State Option Eligibility

HIPAA Eligibles What qualifies me as a HIPAA Federally-Defined Eligible Individual? You are considered HIPAA-eligible if: You have a total of 18 months of creditable coverage. You have avoided a significant break in health coverage of 63 or more full days in a row. A significant break in coverage results in the individual losing credit for the coverage before the break. You do not have any medical coverage, other than that which will soon be exhausted; If COBRA, state continuation coverage, or Federal Temporary Continuation Coverage was offered, you must have accepted and exhausted it. Although an individual may apply for HIPAA coverage before the termination of COBRA, COBRA must be exhausted and then the new coverage will start. You must not be eligible for any other employment related group health coverage, Medicare or Medicaid. Your last coverage must have been through an employer or union plan (COBRA, State and Federal continuation coverage also meet this requirement) or a church plan (as defined under section 3(33) of the Employee Retirement Income Security Act of 1974. You must not have lost your last coverage through fraud or nonpayment of premiums. Generally, you must not have accepted, after losing employer group coverage, a conversion policy or policy of limited duration because they are both forms of individual coverage and will terminate your HIPAA portability rights*. HCTC Eligibles What qualifies you as eligible for HCTC? Click here for more info.

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