Any prior health insurance coverage that a person has received. Creditable coverage is used to decrease exclusion periods for pre-existing conditions when an individual switches insurance plans. Insurers cannot exclude coverage of pre-existing conditions, but may impose an exclusion period (no more than 12 months) before covering such conditions. (See also, Health Insurance Portability and Accountability Act)
with respect to an individual, coverage of the individual under any of the following: 1. a group health plan; 2. Health Insurance Coverage; 3. Medicare; 4. Medicaid; 5. Title 10 United States Code Chapter 55 (i.e. medical and dental care for members and certain former members of the uniformed forces and their dependents); 6. a medical care program of the Indian Health Service or of a tribal organization; 7. a state health benefits risk pool; 8. a health plan offered under chapter 89 of title 5. United States Code (the Federal Employee Health Benefits Program); 9. a public health plan (any plan established or maintained by state, county or other political subdivision of a state that provides Health Insurance Coverage); or 10. a health benefit plan under Section 5(e) of 22 United States Code 2504(e), the Peace Corps Act. Creditable Coverage does not include coverage consisting solely of those benefits excepted from the definition of Health Insurance coverage.
Credit for recent prior coverage towards any pre-existing condition exclusion period imposed by a new plan. Credit is on a day-for-day basis and recent coverage must have been within 63 days unless a longer period is allowed by state regulations.
this is the language used by CMS that a plan has comparable coverage ( actuarial equivalent) to Part D plans. Some plans offering creditable coverage may be through an employer, TriCare, or a union.
For purposes of the Health Insurance Portability and Accountability Act (HIPAA), when moving to a new group health plan, if an insured has had coverage under another qualifying group or individual health plan -- without a lapse in coverage of 63 days or more -- this coverage can be honored by the new plan for the purpose of satisfying all or a portion of the pre-existing condition waiting period.
The period of time a covered person was covered by a health plan or insurance contract defined as creditable coverage in the provisions of the Health Insurance Portability and Accountability Act of 1996. Common health plans and insurance contracts providing creditable coverage include: Employer Group Health Insurance, Individual Comprehensive Health Insurance, Medicare, Medicaid, CHAMPUS, and a State Health Benefits Risk Pool. Any continuous sixty-three (63) day period during which the covered person was not covered will start a new period of creditable coverage.
Prescription drug coverage from a retiree or union plan that on average provides coverage at least as good as a standard Medicare drug plan. If you are currently enrolled in a drug plan that gives you prescription drug coverage, your plan will tell you if it meets the Medicare standards for creditable coverage. See late enrollment fee.
Health insurance coverage under any of the following: a group health plan; individual health insurance; Medicare; MassHealth; CHAMPUS and TRICARE (health coverage for military personnel, retirees, and dependents); the Federal Employees Health Benefits Program; Indian Health Service; the Peace Corps; or a state health insurance high risk pool. See also Continuous Coverage, Group Health Plan, Individual Health Insurance.
Coverage that is as good as or better than the standard Medicare prescription drug coverage.
Coverage that’s, on average, at least as good as the coverage offered in a Medicare Prescription Drug Plan.
Prescription drug coverage from an insurance plan other than Medicare Part D (e.g., union or employer health coverage for retirees) that pays out as much or more than Medicare's standard Part D prescription drug coverage. If someone has creditable coverage, they will be notified in writing by their plan provider.
The period of an individual's coverage under a Group Health Plan, health insurance, Medicare of any one of several other specified health plans or health insurance sources that is not interrupted by a 63 day break in coverage.
Coverage that is at least as good as the standard Medicare prescription drug coverage.
Any health insurance coverage you had within 63 days of securing a new insurance policy that can be used to shorten the waiting period for pre-existing conditions.
Coverage of a Member under the Plan.
Any previous health insurance coverage that can be used to shorten the pre-existing condition waiting period.
Coverage of an individual is considered creditable coverage if it's under any of the following: individual or group health insurance, a self-funded ERISA group health plan, Part A or B of Medicare, Medicaid, CHAMPUS, an Indian Health Service program or of a tribal organization, a state health benefits risk pool, the Federal Employees Health Benefits Program, a public health plan, or the Peace Corps Act.
The number of months you were covered by health insurance before your current or new policy took effect. Creditable coverage must count towards any preexisting condition exclusion in either an individual or group policy. This is also referred to as "prior qualifying cverage."
Coverage that is at least as good as that offered through Medicare Part D. Your health coverage plan can tell you whether or not your coverage is creditable.
Prescription drug coverage, from a plan other than a Part D plan, which meets certain Medicare standards. If you are currently enrolled in a drug plan that gives you prescription drug coverage, your plan will tell you if it meets the Medicare standards for creditable coverage. See late enrollment fee.
Is health coverage that you had in the past that gives you certain rights when you apply for new coverage.
Certain kinds of previous health insurance coverage that can be used to shorten a pre-existing condition waiting period under a Medigap policy. (See pre-existing conditions.)
Under HIPAA, creditable coverage is prior health coverage that allows you to reduce pre-existing condition exclusionary periods when applying for new coverage. Most forms of health coverage can count as creditable.
(South Dakota only) Coverage through an individual or employer-sponsored health plan with benefits equal to or greater than the Basic plan, Medicare or Medicaid, TriCare (formerly CHAMPUS), Indian Health Service (or tribal organization), state health benefits risk pool, FEP, a public health or church plan, or a college plan that is not a limited benefit plan. Creditable coverage does not include limited benefit plans, dread disease plans, or short-term major medical if it is the coverage immediately prior to the effective date of the Basic or Standard coverage.
For purposes of the Health Insurance Portability and Accountability Act (HIPAA) in the United States, coverage of an individual under a group health plan or other specified health insurance coverage without a lapse of 63 days or more.