What does "qualified health plan" mean?
A qualified health plan is a health insurance policy that meets criteria outlined by the Affordable Care Act (ACA). This criteria requires plans to provide essential health benefits, such as preventive care and limits on out-of-pocket spending. (You can read more about the types of benefits here.)
Importantly, all health plans purchased through the marketplace (sometimes referred to as the health insurance exchange) comply with ACA criteria and therefore are qualified health plans. That means they are also "approved" to receive the StretchDollar premium reimbursement health benefit that your employer offers. So the easiest way to know your plan is qualified is to enroll through the marketplace!
There are also a few more types of qualified health plans (in addition to marketplace plans) that qualify for StretchDollar reimbursement benefits.
This includes:
- Medicare
- Medicare Parts A and B (you must be enrolled in both A & B to qualify); or
- Medicare Part C
- Student health insurance plans
- Catastrophic plans (limited to those under 30 yrs old who qualify for hardship exemption)
What types of plans are not qualified health plans?
Plans that are not qualified health plans are not eligible to be reimbursed with StretchDollar benefit dollars.
These types of health plans include:
- Health sharing ministries
- Tricare
- Self-insured student health plans
- Association health plans
- COBRA
- Short-term limited duration plans