What Is a HIPAA Certificate of Creditable Coverage?

Creatas Images/Creatas/Getty Images

The federal Health Insurance Portability and Accountability Act of 1996 was designed to simplify health coverage, improve patients' ability to change policies, fight fraud and waste, and guarantee patient privacy. Like any omnibus bill that promised so much, HIPAA ended up long, loquacious and full of acronyms. One such acronym, COCC, refers to the Certificate of Continuous Coverage that eases movement from one plan to another.

HIPAA and Portability

Many HIPAA provisions regulate various healthcare providers, researchers and clinicians, but some directly affect patients. In addition to new privacy rules for patient records and the establishment of Medical Savings Accounts, HIPAA guarantees continuous coverage for employees who change policies, and job-changers or retirees who utilize a policy continuation known as COBRA -- named for the Consolidated Omnibus Budget Reconciliation Act of 1986. The COCC instrument guarantees continuous coverage of ongoing health conditions as the patient changes plans.

COCC Details

Health plan and COBRA administrators issue Certificates of Continuous Coverage to an insured 30 days before the expiration of the plan's coverage or before the insured leaves employment, provided the insured has been covered for at least 18 months. This eliminates many waiting periods for new coverage under a policy, but do not eliminate all waiting periods. For example, a health plan might impose a six-month waiting period for treatment of a pre-existing condition. Also, a COCC cannot force a plan to cover a condition not included in its policy. Supplemental insurance plans do not provide COCC's, nor do foreign medical insurance plans.