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Creditable Coverage 101

What Do I Do With The Certificate When I Get It?

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Generally, you need to present the Certificate Of Coverage to the new insurance company as proof that you are eligible for the HIPAA benefits.

To avoid a new Pre-Existing Conditions Waiting Period.

Call the new employer's insurance company. Tell them that you have a Certificate of Creditable Coverage and want to send it to them so they will waive the Pre-Existing Conditions Waiting Period. Ask for a name and mailing address. Send it in a manner that provides proof of receipt (such as registered mail, return, receipt requested or via an overnight service.) Include a cover letter which:

  • Identifies you and your employer.
  • States you are enclosing a Certificate of Creditable Coverage.
  • Mention the number of months covered by the Certificate.
  • Includes a telephone number in case the company has to contact you.

To obtain individual coverage due to HIPAA.

Present the Certificate of Creditable Coverage to the insurance company providing the individual policy. A reminder: You must start the new coverage within 63 days of the old coverage terminating for the full HIPAA protections to apply.


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