Friday, January 9, 2015

Insurance policies that do NOT qualify as Minimum Essential Coverage under ACA

In general, NON-qualifying policies tend to be restricted scope narrow insurance polices as described in the list below.  Note that the programs highlighted in yellow and marked with an asterisk below qualify for special relief as described in the footnote at the end of this post.  Plans highlighted in red do NOT have minimum essential coverage (MEC) and do NOT qualify for any special relief treatment.

Source:  IRS

Certain coverage that may provide limited benefits:
  • Coverage consisting solely of excepted benefits, such as:
    • Stand-alone dental and vision insurance
    • Accident or disability income insurance
    • Workers' compensation insurance
  • Medicaid providing only family planning services*
  • Medicaid providing only tuberculosis-related services*
  • Medicaid providing only coverage limited to treatment of emergency medical conditions*
  • Pregnancy-related Medicaid coverage*
  • Medicaid coverage for the medically needy*
  • Section 1115 Medicaid demonstration projects*
  • Space available TRICARE coverage provided under chapter 55 of title 10 of the United States Code for individuals who are not eligible for TRICARE coverage for health services from private sector providers*
  • Line of duty TRICARE coverage provided under chapter 55 of title 10 of the United States Code*
  • AmeriCorps coverage for those serving in programs receiving AmeriCorps State and National grants
  • AfterCorps coverage purchased by returning members of the PeaceCorps
*In Notice 2014-10, the IRS announced relief from the individual shared responsibility payment for months in 2014 in which individuals are covered under one of the programs highlighted in yellow above and marked with an asterisk above. Information will be made available later about how to claim an exemption for one of these programs on your income tax return.


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  3. Mary,

    Hi..I was in the class you taught with Dutch Leonard on Financial Management, Budgeting and Control in Fall, 1988, and would like to reconnect. Could you please send me your email address? (Mine is

    You can also connect with me via LinkedIn.

    I hope this message gets through.

    Karl Polzer, MPA, 1989, KSG


  4. This comment has been removed by the author.

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