Definitions for "Creditable Coverage"
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.