Access to Coverage

What is Minimum Essential Coverage, and why is it important?

Minimum Essential Coverage (MEC) refers to any health insurance plan that meets Affordable Care Act (ACA) standards. This would also be considered a “qualified health plan.” Types of MEC include:

• Health insurance offered through an employer (also known as Employer Sponsored Insurance)
• Health plans offered through HealthSource RI
• Government-sponsored insurance

• • • Medicaid
    • Children’s Health Insurance Program (CHIP)
    • Medicare Part A that does not require paying a ‘Part A’ premium
    • Medicare Part C (Medicare Advantage Plans)
    • CHIP
    • TRICARE
    • Veteran’s Health Coverage
    • Student Health plans
  • Other coverage that is recognized as MEC by the Secretary of Health and Human Services, including foreign health coverage and self-funded student health coverage

MEC does not include:

• Vision-only coverage
• Workers’ compensation
• Dental-only coverage
• Plans offering only discounted healthcare services

Individuals must attest whether they have access to other forms of Minimum Essential Coverage in order for HealthSource RI to determine whether they are eligible to purchase a plan through the exchange or receive financial assistance in the form of Advanced Premium Tax Credits (APTCs) and Cost-Sharing Reduction (CSR) plans offered through the exchange. If a household member is covered or has access to other Minimum Essential Coverage (MEC), it must be reported in the application. Individuals that attest to being enrolled or having access to MEC will become ineligible for APTCs/CSRs. If the individual is already enrolled and reporting MEC, eligibility will be updated going forward but they will not be disenrolled.

You can submit one of the documents below to prove that you do NOT have access to minimum essential coverage (MEC):

• Letter from health insurer including coverage termination date
• Statement of health benefits that provides confirmation of health coverage and expiration dates
• Letter from Veterans Administration that provides clarification of scope of access to coverage, confirmation of health coverage with and expiration dates
• Letter from Peace Corps or AmeriCorps that provides clarification of scope of access to coverage, confirmation of health coverage and expiration date or that provides clarification of scope of access to coverage
• Letter or statement of Medicare or Medicaid benefits that proves clarification of scope of access to coverage, confirmation of health coverage and expiration dates
• Letter or statement of Medicaid or Children’s Health Insurance Program (CHIP) benefits that provides clarification of scope of access to coverage, proves confirmation of health coverage and expiration dates

If you are unable to obtain any of the above documents, you may fill out this form to attest that you have no access to other health coverage.