Creditable Coverage

Q:  What is a certificate of creditable coverage?

When you end coverage on one insurance plan, you will receive a certificate you can present to the next plan. This shows you had prior coverage. If you have preexisting conditions, your next plan will look at your prior coverage before deciding whether to pay your claims.

 

Effective January 1, 2011, enrolled dependents under the age of 19 will no longer have pre-existing condition exclusions or require proof of prior coverage.

See Preexisting Conditions section.

 

Q:  My prior coverage is with a Christian group that helps to pay each other’s doctor bills. Does this count as creditable coverage?

No, voluntary sharing cooperatives are not qualified health insurance plans and so do not count as creditable coverage. Preexisting conditions will not be paid for up to 12 months on the C&MA Health Plan.

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Please Note: The information contained in this site is intended as a summary of benefits. It does not guarantee coverage. The Health Plan pays benefits for medically necessary services resulting from illnesses or injuries that are not work related, up to reasonable and customary limits. Even though a doctor recommends or performs a service for you or your covered dependent, this does not automatically mean the service is covered by the Plan. If you have any doubt about whether a proposed treatment or service is covered under the Health Plan, please contact the number shown on your ID card.