Get the up-to-date certificate of creditable coverage 2025 now

Get Form
certificate of creditable coverage Preview on Page 1
Show details
4 out of 5
54 votes
The document is an administrative directive from the New York State Department of Health, informing local social services departments about the requirements for issuing Certificates of Creditable Coverage (CCC) to Medicaid recipients who lose their eligibility. This requirement stems from the federal Health Insurance Portability and Accountability Act (HIPAA) of 1996, which aims to improve health insurance portability and limit exclusions for preexisting conditions. The directive outlines the process for issuing CCCs, the responsibilities of local departments, and provides guidance on how these certificates can help individuals secure new health coverage without facing preexisting condition exclusions.
DocHub Reviews
44 reviews
DocHub Reviews
23 ratings
15,005
10,000,000+
303
100,000+ users

Here's how it works

01. Edit your certificate of creditable coverage online
Type text, add images, blackout confidential details, add comments, highlights and more.
02. Sign it in a few clicks
Draw your signature, type it, upload its image, or use your mobile device as a signature pad.
03. Share your form with others
Send reportmycreditablecoverage uhc com via email, link, or fax. You can also download it, export it or print it out.

The best way to modify Certificate of creditable coverage in PDF format online

Form edit decoration
9.5
Ease of Setup
DocHub User Ratings on G2
9.0
Ease of Use
DocHub User Ratings on G2

Working on documents with our extensive and user-friendly PDF editor is easy. Follow the instructions below to complete Certificate of creditable coverage online easily and quickly:

  1. Log in to your account. Log in with your email and password or register a free account to try the service before upgrading the subscription.
  2. Upload a form. Drag and drop the file from your device or add it from other services, like Google Drive, OneDrive, Dropbox, or an external link.
  3. Edit Certificate of creditable coverage. Quickly add and highlight text, insert images, checkmarks, and icons, drop new fillable areas, and rearrange or remove pages from your document.
  4. Get the Certificate of creditable coverage completed. Download your modified document, export it to the cloud, print it from the editor, or share it with other people using a Shareable link or as an email attachment.

Benefit from DocHub, the most straightforward editor to rapidly handle your documentation online!

Fill out certificate of creditable coverage online
It's free
Start now
be ready to get more

Complete this form in 5 minutes or less

Get form

Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.
Contact us
How to Get Insurance Continuity Certificate? Take the Old Insurance Card of Daman or any other insurance company. Visit any local branch of Insurance Company. Collect Certificate of Continuity.
If an employee needs a COCC for proof of loss of coverage, they can contact their insurance carrier directly. In most instances, the insurance carrier will fax or email the COCC to them.
You may have creditable coverage through a current or former employer, trade union, or one of the following: Federal Employee Health Benefits (FEHB) Program. Veterans Benefits. TRICARE (military health benefits)
The certificate indicates the date on which an individuals coverage ends and how long the individual had the coverage. Individuals should retain this document for their records because the certificate provides evidence of an individuals prior coverage.
A Certificate of Creditable Coverage may be obtained from your former health insurance carrier. Please contact your previous health carrier and request them to provide you with a certificate. This certificate may partially or fully apply to your new coverage and alleviate pre-existing situations.

report my creditable coverage uhc com

Certificate of creditable coverage template How to get certificate of Creditable coverage Certificate of Creditable Coverage form Why do I need a Certificate of creditable coverage Certificate of creditable coverage Medicaid Certificate of creditable coverage Cigna How to get a Certificate of Creditable Coverage Blue Cross Certificate of creditable coverage pdf

