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Individual Mandate - Minimum Essential Coverage

Today we will continue to address the requirement that individuals maintain health insurance, specifically the meaning of the term “minimum essential coverage.”

For purposes of the requirement that “applicable individuals” will have to maintain “minimum essential coverage” after 2013, the term “minimum essential coverage” will mean coverage under any of the following:

  • Medicare program under Part A of Title XVIII of the Social Security Act

  • Medicaid program under Title XIX of the Social Security Act

  • CHIP (Children's Health Insurance Program) program under Title XXI of the Social Security Act

  • TRICARE for Life program (TRICARE is the health care program serving active duty service members, National Guard and Reserve members, retirees, their families, survivors and certain former spouses; TRICARE for Life is TRICARE's Medicare-wraparound coverage available to all Medicare-eligible TRICARE beneficiaries)

  • Veteran's health care program under Chapter 17 of Title 38 of the United States Code

  • Health plan under Section 2504(e) of Title 22 of the United States Code (relating to Peace Corps volunteers)

  • Coverage under an eligible employer-sponsored plan

  • Coverage under a health plan offered in the individual market within a state

  • Coverage under a grandfathered health plan

  • Any other health benefits coverage, such as a state health benefits risk pool, which the Secretary of Health and Human Services, in coordination with IRS, recognizes for purposes of the definition of “minimum essential coverage”

Disclaimer: The items included in the Tax Tip Tuesday Video Blog are informational only and are not meant as tax advice. Consult with your tax advisor to determine how any item applies to your situation. IRS Circular 230 disclosure: To ensure compliance with requirements imposed by the IRS, we inform you that any U.S. federal tax advise contained in this communication (including any attachments) is not intended or written to be used, and cannot be used, for the purpose of (i) avoiding penalties under the Internal Revenue Code or (ii) promoting, marketing or recommending to another party any transaction or matter addressed herein.

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