In order to comply with the shared responsibility provision (individual mandate), all Americans must maintain health insurance that is deemed minimum essential coverage, unless they qualify for an exemption.
Plans that qualify as minimum essential coverage include employer-sponsored plans, individual major medical plans (including new ACA-compliant plans, grandfathered plans, or pre-2014 grandfathered plans that have been extended into 2014), 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
- 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)
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