• A government-sponsored program, such as coverage under the Medicare or Medicaid programs, CHIP, TRICARE and certain types of Veterans health coverage
• An eligible employer-sponsored plan (including COBRA and retiree coverage), defined as any plan offered by an employer to an employee which is a governmental plan or a plan or coverage offered in the small or large group market within a state (a self-funded plan can also qualify as an eligible employer-sponsored plan)
• A health plan purchased in the individual market
• A grandfathered health plan
MEC also includes any additional types of coverage that are designated by HHS or when the sponsor of the coverage follows a process to be recognized as MEC. HHS has designated the following other types of coverage as MEC:
• Self-funded student health coverage and state high risk pools for plan or policy years that begin on or before Dec. 31, 2014 (for plan or policy years that begin after Dec. 31, 2014, sponsors of self-funded student health plans and state high risk pools may apply to be recognized as MEC)
• Refugee Medical Assistance supported by the Administration for Children and Families
• Medicare Advantage plans
MEC excludes any coverage, whether insurance or otherwise, that consists solely of excepted benefits (as defined by HIPAA). MEC does not include specialized coverage, such as coverage only for vision or dental care, workers’ compensation, disability policies or coverage only for a specific disease or condition.
