Minimum essential coverage is a term that refers to a number of health insurance types that protect a person from the fee for not having coverage. Minimum essential coverage isn’t based off the benefits that the insurance has, it’s based off the type of insurance.

What Insurance Counts as Minimum Essential Coverage?

All private and public major medical plans count as minimum essential coverage. First, we will give you a short general list and then a detailed list of every type directly from the IRS.

Minimum essential coverage includes:

  • Any Health Insurance purchased on the Health Insurance Marketplace (HealthCare.Gov or your state Marketplace)
  • Major medical insurance bought outside of the Health Insurance Marketplace
  • Insurance obtained through an employer (including grandfathered group plans) and COBRA
  • Medicaid and CHIP (excluding limited benefit Medicaid coverage)
  • Medicare Part A, Medicare Advantage, and retiree coverage
  • All government plans, such as Federal Employees Health Benefit program, TRICARE, and VA
  • Some foreign health insurance

Minimum essential coverage does not include:

  • Short term health insurance or Traveler’s insurance
  • Limited benefit health insurance
Coverage Type Qualifies As Minimum Essential Coverage Doesn’t Qualify As Minimum Essential Coverage
Employer-sponsored coverage:

  • Group health insurance coverage for employees under –
  • A governmental plan, such as the Federal Employees Health Benefit program
  • A plan or coverage offered in the small or large group market within a state
  • A grandfathered health plan offered in a group market
  • A self-insured group health plan for employees
  • COBRA coverage
  • Retiree coverage
Individual health coverage:

  • Health insurance you purchase directly from an insurance company
  • Health insurance you purchase through the Health Insurance Marketplace
  • Health insurance provided through a student health plan
  • Health coverage provided through a student health plan that is self-funded by a university (only for a plan year beginning on or before December 31, 2014, unless recognized as minimum essential coverage by HHS)
  • Catastrophic plans
Coverage under government-sponsored programs:

  • Medicare Part A coverage
  • Medicare Advantage plans
  • Most Medicaid coverage
  • Children’s Health Insurance Program (CHIP)
  • Most types of TRICARE coverage
  • Comprehensive health care programs offered by the Department of Veterans Affairs
  • State high-risk health insurance pools (only for a plan year beginning on or before December 31, 2014, unless recognized as minimum essential coverage by HHS)
  • Health coverage provided to Peace Corps volunteers
  • Department of Defense Nonappropriated Fund Health Benefits Program
  • Refugee Medical Assistance
Other coverage:

  • Certain foreign coverage
  • Certain coverage for business owners
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 these programs. See the instructions for Form 8965, Health Coverage Exemptions, for information on how to claim an exemption for one of these programs on your income tax return.

Doesn’t Qualify