TaxBandits Knowledge Base

What is Minimum Essential Coverage under ACA?

Minimum essential coverage is the minimum level of health insurance coverage that individuals must have in order to avoid paying the penalty under the individual mandate.

An example of minimum essential coverage under the ACA would be a plan that covers the ten essential health benefits, which include:

1. Outpatient care
2. Emergency services
3. Hospitalization
4. Maternity and newborn care
5. Mental health and substance abuse treatment
6. Prescription drugs
7. Rehabilitation and habilitation services and devices
8. Laboratory services
9. Preventive and wellness services and chronic disease management
10. Pediatric services, including oral and vision care for children.

Some examples of health insurance plans that provide minimum essential coverage under the ACA include:

• Employer-sponsored health plans
• Medicare and Medicaid
• Health insurance purchased on the individual market, including those purchased through the Health Insurance Marketplace.