What is Minimum Essential Coverage?

The Affordable Care Act requires most US citizens to have minimum essential coverage for at least one day during at least 9 calendar months of 2014 to avoid the Shared Responsibility Payment.

This is tricky because the open enrollment period is closed unless special circumstances allow you to enroll through your government run exchange.

The only other way for most individuals to avoid an Obamacare fine is by qualifying for an exemption or obtaining health insurance through other means such as an employer.

Medicare or Medicaid, both of which are usually considered Minimum Essential Coverage with few exceptions, are also available year round if you quality.

The Individual Mandate, specifically the provision requiring Minimum essential coverage, means that your health insurance must meet very specific requirements. If you are buying new insurance outside the government exchanges the insurer is required by law to inform you if the plan you are purchasing meets the definition of minimum essential coverage.

If you are simply renewing an existing plan, ask your insurer if it meets the strict guidelines set by the Federal government. Failure to comply with the minimum essential coverage mandate means even if you have insurance you will be subject to the Obamacare penalty.

So What Qualifies as Coverage?

The following is a list of health insurance classifications which are considered Minimum Essential Coverage which will allow you to avoid an Obamacare fine:


√  Medicare Advantage plans

√  Medicare Part A coverage

√  Employer-sponsored coverage (including retiree & COBRA)

√  Children’s Health Insurance Program coverage (CHIP)

√  Non appropriated Fund Health Benefit Program coverage

√  Refugee Medical Assistance program

√  Most Medicaid coverage

√  Peace Corps volunteers coverage

√  State high risk pools for years beginning on or before December 31, 2014

√  Self-funded health coverage for students of universities for years beginning before December 31, 2014

√  Coverage purchased in the individual market

√  Certain types of veterans health coverage

The above list are the main types of plans which are acceptable under the law. Any plan or arrangement that is recognized by the Secretary of HHS, in coordination with the Secretary of the Treasury is considered to be minimum essential coverage.