1. Home
  2. Health
  3. Health Insurance

Creditable Coverage

From Kelly Montgomery, for About.com

Updated: May 28, 2008

About.com Health's Disease and Condition content is reviewed by our Medical Review Board

Definition: Creditable coverage is health insurance coverage that can be used to offset a preexisting condition exclusion period.

Let's say you get insurance through your job for 9 months, and then when you leave your job you immediately purchase an individual policy that has a preexisting condition exclusion period of 12 months. In this case, you can use your 9 months of prior creditable coverage to shorten your preexisting condition exclusion period to 3 months. If your prior creditable coverage had been longer than 12 months, you would not have had to wait through a preexisting condition exclusion period at all.

You will lose all of your creditable coverage if you have a lapse in coverage of 63 days or more - which is why it is to your advantage to stay continuously covered. In the example above, if you left your job but waited 4 months before buying your individual policy, you would have to wait through the entire 12 month preexisting condition exclusion period no matter how many months of creditable coverage you had.

Federal law states that almost all kinds of health insurance coverage are creditable, including group health coverage, individual policies, HMOs, Medicare, and Medicaid. Health plans that only cover specific medical conditions like cancer are not creditable.

Explore Health Insurance
About.com Special Features

Learn how you can reduce your your numbers with these nutrition and exercise tips. More >

Keep yourself, and your family, happy and healthy this fall with these tips. More >

We comply with the HONcode standard for trustworthy health information: verify here.
  1. Home
  2. Health
  3. Health Insurance
  4. Glossary
  5. Creditable Coverage

©2009 About.com, a part of The New York Times Company.

All rights reserved.