HIPAA/COBRA Eligible

This also includes those who currently have coverage through an insurer. You are considered HIPAA-eligible if:

• You have exhausted COBRA coverage before Inclusive Health coverage will start.
• Your most recent coverage was not terminated as a result of non-payment of premium or fraud.
• If offered, you elected and exhausted any continuation coverage with the most recent coverage under COBRA or a similar state or federal program.
• You did not enroll in an individual insurance policy or accept a conversion policy of limited duration after losing group coverage or health insurance plan.
• You have 18 months of recent credible coverage under a health plan with your most recent coverage under an employer sponsored, government, union or church plan.
• You have no more than a 63 day break in coverage since the last coverage terminated.

You will be asked to provide a Certificate of Creditable Coverage or otherwise provide evidence in writing for the periods of health coverage totaling 18 months. If COBRA or other continuation coverage has been offered by a state or the Federal government, please indicate the date such coverage began and the date it was exhausted. Note: if you move out of the service area of a plan and are not offered alternative coverage that will pay benefits in your new location, you have exhausted your continuation coverage.