Minimum Essential Coverage Guidance

Bookmark and Share

This letter provides guidance on the types of Medicaid coverage that qualify as minimum essential coverage (MEC), which includes certain coverage for low-income pregnant women, coverage for medically needy individuals, and coverage under an 1115 waiver program. This letter also clarifies how other Medicaid and CHIP coverage is regarded as MEC, and discusses related federal guidance issued by the Internal Revenue Service (IRS) to ensure pregnant women are not adversely impacted by a decision either to recognize or to not recognize certain coverage as MEC. Finally, this letter discusses hardship exemptions and the availability of special enrollment periods for individuals enrolled in Medicaid coverage that is not MEC.

Resource Details

Date: Dec 2014
Author: Centers for Medicare and Medicaid Services