Creditable Coverage. The plan will accept certificates of coverage from new employees and apply the creditable coverage to the preexisting condition clause. The preexisting condition waiting period will be reduced by the number of days creditable coverage provided by the employee for new participants who were fully covered under another plan within sixty-three (63) days before enrollment in this plan.
Creditable Coverage. Coverage of the Member under a group health plan (including a governmental or church plan), a health insurance coverage (either group or individual insurance), Medicare, Medicaid, a military-sponsored health care (CHAMPUS), a program of the Indian Health Service, a State health benefits risk pool, the Federal Employees Health Benefits Program (FEHBP), a public health plan, and any health benefit plan under section 5(e) of the Peace Corps Act. Creditable Coverage does not include coverage only for accident; Workers’ Compensation or similar insurance; automobile medical payment insurance; coverage for on-site medical clinics; or limited-scope dental benefits, limited-scope vision benefits, or long-term care benefits that is provided in a separate policy.
Creditable Coverage. Prior health insurance coverage as defined under Section 2701(c) of the Public Health Service Act (42 U.S.C. § 300gg(c)). Creditable Coverage includes coverage under group or individual health plans or health insurance, Medicare, Medicaid, other governmental plans and state health benefit risk pools.
Creditable Coverage. Coverage of the Member under a group health plan (including a governmental or church plan), a health insurance coverage (either group or individual insurance), Medicare, Medicaid, a military-sponsored health care (CHAMPUS), a program of the Indian Health Service, a State health benefits risk pool, the Federal Employees Health Benefits Program (FEHBP), a public health plan, including coverage received under a plan established or maintained by a foreign country or political subdivision as well as one established and maintained by the government of the United States, any health benefit plan under section 5(e) of the Peace Corps Act and the State Children’s Health Insurance Program (S-Chip). Creditable Coverage does not include coverage only for accident; Workers’ Compensation or similar insurance; automobile medical payment insurance; coverage for on-site medical clinics; or limited- scope dental benefits, limited-scope vision benefits, or long-term care benefits that is provided in a separate policy. • Custodial Care. Services and supplies that are primarily intended to help a Member meet their personal needs. Care can be Custodial Care even if it is prescribed by a Physician, delivered by trained medical personnel, or even if it involves artificial methods (or equipment) such as feeding tubes, monitors, or catheters. Examples of Custodial Care include, but are not limited to:
Creditable Coverage. The Group will report to BCBSF/HOI the amount of creditable time to be applied to satisfy the pre-existing condition exclusion limitation for those members providing that information at time of eligibility. If this information is not supplied, BCBSF/HOI will deny the impacted claim. The denial advises the member that if they had previous coverage a credit may be applicable and to please contact customer service. Once information is received and reviewed, the claim will be reprocessed and pre-existing condition limitation updated in their system. The Group will not track creditable time in their system.
Creditable Coverage. The Pre-Existing Condition exclusion period may be reduced in the event a Member has had insurance coverage through another health insurer. The Member may have received a certificate with information regarding prior Creditable Coverage from the Member’s previous employer, insurer or other health benefits provider. The certificate of Creditable Coverage is extremely useful for demonstrating Creditable Coverage. If the Member does not have such a certificate, the Member has the right to request one (within twenty-four (24) months after coverage ceases). At the Member’s request, the PPO will assist the Member in obtaining the certificate of Creditable Coverage. The Member can request assistance from the PPO by calling the Customer Service Team at the telephone number indicated on the back of the Member’s Identification Card.
Creditable Coverage. Credit for Prior Coverage. The period of any Preexisting Condition limitation under this Plan will be reduced by the number of days of Creditable Coverage without a Significant Break in Coverage that the Member has as of the Enrollment Date. Any days accumulated during a Waiting Period for a determination of coverage under this Plan are not counted towards a Significant Break in Coverage.
Creditable Coverage. This section explains how long an Insured must wait before benefits are available under this Plan for treatment of a Preexisting Condition. A Preexisting Condition is a physical or mental condition, regardless of the cause or the condition, for which medical advice, diagnosis, care or treatment was recommended or received within the six
Creditable Coverage. An Insured must submit to SHL a Certificate of Creditable Coverage from the previous plan or carrier, or other proof of prior coverage, acceptable to SHL, in order to receive a credit for Creditable Coverage. Coverage prior to a Significant Break in Coverage is not credited toward any Preexisting Condition limitation period.
Creditable Coverage. Any individual or group policy, contract or program that is written or administered by a disability insurer, health care service plan, fraternal benefits society, self-insured employer plan, or any other entity, in this state or else- where, and that arranges or provides medical, hospital, and surgical coverage not designed to supplement other private or governmental plans. The term includes con- tinuation or conversion coverage but does not include accident only, credit, disability income, Medicare sup- plement, long-term care, dental, vision, coverage issued as a supplement to liability insurance, insurance arising out of a workers' compensation or similar law, automo- bile medical payment insurance, or insurance under which benefits are payable with or without regard to fault and that is statutorily required to be contained in any liability insurance policy or equivalent self- insurance.
