Health insurance paperwork: what to keep and what to toss?
February 3, 2010 12:20 PM   Subscribe

Which US health insurance paperwork should I file and keep, and which should I toss?

I'm in the US, specifically in California with no foreseeable plans to leave.

I've been through several health insurance providers over the years, and all of them have different plans, prices, coverage, etc. I've had a chronic condition through this time as well. Recently I got married, and my wife has similar circumstances.

To keep coverage for our chronic (pre-existing?) conditions, do we need to keep all the paperwork from previous health insurance providers? I'm talking nine years of phone-book-sized coverage plans, as well as other assorted health insurance detritus. Or should we only keep the bills, explanation of benefits, and actual records from doctors?

I know about tax-related benefits to keeping good medical records, but what we are really concerned about is a future provider saying "This thing that's been covered for eight years by other companies is a pre-existing condition, GTFO." There's plenty of guidance online about which tax records to keep, seven years worth of cancelled checks, etc., but very little about health insurance and care records.

Thanks for the help, hive mind!
posted by infinitewindow to Health & Fitness (3 answers total) 1 user marked this as a favorite
Best answer: When you move from one insurance company to another, the previous insurer (the one you're leaving) should issue you proof of prior coverage. Basically, a statement that says "Yep, they had coverage under us." You should be able to contact your previous insurer and get it.
posted by Thorzdad at 12:56 PM on February 3, 2010

FWIW, a photocopy of your most recent insurance card might be enough to prove prior coverage. It was for me, at least temporarily. So those cards can be useful and are pretty compact -- I'd say keep them.
posted by tantivy at 3:58 PM on February 3, 2010

Best answer: Thorzdad has it. You are entitled to receive a Certificate of Creditable Coverage from your previous insurance carrier(s). This CoCC should include the effective dates for your coverage. If you don't have copies of your previous CoCC(s), you can call the insurance carrier and request a copy. While the CoCC is a must, the other consideration when switching to a new carrier/plan is whether or not you've had a break in coverage.

Most insurance plans have a "look back" period in which they check to see if you've had a break in coverage during that time. This can differ plan to plan. If you did have a break in coverage, the plan will have a specific number of days that are acceptable before they will refuse to cover a pre-existing condition. For example, at my company, as long as you did not have a break in coverage longer than 63 days in the past 12 months, pre-existing conditions will be covered.

Should you need to change plans any time in the future, you'll want to ask the new plan administrator about their look back period and acceptable coverage break.

Other than the CoCCs, I would keep copies of the EOBs under your current plan (if you don't have access to them online), as well as your current Summary Plan Description. The SPD is the primary reference document for the various services covered under the plan.
posted by clpage at 5:33 PM on February 3, 2010 [1 favorite]

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