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Federal “Eligible individual” defined
See also Disability 101 FAQ # 16
§ 300gg–41. PDF
(b) “Eligible individual” defined
In this part, the term “eligible individual” means an individual—
(A) for whom, as of the date on which the individual seeks coverage under this section, the aggregate of the periods of creditable coverage (as defined in section 300gg (c)of this title) is 18 or more months and
(B) whose most recent prior creditable coverage (63 Days) (300gg-43) was under a group health plan, governmental plan, or church plan (or health insurance coverage offered in connection with any such plan);
(2) who is not eligible for coverage under
(A) a group health plan,
Federal HIPAA Definition of Group Insurance & Other Terms
CA AB 1672 Definition
(B) part A or part B of title XVIII of the Social Security Act [42 U.S.C. 1395c et seq., 1395j et seq.],
(C) a State plan under title XIX of such Act [42 U.S.C. 1396 et seq.] (or any successor program),
and does not have other health insurance coverage;
(3) with respect to whom the most recent coverage within the coverage period described in paragraph (1)(A) was not terminated based on a factor described in paragraph (1) or (2) of section 300gg–12 (b) of this title (relating to nonpayment of premiums or fraud);
(4) if the individual had been offered the option of continuation coverage under a COBRA continuation provision or under a similar State program, who elected such coverage; and
(5) who, if the individual elected such continuation coverage, has exhausted such continuation coverage under such provision or program.
I am covered by Anthem HIPAA Insurance since 2009 in a PPO plan with a $1500 deductible.
What will happen if I want to move to New York?
Will Empire Blue Cross give me the same plan?
I have pre-existing conditions and am 56. I am considering a move.
If I will lose my health insurance, I may not be able to move.
- ***Check with a New York Agent….
nahu.org Agent Finder
New York has guaranteed issue coverage.
state health facts.org
med health insurance.com
(B) whose most recent prior creditable coverage ( 63 Days) ( 300gg-43) was under a group health plan, governmental plan, or church plan (or health insurance coverage offered in connection with any such plan);
***Thus you cannot shop plans around later, as HIPAA coverage is not group health coverage
If you move outside of California,…Options to continue individual coverage include the following:
Transfer your coverage to the Blue Cross or Blue Shield Plan serving your new address. The type of coverage offered will be at the discretion of the new Blue Cross or Blue Shield Plan.
blue_cross EOC page+47
if your coverage is through a network plan, HIPAA does not guarantee that your policy will be renewed if you move outside the area served by providers under contract with your insurer.
IMHO (In my humble opinion) if you cannot exchange your HIPAA coverage… there is a 14th Amendment violation.