1. Health

Creditable Coverage

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Updated January 05, 2010

Definition:

Creditable coverage is health insurance coverage you had before you enrolled in your new health plan, as long as it was not interrupted by a period of 63 or more days. The amount of time you had “credible” health insurance coverage can be used to offset a pre-existing condition exclusion period in your new health plan.

The bottom line: If you had at least a full year of health coverage at your previous job and you enrolled in your new health plan without a break of 63 days or more, your new health plan cannot subject you to the pre-existing condition exclusion.

More Information from Dr. Mike:

Examples:

Greg L. decided to change jobs for better promotion opportunities. He found a new job, which he started four weeks after resigning from his previous position. His new job offered similar health insurance and he enrolled in a family plan. Although Greg is in good health, his wife has type 2 diabetes and one of his children has asthma.

Greg had worked for his previous company for two years and had no health insurance coverage for four weeks (less than 63 days). In spite of pre-existing health conditions in his family, Greg’s health plan was not able to impose a pre-existing condition exclusion period.

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