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Health > HIPAA Coverage

You may be eligible for coverage under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) if you meet certain criteria. Being eligible for HIPAA coverage may give you access to health plans without medical underwriting or pre-existing condition waiting periods. To be eligible for HIPAA coverage, you must meet ALL of the following criteria:

  • Have elected and exhausted health insurance benefits through a COBRA or similar group, state or federal continuation. This would include the Federal Employee Health Benefits Program (FEHBP), FEHBP Temporary Continuation of Coverage (TCC) or state continuation coverage, if available.
  • Have 18 months of creditable coverage with the most recent coverage under an employer-sponsored plan, governmental plan, church plan, or a health benefit plan offered in conjunction with any of these plans. Certificates of creditable coverage must indicate at least 18 months of aggregate health insurance coverage.
  • Have no more than a 62-day break in coverage.
  • Be ineligible for Medicare A or B, Medicaid, or any other employer-sponsored plan.
  • Not be covered by any other health insurance plan.
  • Your prior coverage was not terminated because of your failure to pay the required premium or because you committed fraud.

If you believe that you meet all the criteria above, you may be eligible to apply for HIPAA coverage. You can call us at 1-800-511-ENET to find out more.

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