Related forms

Form preview
Official publication - Journal of Nutrition - jn nutrition
Learn more
Official publication - Journal of Nutrition - jn nutrition
The document is a guide for authors submitting manuscripts to The Journal of Nutrition, published by the American Instit ...
Learn more
Form preview
Appendix A Groundwater Discharge Permit Application Form - Land - lic wisc
Learn more
Appendix A Groundwater Discharge Permit Application Form - Land - lic wisc
The document is an application form for a Groundwater Discharge Permit for the Wastewater Treatment Facility associated ...
Learn more
Form preview
Soil Erosion and Sedimentation Control Permit - City of Rockford
Learn more
Soil Erosion and Sedimentation Control Permit - City of Rockford
The City of Rockford has established a Soil Erosion and Sedimentation Control Ordinance to protect its public utility sy ...
Learn more
Form preview
1 APPLICATION 2 doc Tabel of Contents
Learn more
1 APPLICATION 2 doc Tabel of Contents
The document outlines the application process for obtaining a Soil Erosion & Sedimentation Control Permit in Ottawa Coun ...
Learn more
Form preview
The directv group, inc - Analist nl - analist
Learn more
The directv group, inc - Analist nl - analist
Learn more
Form preview
Certification Application Booklet - June, 2011 - District
Learn more
Certification Application Booklet - June, 2011 - District
The document is an application booklet from the District of Columbia Department of the Environment for the certification ...
Learn more
Form preview
Continuing Disclosure Certificate as of June 30, 2001 Continuing Disclosure Certificate as of June 3
Learn more
Continuing Disclosure Certificate as of June 30, 2001 Continuing Disclosure Certificate as of June 3
The document is the Annual Report Cover Sheet for the City of Grand Rapids, Michigan, detailing compliance with SEC Rule ...
Learn more
Form preview
FLORIDA LIVE BIRTH MASTER TAPE Page 1 of 7 - USF Health - health usf
Learn more
FLORIDA LIVE BIRTH MASTER TAPE Page 1 of 7 - USF Health - health usf
The document is a detailed structure of the Florida Live Birth Master Tape for the years 1989-1994, outlining various fi ...
Learn more
be ready to get more

Complete this form in 5 minutes or less

Get form

People also ask

This disclosure must be provided to Medicare eligible active working individuals and their dependents, Medicare eligible COBRA individuals and their dependents, Medicare eligible disabled individuals covered under your prescription drug plan and any retirees and their dependents.
Enrollment Steps. Apply. Activate Account. Bobcat Welcome. Take Placement Assessment. Advising Registration. Register for Classes. Bobcat Orientation.

Related links

Your Exam Content Outline

Oct 1, 2019 The following outline describes the content of one of the Connecticut insurance examinations. The outlines are the basis.

Learn more
Sample Certificate of Creditable Coverage

This certificate provides evidence of your prior health coverage. You may need to furnish this certificate if you become eligible under a group health plan

Learn more

Try more PDF tools

Edit & Annotate
Edit PDF
Add Fillable Fields
Create PDF
Insert and Merge
Add Page Numbers
Rotate Pages
Delete Pages
Convert
Word to PDF
TXT to PDF
HTML to PDF
CSV to PDF
PPT to PDF
RTF to PDF
JPG/JPEG to PDF
PNG to PDF
Collaborate & Share
Add Comments
Fax
PDF Status
Sign & Send
Sign a PDF
Send for Signing
Protect PDF
Set PDF password
Readable PDF
Certify PDF
PDF Audit Trail
Others
Search for PDF
Export
Download
Flatten Fields
Print out
If you believe that this page should be taken down, please follow our DMCA take down process here
support@dochub.com
17 Station St., Ste 3 Brookline, MA 02445
Google Play App Store
© 2025 DocHub, LLC
Products
PDF Editor
Forms & Templates
Sign Documents
Server Status
Pricing
Forms Library
Features
Functions
Company
About
Terms
Privacy Notice
Legal
Support
Release Notes
Resources
pdfFiller
US Legal Forms
Electronic Signature
No-code document workflows
DocHub Mobile App
What's New
New
DocHub v6 Released! Multi-file envelopes, bulk file importing, and multi-page reordering and much more.
Contact us
support@dochub.com
17 Station St., Ste 3 Brookline, MA 02445
Google Play App Store
© 2025 DocHub, LLC
This site uses cookies to enhance site navigation and personalize your experience. By using this site you agree to our use of cookies as described in our Privacy Notice. You can modify your selections by visiting our Cookie and Advertising Notice.... Read more...Read less
Accept