Health Insurance Jargon Defined


insurance-glossary-terms
Understanding the key terms will help you get the coverage you need.
(HEALTH)
COBRA
Stands for the Consolidated Omnibus Budget Reconciliation Act of 1985. It’s a federal law that gives you the right to temporarily (for 18 months or more, in most cases) continue with the group insurance plan of your employer even after you leave a job—voluntarily or involuntarily—or when you reduce your hours, such as from full-time to part-time.

Creditable coverage
Almost any health-insurance policy (see "excepted benefits")—such as an employer-provided health plan, an HMO, an individual health-insurance policy, Medicare, or Medicaid—that you were covered by before signing up for a new policy. A certificate of creditable coverage, which is a written document issued by the health insurer, will state how long you were covered under your former policy; that amount of time offsets any preexisting-condition exclusion period imposed by your new health-insurance plan. If you were insured continuously (with no significant break in coverage) for 12 months prior to joining a new plan, for instance, there will be no preexisting-condition exclusion imposed.

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Excepted benefits
Certain types of insurance that do not qualify as "creditable," and therefore will not help establish continuous coverage for the purpose of avoiding a preexisting-condition exclusion under a new health plan. Some examples: accident-only insurance, disability income insurance, and workers’ compensation. These are not considered health coverage. Certain other benefits, such as dental or vision coverage, or long-term care coverage, are excepted if they are offered separately or are not an integral part of a health plan.

HIPAA
Health Insurance Portability and Accountability Act. It is a federal law that determines your rights regarding preexisting-condition exclusions, special enrollment in health plans when certain life or work events occur, and availability and renewability of health coverage, among other things.


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Lead writer: Jeanne Lee
Last Updated: September 17, 2008
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