What are the requirements for Massachusetts insurance plans to meet the Minimum Creditable Coverage (MCC) standards?
Definition TheMinimum Creditable Coverage (MCC)is the minimum level of benefits adults who file taxes in Massachusetts need to have in order to avoid penalties. Measuring Compliance To be compliant, insurance plans in Massachusetts need the following: Coverage for a comprehensive set of services (e.g. doctor visits, hospital admissions, day surgery, emergency services, mental health and […]
Definition
TheMinimum Creditable Coverage (MCC)is the minimum level of benefits adults who file taxes in Massachusetts need to have in order to avoid penalties.
Measuring Compliance
To be compliant, insurance plans in Massachusetts need the following:
- Coverage for a comprehensive set of services (e.g. doctor visits, hospital admissions, day surgery, emergency services, mental health and substance abuse, and prescription drug coverage)
- Coverage of doctor visits for preventive care, without a deductible
- A cap on annual deductibles of $2,000 for an individual and $4,000 for a family
- For plans with up-front deductibles or co-insurance on core services, an annual maximum on out-of-pocket spending of no more than the annual limit set by the IRS for high-deductible health plans. In 2015, out-of-pocket costs are limited to $6,600 for an individual plan and $13,200 for a family plan.
- No caps on total benefits for a particular illness or for a single year
- No policy that covers only a fixed dollar amount per day or stay in the hospital, with the patient responsible for all other charges
- For policies that have a separate prescription drug deductible, it can’t exceed $250 for an individual or $500 for a family
Forms
In order to prove that individuals have met MCC,Form MA 1099-HCneeds to be filled out and filed.
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