What does the member pay during catastrophic coverage?

During the catastrophic coverage phase of a health insurance plan, the member typically pays a small copay or coinsurance for covered services. This is designed to provide financial protection for members who face significant healthcare costs. Catastrophic coverage usually comes into play after the member has met their deductible, which is often quite high.

Once the deductible is met, the plan covers a substantial portion of the costs, leaving the member responsible for only a small copay or coinsurance for subsequent visits or services. This structure encourages members to seek necessary care, as the out-of-pocket costs are minimized after significant expenses have already been incurred.

In contrast, the other options do not accurately reflect the nature of catastrophic coverage. There's generally no complete waiver of cost (no cost option), which would be impractical, and the idea of a large copay or a fixed percentage does not align with the intent of catastrophic coverage, where the goal is to limit out-of-pocket spending.