certificate of creditable coverage
Polish translation: zaświadczenie o należytym przebiegu ubezpieczenia
| 16:42 Jan 23, 2015 |
| English to Polish translations [PRO] Medical - Insurance | |||||||
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|  Selected response from: Roman Kozierkiewicz Local time: 17:42 | ||||||
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Answers
57 mins confidence: 
zaświadczenie o należytym przebiegu ubezpieczenia Explanation: Propozycja |
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5 hrs confidence: peer agreement (net): +2
peer agreement (net): +2zaświadczenie o okresie objęcia (ubezpieczonego) (wygasającym) ubezpieczeniem zdrowotnym Explanation: O to tutaj chodzi. Zaświadczenie takie dotychczas potrzebne było do uzyskania czasowego ubezpieczenia COBRA (przy utracie pracy i ubezpieczenia pracowniczego) lub przy zmianie ubezpieczyciela - w celu objęcia ubezpieczeniem tzw. "preexisting conditions" z a które po części odpowiada poprzedni ubezpieczyciel (zwykle w okresie pierwszych 6-ciu do 12-tu miesięcy nowego ubezpieczenia, w zależności od ubezpieczyciela). Od tego roku zaświadczenie takie przestaje mieć znaczenie i zdaje się że nie będzie już wystawiane, ponieważ tzw. "Obamacare" zabrania stosowania wykluczeń pokrywania leczenia ze względu na "preexisting conditions" Certificate of Creditable Coverage A written certificate issued by a group health plan or health insurance issuer (including an HMO) that shows your prior health coverage (creditable coverage). A certificate must be issued automatically and free of charge when you lose coverage under a plan, when you are entitled to elect COBRA continuation coverage or when you lose COBRA continuation coverage. A certificate must also be provided free of charge upon request while you have health coverage or within 24 months after your coverage ends. The Department has developed a model certificate that can be used by a group health plan or a health insurance issuer. Correct use of the model will generally assure compliance with the regulatory requirements. http://www.dol.gov/elaws/ebsa/health/glossary.htm?wd=Certifi... How does HIPAA limit the pre-existing condition exclusion of group or employer health insurance coverage? It counts “creditable” health coverage against the pre-existing condition time. Under HIPAA, a group health plan may not impose a pre-existing condition exclusion if the person has had creditable medical coverage for at least 12 months as long as the person had no more than 63 days with no coverage. (Creditable coverage refers to health insurance, and includes most health coverage, such as a group health plan, HMO, individual health insurance policy, Medicaid, or Medicare.) If the coverage was for less than 12 months, the pre-existing exclusion period may be reduced by the number of months of prior creditable coverage. Example: Maria completed her cancer treatment 2 months ago. She had health coverage for the 14 months before she left her job 6 weeks ago, which means she would have 14 months of creditable coverage. The 42 days she went without insurance doesn’t qualify as a “significant break” in coverage. She would have no pre-existing condition exclusion at her new job if she signs up for insurance there, but she must sign up before she has had 63 days without insurance. It only allows exclusion of pre-existing conditions for which you were seen or treated in the past 6 months. A group health plan may only impose a pre-existing condition exclusion on new enrollees for conditions for which medical advice, diagnosis, care, or treatment was received or recommended within the 6-month period before their enrollment date (called the 6-month “look-back” period). A person’s enrollment date is the earlier of either the first day of coverage or the first day of any waiting period for coverage. If you had a medical condition in the past, but have not received any medical advice, diagnosis, care, or treatment for it within the 6 months before your enrollment date in the plan, that condition cannot be considered a pre-existing condition. (Check with your state’s Insurance Commissioner’s Office to see if a shorter look-back period might apply to you.) Example: Alana was diagnosed with lobular breast carcinoma in situ 4 years ago. She didn’t need treatment, but she was told to follow up every year with her oncologist. She saw her doctor a year ago. Then 10 months later, she found a job and signed up for their group insurance. Her breast carcinoma would not be considered a pre-existing condition because she has had no treatment nor was treatment recommended for her in the 6 months before she enrolled. Her break in coverage does not come into play because she is not considered to have a pre-existing condition. http://www.cancer.org/treatment/findingandpayingfortreatment... New final regulations on Exchange and Insurance Market Standards for 2015 and Beyond published by the U.S. Department of Health and Human Services (HHS) on May 16, 2014 confirm the end of the requirement to issue certificates of creditable coverage. Certificates of creditable coverage are no longer required after December 31, 2014. This information does not come as a surprise, although it does come more than a year after the proposed regulations were issued in March of 2013. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) required certificates of creditable coverage to be issued to individuals switching from one health insurance plan to another to bypass pre-existing condition exclusions. After December 31, 2014, most health insurance plans will no longer contain pre-existing condition exclusions as a result of the Patient Protection and Affordable Care Act (PPACA). Although the regulators recognize that certain individual policies may still contain pre-existing condition exclusions after December 31, 2014, the response to a public comment indicates that certificates of creditable coverage will no longer be relevant, even in this circumstance Read More http://www.healthcarereformdigest.com/new-final-rule-elimina... |
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