Qualifying Health Coverage

Qualifying Health Coverage

Tue, 04/17/2018 - 15:37

Qualifying health coverage is easily confused with the term Qualified Health Plan.  They are related but not the same.

♦ Any health insurance that meets the Affordable Care Act requirement for having coverage would be called qualified health coverage.

The Affordable Care Act require everyone to have at least qualified health coverage or pay a penalty.

• To satisfy this requirement it is possible to have coverage that provides only minimum essential coverage (MEC).

Such plans provide a lower level of protection then the plans sold through the Marketplace.

♦ Marketplace plans will be Qualified Health Plans. All Qualified Health Plans must provide Essential Health Benefits

Essential health benefits consist of a set of 10 categories of health care services that Marketplace plans must cover.

Examples of qualified health coverage

• Job-based plans

• Health Insurance Marketplace plans

• Most individual plans bought outside the Marketplace

• Medicare

• Medicaid

• The Children's Health Insurance Program (CHIP)



• Plans sold through the Small Business Health Insurance Program (SHOP) Marketplace

Related content

Minimum Essential Coverage