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What Is Minimum Essential Coverage?

Not all health plans are created equal. Under the Affordable Care Act (ACA), “minimum essential coverage” (MEC) is any kind of insurance coverage that meets the individual shared responsibility requirement—aka individual mandate.

This definition can seem unclear, especially to a person who’s buying insurance on their own for the first time or who has never been insured at all. 

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Key Features of MEC:

What Health Insurance Meets MEC Requirements?

Many options meet the ACA’s requirements for Minimum Essential Coverage. Some of the most common choices are:

  • Most employer-sponsored plans
  • COBRA plans
  • Retiree plans
  • Marketplace plans
  • Individual and family plans
  • Medicare Advantage plans
  • Certain types of Veteran’s Affairs Benefits

To qualify as MEC, an insurance policy must cover a minimum level of health needs.

Any coverage that provides only a limited set of benefits doesn’t comply with the individual insurance mandate.

What Does NOT Meet MEC Requirements?

Certain types of health insurance don’t meet the requirements as set forth by the ACA. These include:

  • Stand-alone dental and vision plans
  • Accident or disability income insurance
  • Short-term medical insurance
  • Travel insurance
  • Certain types of Medicaid
  • Worker’s compensation insurance

What Happens If You Don’t Have Minimum Essential Coverage?

As of 2019, the individual mandate is no longer in force for most states. This means you don’t have to have a policy that meets MEC if you don’t want to. However, there are certain Health Reimbursement Arrangements (HRAs) that require you to have MEC to participate—or fully benefit from it. 

What We Provide

Minimum Essential Coverage includes preventive and wellness services covered at 100% with no deductible, no co-pay, and no out-of-pocket costs. It provides access to important vaccines, medical screenings, counseling, and more to help you stay healthy. At North American Health Plans, the MEC plan we offer is penalty proof, protecting you from taxation penalties under the Individual Mandate of the ACA.

Minimum Essential Coverage vs. Essential Health Benefits

People often confuse Minimum Essential Coverage with the Essential Health Benefits (EHB). MEC insurance fulfills a minimum requirement that helps you avoid the tax penalty, while EHB is a series of core benefits that new plans for individuals and small groups have to cover. Some plans don’t cover the Essential Health Benefits but still meet the MEC requirement, like large group plans or grandfathered plans. 

Why it Matters

Since you understand which types of insurance plans are considered MEC, you’ve taken an important first step to pick a policy that works for you and your family. 

As you move forward, you’ll have an easier time making decisions about your health insurance to get the coverage you need. If you experience any hurdles or would like more information, contact us at North American Health Plans.