HHS Expands Access to Affordable Health Insurance Through Hardship Exemptions

The U.S. Department of Health and Human Services (HHS) has issued new hardship exemption guidance that expands access to affordable catastrophic health insurance plans.

This change helps Americans who don’t qualify for financial assistance programs like premium tax credits (APTC) or cost-sharing reductions (CSRs) get covered at lower costs.

Beginning November 1, 2025, in line with open enrollment, more individuals can qualify for catastrophic plans based on financial need.

These plans are designed to offer lower monthly premiums, cover three primary care visits before the deductible, and provide strong protection against high out-of-pocket costs for major medical events.

Catastrophic coverage has traditionally been limited to people under 30. With this update, eligibility now extends to more consumers facing hardship, giving families and individuals a new, affordable option for health insurance in today’s uncertain economy.

Read: Applications Open: States Can Claim Share of $50B Rural Health Program Funding
 

How to Apply?

Starting November 1, 2025, consumers can apply for the hardship exemption in two ways:

• Online: Apply for Marketplace coverage through HealthCare.gov or via a certified partner. Household income will be reviewed during the application.

• By Mail: Submit a hardship exemption form by mail. HHS has streamlined the review process to reduce delays and administrative burdens.

You may have access to support you didn’t know about. Find out more here!

Once approved, eligible individuals can purchase catastrophic plans both on and off the Exchange.

These plans must still meet Affordable Care Act (ACA) standards, covering all essential health benefits and preventive services without cost-sharing.

More information:

• HHS hardship exemption guidance: CMS.gov Guidance

• Fact sheet: HHS Fact Sheet on Catastrophic Coverage

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