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How to Find Qualifying Health Coverage

Meredith Miller | Published: June 14, 2018

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There are penalties charged if you do not have health insurance, but if you want to avoid them, then you should enroll for health coverage that you qualify for. Qualifying health insurance coverage, also called the Minimum Coverage Essential (MEC), includes coverage of several health care plans. Here are examples of qualifying health coverage plans:

Government Plans

The following Medicaid and Medicare health plans are considered qualifying health plans:

  • Medicare that offers affordable health insurance to the disable and those aged 65 and above 
  • Healthcare benefits for Veterans
  • Children’s Health Insurance Program (CHIP)
  • Tricare that covers military men and women and their families
  • Peace Corps volunteers' coverage

Health Insurance Coverage for Employers

The group health coverage plan offered to you by your employer is a minimum essential coverage. In case your family gets health coverage through your job, then you should have minimum essential coverage, which should include:

  • Coverage for retirees  
  • COBRA continuation coverage, which allows the former employees to hold on with the insurance cover for a given period after leaving the job 
  • Coverage for current employee students who get affordable health insurance coverage from their campuses while enrolled is also considered qualifying health coverage. They, therefore, do not make an overpay on health checkups or treatment in their institution’s hospital. 

Individual Plans

If you decide to buy a health insurance plan directly from a health care provider, then that health care is referred to an individual policy, which makes it different from the group coverage offered by the employers. It can also be referred to as a private health insurance, which is meant for a private individual, or a family.

  • An individual insurance plan taken before Obamacare became law and an insurance company allowed you to keep it, which protects you from an overpay on health treatments
  • Insurance plan coverage bought through the federal online insurance marketplace which was set under the Obamacare
  • Any other private health insurance you qualify for. You should confirm with your insurance company whether you have MEC.

Plans Not Considered Qualifying Health Coverage

Some plans do not qualify as minimum essential coverage though they look like traditional they may appear to be. These plans include:  

  • All Plans that are relisted under workers compensation plans
  • Those plans that provide coverage for a specific condition and not general medical coverage
  • All Plans that offer discounts on health care services

When Can One be Exempted?

If you do not have a minimum essential coverage, then you will have to pay the penalty when filing returns. However, some individuals or families are exempted; thereby, avoiding the fee. If you are lucky to be in this category, you can have a non-MEC coverage meaning that you will have no coverage at all. Some of the reasons that may make you exempted include:

  • The income you get is not enough to require filing returns
  • If you feel that you will make an overpay on health coverage given by the insurance providers, that is, more than 8 percent of your income  
  • You belong to a religious group that does not accept any form of insurance coverage
  • You have a financial hardship that makes you unable to pay premiums

Why Buy Health Insurance?

Health insurance coverage will protect you in an emergency. It offers you protection, especially in families where regular care is needed; otherwise, they would have to overpay on health checkups or treatment. A health insurance agent or broker works with a health care provider and reduces prices while finding you the best plan for your needs. If it were not for them, your medical bills would have been unaffordable. Ensure that you confirm with your health care provider if your cover is a minimum essential coverage.