What Is Minimum Essential Coverage (MEC)?

Minimum essential coverage (MEC) is the type of health coverage the Affordable Care Act counts as qualifying coverage. Under the federal shared responsibility provision (individual mandate), people without MEC used to owe a federal tax penalty, but that penalty was reduced to $0 starting in 2019. Some states, including California, Massachusetts, New Jersey, Rhode Island and the District of Columbia, still require residents to have MEC or pay a state tax penalty unless they qualify for an exemption.

Plans that qualify as minimum essential coverage include employer-sponsored plans, individual major medical plans (including ACA-compliant plans and grandfathered plans), TRICARE, Medicare, most Medicaid plans, and CHIP, among others.

Policies that are not major medical coverage and not regulated by the ACA (including discount plans, limited-benefit plans, critical-illness plans, accident supplements, and dental/vision plans) do not count as minimum essential coverage.

Minimum Essential Coverage List

Minimum essential coverage includes the following types of health insurance:

• Employer-sponsored coverage (including COBRA coverage and retiree coverage)
• Coverage purchased in the Individual Market, including a qualified health plan offered by the Health Insurance Marketplace (also known as an Affordable Insurance Exchange)
• Medicare Part A coverage and Medicare Advantage plans
• Most Medicaid coverage
• Children’s Health Insurance Program (CHIP) coverage
• Certain types of veterans health coverage administered by the Veterans Administration
• TRICARE
• Coverage provided to Peace Corps volunteers
• Coverage under the Non-appropriated Fund Health Benefit Program
• Refugee Medical Assistance supported by the Administration for Children and Families
• Self-funded health coverage offered to students by universities for plan or policy years that begin on or before Dec. 31, 2014 (for later plan or policy years, sponsors of these programs may apply to HHS to be recognized as minimum essential coverage)
• State high risk pools for plan or policy years that begin on or before Dec. 31, 2014 (for later plan or policy years, sponsors of these program may apply to HHS to be recognized as minimum essential coverage)