Can COBRA Be Creditable Coverage?
1. Creditable coverage is defined in the MMA Regulations as:
§ 423.56 Procedures to determine and document creditable status of prescription drug coverage.
(a) Definition. Creditable prescription drug coverage means any of the following types of coverage listed in paragraph (b) of this section only if the actuarial value of the coverage equals or exceeds the actuarial value of defined standard prescription drug coverage as demonstrated through the use of generally accepted actuarial principles and in accordance with CMS actuarial guidelines.
(b) Types of coverage. The following coverage is considered creditable if it meets the definition provided in paragraph (a) of this section: (…)
(3) Coverage under a group health plan, including the Federal employees health benefits program, and qualified retiree prescription drug plans as defined in section 1860D–22(a)(2) of the Act.
2. Group health plans are defined in 29 USC 1197 (1) as:
§ 1167. Definitions and special rules
For purposes of this part—
(1) Group health plan
The term "group health plan" means an employee welfare benefit plan providing medical care (as defined in section 213 (d) of title 26) to participants or beneficiaries directly or through insurance, reimbursement, or otherwise. Such term shall not include any plan substantially all of the coverage under which is for qualified long-term care services (as defined in section 7702B (c) of title 26).
3. COBRA is defined in 29 USC 1161 as:
Sec. 1161. - Plans must provide continuation coverage to certain individuals
(a) In general
The plan sponsor of each group health plan shall provide, in accordance with this part, that each qualified beneficiary who would lose coverage under the plan as a result of a qualifying event is entitled, under the plan, to elect, within the election period, continuation coverage under the plan.
First, we see that coverage under a group health plan is creditable if the actuarial value of the coverage is equal to or greater than standard Medicare prescription drug coverage. Second, we see that group health plans include coverage provided to employees for medical care. Third, we see that COBRA coverage is considered a type of group health plan. We must conclude that COBRA coverage, as any other group health coverage, can be creditable coverage.