What is major medical insurance?
It's the common name for comprehensive health insurance that pays toward a broad range of care, from doctor visits to hospital stays, rather than a fixed amount or a short gap. For individual coverage today, that generally means a plan that follows ACA rules, like any Marketplace plan.
Is ACA-compliant insurance the same as major medical?
Usually that's what people mean. An ACA-compliant plan covers the essential health benefits, has an out-of-pocket maximum, can't put dollar limits on those benefits, and can't turn you down for your health history. Every Marketplace plan meets those rules, and some plans sold outside the Marketplace do too.
What is minimum essential coverage?
It's the federal term for coverage that meets the ACA requirement for having health insurance. Marketplace plans, job-based plans, and Medicaid and CHIP are examples. Short-term plans and coverage made only of excepted benefits don't count.
Is short-term health insurance major medical?
No. Federal rules keep short-term, limited-duration insurance separate from individual health insurance coverage, so ACA protections such as the essential health benefits don't apply to it. It may fit a short gap, but read its limits first.
Is there still a penalty for not having major medical coverage?
Not at the federal level. Starting with the 2019 plan year, the federal fee for not having coverage no longer applies. Losing qualifying coverage can still open a special enrollment period on the Marketplace.
Do I have to wait for open enrollment?
Not for every plan. A private plan (not from the Marketplace) can often be bought any time of year. Some private plans ask health questions, and approval is not guaranteed. Some may not cover care for health problems you had before you enrolled. Marketplace plans, and other plans that follow ACA rules, work differently. As of October 29, 2026, under current law, open enrollment for 2027 plans on HealthCare.gov runs from November 1, 2026, to January 15, 2027. To start coverage January 1, pick a plan by December 15. States that run their own Marketplace may set different dates, so check with your state's Marketplace. A federal appeal about these rules is pending (City of Columbus v. Kennedy, 4th Cir. No. 26-1938), with oral argument set for October 30, 2026, so confirm the dates before you enroll. Outside open enrollment, you need a special enrollment period, such as one after losing job-based coverage.
