Wednesday, April 2, 2014

How do I know if my health plan meets federal requirements?

More than half a million people enrolled for coverage through our state’s exchange, Washington Healthplanfinder, before the 2014 enrollment ended (for most people) on March 31. Now the question consumers are asking is whether their plans meet federal requirements and therefore exempt them from paying the tax penalty for people who lack health insurance. You can read more about the tax penalty and exemptions to it on our March 28 blog post.

The Affordable Care Act requires people to have a plan that includes “minimum essential coverage.” The following types of plans meet that requirement:
  • Employer-sponsored health insurance, including self-insured plans, COBRA and retiree plans.
  • Plans purchased in the individual market, including a qualified health plan offered by Washington Healthplanfinder, our states’ health benefit exchange.
  • Medicare Part A coverage and Medicare Advantage plans.
  • Most Medicaid coverage.
  • Children's Health Insurance Program (CHIP).
  • Certain veterans health plans administered by the Veterans Administration.
  • Most types of TRICARE coverage for member of the military.
  • Coverage provided to Peace Corps volunteers.
  • Coverage under the Nonappropriated Fund Health Benefit Program.
  • Refugee Medical Assistance supported by the U.S. Administration for Children and Families.
  • Self-funded health coverage offered to college students for plan or policy years that began on or before Dec. 31, 2014 (for later plan or policy years, sponsors of these programs may apply to HHS to be recognized as minimum essential coverage).
  • State high-risk pools for plans or policy years that began on or before Dec. 31, 2014 (for later plan or policy years, sponsors of these program may apply to HHS to be recognized as minimum essential coverage).
  • Other coverage recognized by the Secretary of HHS as minimum essential coverage.
There are circumstances that allow people to enroll in or change their health plan during 2014, called a special enrollment. Find out if you qualify for a special enrollment.

If you have questions about whether your plan meets the minimum requirements, you can contact our Consumer Advocates at 800-562-6900 or online.