QUESTION

What types of Medicaid coverage are not considered minimum essential coverage?

Individuals with no coverage | Individual Responsibility Requirement (Individual Mandate)
ANSWER

In general, Medicaid coverage that does not offer comprehensive coverage or full Medicaid benefits is not considered minimum essential coverage. For example, a Medicaid program that only offers family planning services would not be considered minimum essential coverage. An exemption is available for the following types of Medicaid coverage that is not considered minimum essential coverage: pregnant women receiving pregnancy-only coverage or coverage through enrollment of an unborn child in CHIP, and medically needy coverage that is not comprehensive or offers full Medicaid benefits. (IRS, Notice 2014-71; CMS, SHO#14-002, Minimum Essential Coverage, Nov. 7, 2014).

Individuals with no coverage
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