Creditable Coverage 101

If you want to move from one employer to another

HIPAA does not require that your new employer offer you health insurance. It merely provides what happens if the new employer with 2 or more employees offers health insurance to people in a position similar to yours.

If your new employer would normally offer health insurance to someone in your position, the employer cannot refuse to give it to you because of your medical history or current medical condition. 

The amount of time you had Creditable Coverage can be applied to the Pre-Existing Conditions Waiting Period of your new employer's health insurance. (See HIPAA- Pre-Existing Conditions and HIPAA- Portability.)

If you want to leave your employer and obtain individual coverage

By having a history of Creditable Coverage for at least 18 months, the last day of which was group insurance or group insurance extended under COBRA, you have the right under HIPAA to purchase an individual health insurance plan.

Which plan you can purchase depends on the state in which you reside. In some states your only right is to purchase coverage from a state plan. In the others, you have the right to purchase insurance from any insurance company offering health insurance in your state upon losing the group coverage. To learn more, see: Obtaining Health Insurance.)

HIPAA does not guarantee you the right to purchase an individual policy:

• if you already have other health insurance including Medicare or Medicaid or if you are eligible for Medicare or Medicaid.
• If you are leaving another individual health insurance plan. For example, if you are leaving one state in which you have your own HMO coverage, HIPAA does not guarantee you the right to purchase health insurance in another state. If you need coverage in this circumstance, see Obtaining Health Insurance.

Please share how this information is useful to you. 0 Comments