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powered by health insurance experts.

Q: Does Medicare Count as Minimum Essential Coverage?

Asked by Anonymous on October 13, 2017

Hal Levy October 13, 2017

Medicare Part A counts as minimum essential coverage. Under the Affordable Care Act, all taxpayers need to be enrolled in a plan that qualifies as minimum essential coverage (MEC). Such plans cover at least 60 percent of average medical costs and provide 10 essential health benefits, including preventative care, ambulatory and pediatric services.

If you’re a Medicare beneficiary, you almost certainly have minimum essential coverage. If you didn’t have MEC, you’d still owe a tax penalty of $695 or 2 percent of your income – whichever is higher – for being uninsured.

Even after you turn 65, you’re still responsible for maintaining minimum essential coverage. Having MEC is like buying car insurance. Even if your coverage is limited, you’ll have protection for basic and common needs.

Medicare Coverage Meets Minimum Essential Coverage in These Situations

You meet the MEC requirement if you have any of the following:

If Medicare is the secondary payer for your health claims because your primary payer is a private insurance plan, VA care, retiree insurance, or a COBRA plan, then you also have minimum essential coverage. If your plan qualified as minimum essential coverage before you enrolled in Medicare, it will continue to count as such.

If you only have Medicare Part B, then you do not have minimum essential coverage from Medicare.

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