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Question

What is minimum essential health care coverage?

Answer

Minimum essential coverage is defined in the Form 8965 instructions. Generally, minimum essential coverage is coverage under a government-sponsored program, an employer sponsored plan, a plan purchased in the individual market, or certain other coverage.

Government sponsored programs include Medicare, Medicaid, CHIP, TRICARE, health care under title 38 for veterans or under title 22 for Peace Corps volunteers, and the Nonappropriated Fund Health Benefits Program of the Department of the Defense.

An eligible employer-sponsored plan is a group health plan or group health insurance coverage offered by an employer to an employee. This includes grandfathered health plans offered in a group market.

Other coverage includes state health benefits risk pools recognized by the Secretary of Health and Human Services.

For further details, refer to IRS Publication 974.

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