Creditable Coverage 101

Basically, "Creditable Coverage"  is health  insurance coverage. It is a concept created by the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and is relevant in two instances:

• HIPAA provides that when you obtain health insurance from a new employer, you cannot be subjected to a waiting period during which your existing health condition will not be covered if you previously had what is referred to as "Creditable Coverage." 
• HIPAA also provides that if you lose your employer based health insurance you can convert to an individual health insurance policy.

In both instances, the protections are triggered by having a history of "Creditable Coverage." Proof of that history is contained in a Certificate of Creditable Coverage.

NOTE: If a new employer or insurer do not ask about prior coverage, submit the Certificate voluntarily. (We provide a sample cover letter.) It will save a time delaying hassle if you have a claim.

For additional information, see:

• General
  • What is Creditable Coverage?
  • How does Creditable Coverage benefit me?
  • How do I prove my Creditable Coverage?
  • What do I do with the Certificate when I get it?
• A Certificate of Creditable Coverage
  • How do I get a Certificate of Creditable Coverage?
  • What should be in a Certificate of Creditable Coverage?
  • When will I receive a Certificate of Creditable Coverage?
  • What if I don't receive a Certificate of Creditable Coverage?
• Frequently Asked Questions
  • What if I was with my last employer for less than 18 months?
  • What if my prior insurance wasn't as comprehensive as the new one?

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