Questions & Answers

What is California Minimum Essential Coverage?

California has a new health insurance mandate that took effect on January 1, 2020.This new law is very similar to the Affordable Care Act. California minimum essential coverage is the type of coverage that meets the California health insurance mandate's requirement.

This includes:
  • Employer-sponsored plans, including COBRA and retiree coverage
  • Individual health coverage
  • Marketplace insurance from or a Covered CA plan
  • Individual and family plans
  • Individual grandfathered plans - Insurance plans purchased before 3/22/2010 may have been grandfathered in to qualify as CA minimum essential coverage
  • Medicare Part A and Medicare Advantage plans
  • Medicaid or Medi-Cal
  • CHIP, TRICARE, veterans health care programs, Peace Corps Volunteer plans, Refugee Medical Assitance and Student Health Plans
Other plans may also qualify. Your health coverage provider should be able to let you know if your plan qualifies.

Health plans that don't meet minimum essential coverage don't qualify as coverage. If you have only these types of coverage, you may have to pay the fee. Examples include:
Medicare Part B without Part A, coverage only for vision care or dental care, workers' compensation, coverage only for a specific disease or condition, or plans that offer only discounts on medical services.

Note: Even if you had the opportunity to enroll in coverage offered by your employer that would otherwise qualify as minimum essential coverage, the plan won't qualify for for California minimum essential coverage unless
  1. the plan is affordable and
  2. the coverage provides minimum value.

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