The Body: The Complete HIV/AIDS Resource
Follow Us Follow Us on Facebook Follow Us on Twitter Download Our App 
Professionals >> Visit The Body PROThe Body en Espanol
Ask the Experts About

Workplace and Insurance IssuesWorkplace and Insurance Issues
Rollover images to visit our other forums!
  • Email Email
  • Glossary Glossary

Medicare Credible Coverage
Jun 14, 2012

For under 65 disabled, is part A and B considered creditabale converage in case one needs to get a HIPAA policy (ie declared not disabled?

Response from Mr. Chambers

Not really.

Both Medicare and Medicaid are considered Creditable Coverage under HIPAA, but ONLY for crediting pre-existing conditions conditions limitations under a new plan.

However, creditable coverage towards being eligible for a guaranteed issue plan under HIPAA requires: (1) 18 months of coverage with no break longer than 63 days; (2) ; (3) at least the last day of which was under a group health plan. The law defines "group health plan" to be an employer provided plan that falls under the federal ERISA employe benefit welfare law. Medicare and Medicaid to no fit that definition.

To avoid health insurance that requires medical underwriting, the best way to get coverage should you be declared no longer disabled under SSD/Medicare, you would need to find work that provides group coverage. Then the Medicare could erase any waiting period the new plan requires due to a Pre-Existing Conditions Limitations Provision.

Good luck, Jacques

Does group health ins pay for HIV meds?
Nurse Needing to Tell a Minor that he is HIV positive

  • Email Email
  • Glossary Glossary



This forum is designed for educational purposes only, and experts are not rendering medical, mental health, legal or other professional advice or services. If you have or suspect you may have a medical, mental health, legal or other problem that requires advice, consult your own caregiver, attorney or other qualified professional.

Experts appearing on this page are independent and are solely responsible for editing and fact-checking their material. Neither nor any advertiser is the publisher or speaker of posted visitors' questions or the experts' material.

Review our complete terms of use and copyright notice.

Powered by ExpertViewpoint