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How does crediting for prior coverage work under HIPAA? |
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Most plans use the standard method of
crediting coverage.
Under the standard method, you receive credit for your
previous coverage that occurred without a break in coverage of 63 days or
more. Any coverage occurring prior to a break in coverage of 63 days
or more is not credited against a preexisting condition exclusion period.
To illustrate, suppose an individual had coverage for 2
years followed by a break in coverage of 70 days and then resumed coverage
for 8 months. That individual would only receive credit for 8 months
of coverage; no credit would be given for the 2 years of coverage prior to
the break in coverage of 70 days.
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