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Cystic Fibrosis Care Center

Loss of Health Coverage

cf services pharmacy ny state adult cf assistance self advocacy loss of coverage transitional coverage and extensions choosing your health plan accecpted health plans If you lose health insurance due to a change in employment or marital status, you can extend your coverage, provided your employer offers COBRA. (Employers with more than 20 employees are required to offer COBRA.) You are allowed to continue your coverage for as long as three years, depending on your reason for extending coverage. For example, if you are awaiting approval for Social Security Disability Insurance and Medicare, you can extend your health care insurance for 29 months.

The New York State Insurance Department outlines the state's laws and policies on continuation coverage on its website.

Creditable Coverage

Some health insurance plans refuse to cover CF-related medical costs for up to 12 months upon enrollment, on the grounds that it is a pre-existing condition. This exclusion is legal, but you can get around it by invoking the "creditable coverage" provision of the Health Insurance Portability and Accountability Act of 1996 (HIPAA).

For example, if you have 10 months of coverage under a previous group health insurance plan, your new plan will give you credit for 10 months of coverage, so they can refuse to cover your CF-related costs for only two months, instead of 12.

If more than 63 days have passed without coverage, your group insurance can refuse to pay for any pre-existing condition. It is important to use COBRA to avoid any lapse in coverage.

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