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December 11, 2023

“Credible Coverage” and Individual Health Insurance

“Credible Coverage” and Individual Health Insurance

by Eric Smith / Wednesday, 21 March 2012 / Published in Applications, Individual Health Insurance

Most insurance companies consider health insurance “credible” if it is a group or medically underwritten individual medical insurance policy.

Why is this important?

*If you are moving from one group (usually employer sponsored insurance) to another, and have had previous “credible coverage” that was not interrupted for a period of 63 or more days, most pre-exiting conditions must be cover by the new plan.

*Although individual health insurance companies are not required to cover pre-existing conditions, even with prior credible coverage, they often offer better premium prices and eliminate “wait times” for those with this type of prior coverage.

I believe the reason for this is individual health insurance companies would prefer to offer plans to people who have had continuous coverage because the client will have a greater likelihood of having taken care of medical problems along the way, instead of waiting until they obtain a new policy to get issues attended to.

Many individual health insurance companies do not consider travelers insurance, student insurance and short term insurance credible.

And, you do not want to fib on a new application for health insurance about prior coverage, because if this is found out future claims may be denied.

If you would like to know more about how this might affect you, please give me a call at 303-541-9533.

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Tagged under: 2012, Underwriting

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