Minimum Essential Coverage (MEC) Specifications

To qualify as Minimal Essential Coverage (MEC) with the Affordable Care Act, a health insurance plan must cover 10 essential health benefits:

  • Ambulatory patient services
  • Emergency services
  • Hospitalization
  • Maternity and newborn care
  • Mental health and substance abuse services including behavioral health treatment
  • Prescription drugs
  • Rehabilitative and habilitative services and devices
  • Laboratory services
  • Preventive and wellness services and chronic disease management
  • Pediatric services, including oral and vision care

QUALIFIES AS MEC DOES NOT QUALIFY AS MEC
Employer-sponsored coverage

  • Employee coverage
  • COBRA
  • Retiree coverage

Individual health insurance

  • Purchased from a health insurance company
  • Purchased through the Marketplace
  • Provided through a student health plan

Government-sponsored plans

  • Medicare
  • Most Medicaid
  • CHIP
  • Most TRICARE
  • Most VA
  • State high-risk insurance pools
  • Peace Corps
  • Refugee Medical Assistance
Single-benefit coverage

  • dental-only or vision-only plans

Accident or disability insurance

Workers’ compensation

AmeriCorps/AfterCorps coverage

Limited-benefit Medicaid

  • Family planning services
  • Tuberculosis treatment
  • Pregnancy-related
  • Emergency medical condition
  • 1115 demonstrations
  • Medically needy

Limited-benefit TRICARE

  • Space-available care
  • Line-of-duty care