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NHHP-Fed Brochure
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Creditable Coverage is any public or private health insurance or health benefit plan, whether insured or self-insured. The following types of health care coverage are Creditable Coverage:
- A group health benefit plan;
- Individual or group health insurance coverage;
- Medicare - Part A or Part B of Title XVIII of the Social Security Act;
- Medicaid - Title XIX of the Social Security Act;
- Medical and dental care for members and certain former members (and their dependents) of the armed forces, the Commissioned Corps of the National Oceanic and Atmospheric Administration, and the Public Health Service under Chapter 55 of Title 10, United States Code;
- A medical care program of the Indian Health Services or of a tribal organization;
- A state health benefits risk pool;
- A health plan offered under the Federal Employees Health Benefits Program (FEHBP) Chapter 89 of Title 5, United States Code;
- A public health plan established or maintained by a state, a foreign country, the U.S. government, or other political subdivision of a state, the U.S. government or foreign country that provides health insurance coverage;
- A health benefit plan provided under the Peace Corps Act (22 U.S.C. 2504(e)).
- A State Children's Health Insurance Program (CHIP) whether it is a stand-alone separate program, a CHIP Medicaid expansion program, or a combination program, and whether it is provided through a group health plan, health insurance, or any other mechanism.
Health coverage provided under the following is not Creditable Coverage:
- accident-only or disability income insurance;
- coverage issued as a supplement to liability insurance;
- liability insurance, including general liability insurance and automobile liability insurance;
- worker's compensation insurance;
- automobile medical-payment insurance;
- coverage for on-site medical clinics;
- other similar insurance coverage (specified in certain rules) under which benefits for medical care are secondary to other insurance benefits;
- if offered separately and not as part of larger health coverage:
- limited scope dental or vision benefits;
- long-term care coverage, nursing home care coverage, home health care coverage, community-based care coverage or any combination of these;
- prescription drug benefits only; or
- other similar, limited benefits;
- if offered as independent, noncoordinated benefits:
- specified disease or illness benefits; or
- hospital or surgical indemnity benefits;
- if offered as a separate insurance policy, Medicare supplemental health insurance, coverage supplemental to the coverage described in #5 above (that provided under Chapter 55 of Title 10, United States Code), and similar supplemental coverage.
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