Who is Federally Eligible?

Federally eligible individuals in the individual market are those who, at the time they seek individual coverage, satisfy all of the following criteria:

• they must have accrued a total of 18 or more months of prior creditable coverage; they have no more than a 62 day break between periods of creditable coverage;
• their most recent creditable coverage must have been provided under a group health plan;
• they must not be eligible for group health coverage, Medicare or Medicaid, and must not have any other health insurance coverage;
• their most recent coverage must not have been terminated due to nonpayment of premium or fraud; and,
• if offered continuation of coverage under federal COBRA requirements or state continuation laws, they must have elected and exhausted such continuation coverage.