California Certificate of Group Health Plan Coverage with Statement of HIPAA Portability Rights
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How to fill out Certificate Of Group Health Plan Coverage With Statement Of HIPAA Portability Rights?
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FAQ
Individuals should retain this document for their records. CMS does not request or require a copy of this creditable coverage documentation. Therefore, individuals should not be instructed to send the certificate to CMS.
Health plans: Medicare, Medicaid, Medicare+Choice, and Medicare supplement insurers. Long-term care insurers (excluding nursing home fixed-indemnity policies) Employer-sponsored group health plans. Government- and church-sponsored health plans.
The HIPAA certificate, also known as certificate of creditable coverage, documents the health coverage you had before you lost coverage. If you had less than 18 months of continuous coverage, the certificate includes the dates any waiting period began and when coverage began and ended.
This is a letter that says how long you have been covered and provides proof that you have had at least 18 months of coverage. If you are unable to provide a Certificate of Creditable Coverage, you can talk to the health plan about other ways you can prove that you had a least 18 months of coverage.