Minimum Essential Coverage (MEC)

Submit a copy of one of the following documents.

1. Certificate of coverage or letter from the health plan issuer showing the end date of coverage.
2. Government-issued document showing date of termination of coverage or ineligibility to program.
3. Employer statement indicating no offer of affordable minimum value employer-sponsored coverage.
4. Self-attestation, where the individual is unable to provide any of the above documents.

To show lack of Medicare eligibility or enrollment:

1. Letter or statement from Medicare or the Social Security Administration stating that you or your family members are:
   • Not eligible for or enrolled in premium-free Medicare Part A; or
   • Eligible for (but not enrolled in) Part A coverage that requires premium payments. Important: A Social Security document that shows you don’t pay a premium for “Medical Insurance” refers to Part B. It’s not acceptable for verifying eligibility for Part A; or
   • No longer eligible for Social Security Disability Insurance (SSDI) benefits, and your coverage has ended or will end in the next 90 days.
2. If you are unable to obtain this letter, you may complete and submit an Attestation of Medicare Eligibility and Enrollment Status form.