Major medical insurance is a term used to describe plans sold on the Health Insurance Marketplace that meet the Affordable Care Act’s requirements. While major medical plans have different tier levels—with different premiums and deductibles—they all cover the same preventative services and essential benefits.  Catastrophic plans are also sold through the Health Insurance Marketplace but have very high deductibles compared to major medical plans. You’ll typically pay out of your own pocket for routine medical care; a catastrophic plan only provides coverage once you’ve paid thousands and met the deductible.  Catastrophic plans aren’t available to everyone; there are age and hardship restrictions.