Minimum Essential Coverage & 10 Essential Benefits

Affordable Care Act

Minimum Essential Coverage & 10 Essential Benefits

Published on February 27, 2018

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Under the Affordable Care Act, major medical health insurance plans and qualified health plans (QHPs) must meet  Minimum Essential Coverage Standards, which generally means they must:

  1. Have an “Actuarial Value” of 60% or more
  2. Cover 10 Essential Health Benefits

The individual mandate (which requires most Americans to carry a minimum level of health coverage) is still in effect for 2018 even after its repeal in the GOP’s tax bill.
As of right now, the individual mandate will no longer be in effect in 2019, so failing to be insured with an Obamacare plan that meets all minimum essential coverage standards will no longer result in a tax penalty.

Read on to understand more about the Affordable Care Act’s Minimum Essential Coverage Standards since they are still relevant to the individual mandate in 2018.
What is an actuarial value?
 

10 Essential Benefits

All major medical plans, including qualified health plans must cover 10 mandatory benefits, as explained in this video:
https://ehealth.wistia.com/medias/rcfbz8jd75?embedType=async&videoFoam=true&videoWidth=640
What's covered by Qualified Health Plans

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