What is Creditable Coverage?
Creditable Coverage is prior coverage under either group or individual insurance, COBRA, Medicaid, Medicare or a public health plan. The prior coverage only qualifies as creditable if it is continuous under the Health Insurance Accountability Act of 1996 (HIPAA) definition. That is, there must not be a break in coverage of 63 days.
Creditable coverage refers to prior enrollment in public or private health coverage. Creditable coverage is used to reduce pre-existing exclusionary periods when enrolling in a new plan. Many forms of health coverage are considered creditable coverage, including private employer-sponsored, association-sponsored, or individual plans; continuation coverage, and coverage under public health benefits such as Medi-Cal and Medicare.
Creditable coverage refers to coverage from an employee or union plan that is on average at least as good as Medicare’s standard level of coverage. If you are enrolled in a plan that has creditable coverage, you can wait to enroll in a Medicare drug plan. Your current plan will notify you if your retiree benefit provides you with creditable coverage.
Creditable coverage is coverage, from a plan other than a Part D plan, that meets certain Medicare standards. If you currently have prescription drug coverage that is considered creditable coverage, you may keep that coverage and wait to enroll in a Part D plan. If you later decide to enroll in a Part D plan, you will not have to pay a late enrollment fee.
