42 U.S.C. § 18021
Qualified health plan defined
United States · Title 42 — THE PUBLIC HEALTH AND WELFARE · Status: effective
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- Citation
- 42 U.S.C. § 18021, Qualified health plan defined, United States, version 1 as recorded 2026-07-09, yourstate.us, https://yourstate.us/provision/484635
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Full text
In this title: 11 See References in Text note below.
The term “qualified health plan” means a health plan that—
is offered by a health insurance issuer that—
Any reference in this title 1 to a qualified health plan shall be deemed to include a qualified health plan offered through the CO–OP program under section 18042 of this title, and a multi-State plan under section 18054 of this title, unless specifically provided for otherwise.
The Secretary of Health and Human Services shall permit a qualified health plan to provide coverage through a qualified direct primary care medical home plan that meets criteria established by the Secretary, so long as the qualified health plan meets all requirements that are otherwise applicable and the services covered by the medical home plan are coordinated with the entity offering the qualified health plan.
A qualified health plan, including a multi-State qualified health plan, may as appropriate vary premiums by rating area (as defined in section 300gg(a)(2) of this title).
In this title: 1
The term “health plan” means health insurance coverage and a group health plan.
Except to the extent specifically provided by this title,1 the term “health plan” shall not include a group health plan or multiple employer welfare arrangement to the extent the plan or arrangement is not subject to State insurance regulation under section 1144 of title 29.
The terms “health insurance coverage” and “health insurance issuer” have the meanings given such terms by section 300gg–91(b) of this title.
The term “group health plan” has the meaning given such term by section 300gg–91(a) of this title.
Legislative history
The public laws that enacted or amended this section. Tallies are for the whole bill as it passed each chamber — often an omnibus covering far more than this provision — not a vote on this section alone.
- Patient Protection and Affordable Care Act