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What is the individual mandate, and does that mean consumers must buy coverage through the Health Insurance Marketplace?


Under the ACA, starting January 1, 2014, consumers and their dependent children are required to have "minimum essential coverage" or pay a penalty, unless they fit within an exemption. This requirement is commonly known as the "individual mandate."

Consumers may buy a plan through the Health Insurance Marketplace to satisfy the individual mandate, but they don't have to. Other forms of health coverage that satisfy the requirement to have "minimum essential coverage" include most employer-sponsored plans, union plans, and enrollment in a government program such as Medicare, Medicaid, TRICARE, or CHIP. Consumers can continue to use agents to buy insurance available in the market outside the exchange.

Some examples of health plans that do not meet the requirement of minimum essential coverage and do not satisfy the individual mandate requirement to have basic health care coverage are plans that cover only specialty or ancillary services (for example, hearing, chiropractic, etc.).

Check the healthcare.gov website for more information.

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