What Is a HIPAA Certificate of Creditable Coverage?
If you lose or terminate your health insurance coverage, the Health Insurance Portability and Accountability Act requires your former insurer to provide you with written documentation of your insurance coverage.
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HIPAA
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The Health Insurance Portability and Accountability Act is a federal law that protects the rights of individuals who lose their group insurance coverage and mandates certain processes for health care providers and employers.
Pre-existing Conditions
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Under HIPAA, health insurers are limited as how they exclude coverage for pre-existing conditions. If an enrollee had health insurance coverage without a significant break prior to enrollment in a health plan, pre-existing condition exemptions cannot be applied. New enrollees in insurance programs can prove this coverage with a certificate of creditable coverage.
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Certificate of Creditable Coverage
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A certificate of creditable coverage documents your previous health insurance coverage. The certificate will include the dates during which you had health coverage through a particular insurer.
Insurance Company Responsibility
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Insurance companies are required by law to provide you with a certificate of continuous coverage when your coverage ends. If you lose your certificate, you may request another within 24 months of your end of coverage.
Alternate Documentation
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If you have misplaced or do not have access to your certificate of creditable coverage, you may be able to use other documents to prove that you had health care coverage for a given period of time. These documents may include pay stubs showing premium deductions, copies of your premium payments or some form of verification from your doctor or your previous insurer.
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References
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