Minimum Essential Coverage (MEC)

Minimum Essential Coverage is defined as the type of health insurance coverage that you must have in order to comply with the individual mandate set forth by the Affordable Care Act (ACA) . From January 1, 2014, and onward, individuals must have MEC insurance or they will be subject to a tax penalty.

Health Insurance That Meets MEC Requirements

Many different options meet the ACA’s requirements for Minimum Essential Coverage. Here are some of the most common choices as well as who qualifies for this type of coverage:

• Most employer-sponsored plans: If an employer has at least 50 employees, they’re required to offer MEC to all full-time employees and their dependents.

• COBRA plans: Gives former employees, spouses and dependent children temporary continuation of health coverage at group rates in cases of employment termination or a reduction in the number of hours at their place of employment.

• Retiree plans: If you’re retired but do not yet qualify for Medicare, you can receive retiree health insurance from the Health Insurance Marketplace, or in some instances, a former employer.

• Covered CA plans: Covered California partners with 11 different health insurance companies to provide California state residents MEC options. Although most people will be offered three or more health insurance options, everyone will get at least two.

• Marketplace plans: Every American can use the Health Insurance Marketplace to “shop” for the best health insurance for both individuals and families. Plus, it’s the only place where you can receive subsidized assistance from the government if you qualify.

• Individual and family plans: This option is health insurance purchased through an insurance carrier. An example of it is the fast and simple application process provided by Health For California.

• Individual “grandfathered” plans: Individuals who purchased their health insurance by March 23, 2010, or earlier may be “grandfathered” into their health insurance plan and retain the same rate they had previously. However, individuals should ensure with their carrier, as many policies have discontinued grandfathered plans.

• Medicare Part A and Medicare Advantage plans: These solutions are federal health insurance provided to those over the age of 65 or individuals with certain diseases or disabilities. To qualify, an individual must have had at least 10 years in Medicare-covered employment.

• Full-scope Medicaid or Medi-Cal: These options are federal and state programs that provide health coverage to low-income individuals and families or to those who are pregnant or have a disability and qualify for the programs.

• Children’s Health Insurance Program (CHIP): CHIP makes low-cost health coverage available to children in families that earn too much to qualify for Medicaid. It also may cover some pregnant women.

• Certain types of Veteran’s Affairs Benefits: Medical assistance programs are provided to those who served in the active military service and did not receive a dishonorable discharge. In some cases, benefits are provided to spouses and children as well.

• Certain types of TRICARE: This healthcare program is for active duty and retired members of the uniformed services as well as their families and survivors.

• Peace Corps volunteer health benefits: The Peace Corps provides health care to all volunteers during their service and for one month after, during the transition process.

• Student Health Plans: Some schools provide students with affordable coverage during their time as students.

• Other: Some others include coverage designated by the U.S. Department of Health and Human Services as MEC.

Health Insurance That Does Not Meet MEC Requirements

Certain kinds of health insurance do not meet the requirements of Minimum Essential Coverage as set forth by the ACA. They include:

• Stand-alone dental and vision plans

• Accident or disability income insurance

• Short-term medical or temporary insurance

• Travel insurance

• Medical discount plans

• Specific disease policies

• Worker’s compensation insurance

• Certain types of limited Medicaid

• Certain AmeriCorps or AfterCorps coverage

Minimum Essential Coverage vs. Essential Health Benefits

Minimum Essential Coverage is often confused with the Essential Health Benefits. MEC insurance meets a minimum requirement that helps you to avoid the tax penalty, while EHB is a set of 10 core benefits that all new plans for individuals and small groups are required to cover as of 2014. There are some plans that do not cover the Essential Health Benefits but still meet the MEC requirement, such as large group plans or grandfathered plans.