Minimum Creditable Coverage

Minimum Creditable Coverage 2017-12-22T16:13:13+00:00

Minimum Creditable Coverage (MCC) is the essential benefits you need to be considered insured and avoid tax penalties. Health insurers licensed in Massachusetts must let consumers know if their plans meet these standards. Look for a notice on the front of your plan documents.

People enrolled in out-of-state plans or their employer’s “self-insured” plan should contact their employer or insurer.

Types of Coverage That Automatically Meet MCC

  • Medicare Part A
  • Any ConnectorCare plan
  • Any Health Connector plan
  • MassHealth, except MassHealth Limited
  • A Catastrophic Health Plan
  • A Student Health Insurance Plan (SHIP)
  • A tribal or Indian Health Service plan
  • TRICARE
  • The U.S. Veterans Administration Health System
  • Pre-Existing Condition Insurance Plan (PCIP)
  • Peace Corps, VISTA, or AmeriCorps or National Civilian Community Corps coverage
  • Any health arrangement provided by established religious organizations comprised of individuals with sincerely held beliefs

 

MCC Requirements for All Other Plans

A plan must cover a broad range of medical services, limit a subscriber’s out-of-pocket costs, and impose no limits on certain benefits. Please read the specific MCC requirements (PDF).

 

MCC Certification for Employers, Unions, Plan Sponsors and Insurers

Employers, unions, plan sponsors, and insurers can apply for MCC Certification if they have a comprehensive plan that does not quite meet all MCC requirements. They must identify how the plan deviates from the MCC standards. The relative value of the benefits should be at least comparable to a Bronze-level Health Connector, Qualified Health Plan. The MCC Resources box at top right has the documents you need to apply for MCC Certification. You must call 617-933-3030 if you plan to file 50 or more applications.

 Download the 2017 MCC Certification Application →

Important Note: There has been a decrease in the out-of-pocket requirements for 2017.

*A note on High Deductible Health Plans (HDHPs) – PDF

 

MCC Exemptions for Massachusetts Residents

You can get an exemption if Minimum Creditable Coverage is not affordable for you. The Health Connector has an Affordability Information Sheet to help you see if you might be exempt from the penalties.

Exemptions are determined through your state income tax filings. The tax forms also provide an option to appeal any penalties. If you refuse health insurance due to a sincerely held religious belief, you may also claim an exemption on your state tax forms.

The Health Connector also offers Certificates of Exemption if you face special circumstances or hardships. See the next section, below, for more information.

 

Certificate of Exemption

If you face a special financial hardship, the state’s tax forms give you an option to appeal the penalties for remaining uninsured. In addition, the Health Connector offers a Certificate of Exemption for individuals who can provide information about the 2017 tax year before it ends.

 If you missed the December 1, 2017 deadline to apply for an exemption for 2017 when filing your taxes, remember you will also have the opportunity to request an exemption on your 2017 Massachusetts tax return. To learn more about the Federal exemption, visit HealthCare.gov.

 

Interaction with the Federal Health Care Shared Responsibility Payment

The Affordable Care Act instituted a federal mandate on individuals to obtain health insurance. If a nonexempt individual fails to obtain health insurance meeting federal standards, the person is liable for a “shared responsibility payment” that must be reported on his or her federal income tax return. You can also visit the IRS website at IRS page on Affordable Care Act Tax Provisions →

Please note that national health care reform also requires most adults and children to have health insurance.  For more information about the federal requirements and exemption process, go to HealthCare.gov.

Go to HealthCare.gov to learn more about the federal exemption process →

 

Additional Questions?

Please call Customer Service at 1-877-MA-ENROLL (1-877-623-6765), TTY 1-877-623-7773 and choose from the available options.

Related Resources

Two concepts form the basis of the exemptions process:

  • “Minimum Creditable Coverage” – the essential health insurance benefits you need to avoid tax penalties in Massachusetts
  • “Affordability” – the cost of the essential health insurance benefits. Based on that cost, your income, the health insurance options available to you, or a special hardship, you may be exempt from the tax penalties.Use our Affordability Tool to predict your penalty risk. An official penalty determination will come later, when you file your 2014 state tax return.
 Download the 2017 Affordability Schedule (PDF)

The 2017 Affordability Tool is coming soon