One of the main reasons for passage of the Health Insurance Portability

and Accountability Act (HIPAA) was to make it easier for consumers to move

from one health insurance plan to another without the worry of having to

meet another pre-existing exclusion period (usually 12 months). This is accomplished

covered under a health insurance plan. Creditable coverage reduces or eliminates

the amount of pre-existing time you will spend under a new policy. In order

to receive credit for prior coverage you cannot have a lapse in coverage

of more than 63 days on out-of-state issued or self-funded policies, or 90

days for a Georgia-issued policy. Group, individual, Medicare and Medicaid

are all considered creditable coverage.

Q: I was covered under an individual policy for eight months prior to being

hired by my new employer. I am now covered under the group insurance policy

for my new employer. What will be the length of my pre-existing period?

A: Since you have eight months of creditable coverage, your pre-existing

exclusion period will be reduced to four months.

Q: I worked for three different employers over the past four years. There

were times in between each health insurance plan for each employer that I

had no health insurance but the times without coverage was never more than

30 days. Will this reduce my creditable coverage period?

A: No. Since the times between each plan were less than 63 days it will

not change your creditable coverage time.

Q: I am presently covered under an individual policy that has increased

in premium by 50 percent over the past two years. I am familiar with the

HIPAA laws concerning portability and thought that I could transfer to any

individual policy as long as I had the appropriate amount of creditable coverage

time. I applied with a company for an individual policy and was turned down.

Can the company do that?

A: Portability is only applicable when you are changing from group to group

coverage or in some cases when you are transferring from group to individual.

It does not apply when you are changing from one individual policy to another.

Please send your insurance or fire safety questions to Insurance and Fire

Commissioner John Oxendine, 716 West Tower, 2 Martin Luther King Jr. Drive,

Atlanta, GA 30334. Or call 404-656-2070 (toll free at 1-800-656-2298) for

assistance with an insurance question, Monday through Friday, 8 a.m. to 7

p.m. TDD services available at 404-656-4031.