ACA Health Reforms: MEC & Individuals

MEC is often deemed parallel to EHB or essential health benefits, which is actually the most basic of health coverage types accumulated from around ten categories including hospital care, newborn & maternity care, ambulatory services and many others, including rehabilitation. The individual shared responsibility mandate says that each person should have the MEC amount of coverage or face tax penalties. These penalties are likely to be charged on a per month basis or at the end of year when filing the taxes.
Not Having MEC: Understand Repercussions There is a chance that an individual cannot afford minimum essential coverage. Under such circumstances, cooperation can be expected from the IRS. The department regularly works with people who cannot afford payment for their MEC benefits. In such cases, the person cannot be held in contempt of violating the individual shared responsibility mandate. He is sure to be exempted from the financial penalties. However, the individual should be able to establish that there was no way of ensuring MEC under coverage from a spouse, family member or dependent and that the wages or earnings were insufficient to finance a health plan individually.
The individual shared responsibility provision has been mandated under the Affordable Care Act. It is part of a mandate that distributes responsibility of ensuring universal and affordable insurance across employers, employees, insurers, individuals and governments. The idea is to spread the responsibility of affordable and qualitative healthcare coverage across the nation. Penalties for not having MEC despite the opportunity to avail a health plan or coverage like an employer’s health plan will be levied from 2014 onwards.
The individual shared responsibility provision is applicable to individuals of all ages, including young adults below the age of 26 and even children. All dependents who have adults as family members or caretakers invariably hand over the responsibility of ensuring MEC to the adults who are liable to get penalized.
HHS or the Department of Health and Human Services has the authority to promote other types of health insurance coverage as equivalent to MEC. Very few exemptions to the MEC have been accepted by the HHS. These include:• Religious Reasons—the Social Security Administration recognizes sects where acceptance of insurance coverage is in direct conflict with religious beliefs• Healthcare Ministry—certain members from recognized healthcare sharing ministries might be excused from purchasing MEC.
MEC refers to any form of health coverage that offers insurance for availing basic health services. This does not include vision, dental, severe disability or worker’s compensation. MEC can be availed from employer-sponsored coverage such as COBRA or retiree coverage. Coverage bought individually from the private health exchange marketplace or the public exchanges and also Medicare and Medicare advantage plans. Other valid forms of MEC include CHIP and Medicaid coverage and certain types of veteran’s health coverage. TRICARE is also qualified to be treated as MEC.