Minimum essential coverage (MEC) is the phrase given to any insurance plan that meets the ACA requirements for having health coverage.  MEC is sometimes called ‘qualifying health coverage.’

Prior to 2019, failing to have MEC would result in a penalty.  This penalty no longer applies.

Most health insurance plans sold today are considered MEC, including all those purchased on the Marketplace.

What does MEC include? #

The ACA requires that all MEC plan include the following:

• Affordability.  The plan can not cost more than a set percentage of a person’s monthly income.  This percentage changes each year.  In 2025 it is 9.05%.
• Minimum value.  The plan must pay for at least 60% of covered benefits.
• Fair premiums.  The means that the insurance company cannot charge you too much for coverage, regardless of affordability.
• No exclusions.  Plans cannot exclude pre-existing conditions.
• No discriminations.  Plans cannot turn you away or charge you more based on your health status.
• No limits.  Plan cannot have an annual or lifetime coverage limit.
• Access to appeals.  You must have a way to appeal coverage decisions.
• Essential health benefits.  These are a set of services that must be covered by any plan.  You can read about these in detail here.

What types of plans are not considered MEC? #

Most of the health insurance plans offered through an employer, and all of the plans through the Marketplace, as well as most private health insurance options, are MEC.  There are insurance policies out there though that do not carry this label.  

Supplemental insurance, such as critical illness or accidental insurance, is not MEC.

Short-term medical insurance is not MEC because it is only temporary.

Limited benefit plans, such as disability or worker’s compensation, as well as plans that cover only specific conditions are all not considered MEC.