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University of Illinois Extension

What is Minimum Essential Coverage?

What is Minimum Essential Coverage?

Under the Affordable Care Act, minimum essential coverage began on January 1, 2014. It is a shared responsibility provision and applies to individuals of all ages, including children, in the United States. Each individual are required to:

  1. have minimum essential health coverage for each month of 2014;
  2. make a payment when filing his or her federal income tax return, or
  3. qualify for an exemption.

Minimum essential coverage includes the Affordable Health Care individual market policies, job-based coverage, Medicare, Medicaid, CHIP, TRICARE and certain other coverage. Many individuals with job-based health coverage have policies that are already recognized as minimum essential coverage and will not need to do anything more than continue their existing coverage.

An adult or married couple who claim a child or children as dependents on their federal income tax is responsible for making the payment if the child or children do not have coverage or qualify for an exemption.

Exemptions follow:

  • Religious conscience with members of a sect opposed to accepting any insurance benefits, as administered by the Social Security Administration;
  • Health care sharing ministry;
  • Federally recognized Indian tribes;
  • Income below the minimum threshold for filing a tax return;
  • Hardship as defined in regulations issued by the Department of Health and Human Services;
  • Lack of health insurance was less than three consecutive months during the year but only applies to the first gap in coverage if there is more than one in a year;
  • Insurance premiums are more than 8% of household income;
  • Incarceration.


This is a guest post by Jenny Garner, Community and Economic Development Educator.

Posted by Chelsey Byers Gerstenecker at 8:44 AM | Permalink
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