s eligible… both HHS and the state-run exchange in Colorado are clear that people are only eligible through age 29.
And yet the quote tool provides Catastrophic plan quotes for 30-year-olds. I tried it for numerous zip codes throughout the state, and in every case, Colorado HealthOP’s “Bobcat” EPO – a Catastrophic plan – showed up as the least expensive option, and other carriers’ Catastrophic plans were also listed as options.
When I changed the applicant’s age to 31, the Catastrophic plans no longer appeared in the quotes. It seems like there must be a small programming glitch that is allowing Catastrophic plans to show up for people through age 30, rather than under age 30.
We contacted the exchange yesterday and alerted them to the problem, and we’ll follow up with them later in the week to see if they’ve figured out the glitch. But for now, if you’re 30 years old and you’re browsing plans in the Colorado exchange, be aware that Catastrophic plans are not actually available to you (unless you’ve got a hardship exemption), even if they show up in the quote screen.
I’ll update this post later in the week once we get more information from Connect for Health Colorado.
UPDATE, 12/16/14: After I contacted Connect for Health Colorado about this glitch, they opened an IT ticket to look into the problem, and it is being addressed. But as of December 16, the browsing tool was still showing catastrophic plans for a 30-year-old.
UPDATE, 7/10/15: As of today, the Connect for Health Colorado browsing tool still presents catastrophic plans among the options available for a 30-year-old.
To be fair, even Healthcare.gov has some confusion on this issue. Their page about catastrophic plans gets it right at the top, where they state that “people under 30 and people withhardship exemptions” can buy catastrophic plans. But further down the page, they say that “people 30 and under with a hardship exemption” can get catastrophic coverage (this is incorrect… it should be “under 30,” not “30 and under.” And catastrophic plans are available to anyone with a hardship exemption, regardless of age). For clarification, see page 64 of the text of the ACA, where eligibility for catastrophic plans is outlined. For eligibility based on age, the law says a person who “has not attained the age of 30 before the beginning of the plan year” is eligible for catastrophic coverage.