Who qualifies as a “HIPAA eligible” individual?Who qualifies as a “HIPAA eligible” individual?
“HIPAA eligible” individuals must have exhausted all options for coverage under any group plan and must meet all of the following criteria: • Have had continuous coverage for a minimum of 18 months with the most recent period under a group health plan without a significant break in coverage of more than 63 days in a row. • Have been offered the option for continuation of COBRA coverage, and have elected and exhausted it, or are ineligible for continuation of COBRA coverage altogether, or other similar state programs • Did not have their group coverage terminated because of nonpayment of premiums or fraud • Are not eligible for coverage under another group plan, Medicaid, or Medicare. In this case, only applicable individual health policies or state high risk pool plans may not exclude coverage for pre-existing conditions nor turn down an application for coverage only if all of the criteria is met as a “HIPAA eligible” individual and the individual applied within 63 days of the last dat
Related Questions
- What qualifies an individual or a family for a "hardship waiver," a way for those in lower-income brackets to opt out of the mandatory health care policy?
- What if there aren detailed records of hours worked by unpaid staff? How is it determined if an individual qualifies?
- Who determines if an individual qualifies under one or more of the funding priorities?
