Certificate of Creditable Coverage
A certificate of creditable coverage is a document that shows your prior health care coverage. This certificate usually reduces how long a health care plan may exclude you from coverage for a pre-existing health condition. For former TRICARE beneficiaries, the certificate shows a new employer insurance company that you had previous TRICARE health care coverage, for the period noted on the certificate. The Health Insurance Portability and Accountability Act (HIPAA) requires TRICARE to issue you a certificate of creditable coverage if you lose TRICARE eligibility.
Are You Eligible to Receive a Certificate?
If TRICARE covered you before you lost your eligibility, even when you were an active duty service member separating from the service, you are entitled to a certificate of creditable coverage. If you're an active duty service member who retires, you don't get a certificate because you don't lose your eligibility. However, if you're retired and need proof of coverage for a new employer's health plan you must request a letter of eligibility from the Defense Manpower Data Center (DMDC) which reflects ongoing TRICARE medical coverage.
TRICARE issues certificates when:
- The sponsor separates from active duty; the certificate lists all eligible family members.
- A member of the National Guard or Reserves demobilizes; the certificate lists all eligible family members.
- A dependent child loses eligibility
- A former spouse loses eligibility after divorce.
What Type of Information Does the Certificate Contain?
The certificate reflects each period of continuous TRICARE coverage that occurred within the 24 months before you lost eligibility. Each certificate identifies the sponsor's or family member's name for whom it is issued, the dates TRICARE coverage began and ended and the certificate issue date.
When Is a Certificate Required?
If you are a former TRICARE beneficiary who purchases or is offered health care coverage, the other insurance plan may require you to present a certificate of creditable coverage. For example, if you leave active duty and seek a job with a civilian employer, the new employer may require a certificate of creditable coverage for reducing the time the new health plan may keep you from receiving health care for a pre-existing condition.
Who Issues the Certificate of Creditable Coverage?
The DMDC Support Office (DSO), which manages the Defense Enrollment Eligibility Reporting System, issues a certificate of creditable coverage to sponsors and family members on loss of eligibility. It takes, on average, 15 business days to receive your certificate. However, you may request a certificate in writing via mail, fax, or phone at any time, which the DSO will mail you free of charge.
Where Do I Send My Written Request for a Certificate?
You should mail your written request to the following address:
Defense Manpower Data Center Support Office (DSO)
Attn: Certificate of Creditable Coverage
400 Gigling Road
Seaside, CA 93955-6771
The request must include the following:
- Sponsor's name and Social Security number
- Name of person for whom the certificate is requested
- Reason for the request
- Name and address to whom and where the certificate should be sent
- Signature of the requester
Are There Other Ways to Request a Certificate?
You cannot e-mail a request for a certificate, but if you want the certificate to be faxed or mailed to you and not a third party, you can make your request via phone. Any requests for certificates to be provided to a third party must be requested in writing and signed.
1. Send your request via fax to 1-831-655-8317. The request must include the following:
- Sponsor's name and Social Security number
- Name of person for whom the certificate is requested
- Reason for the request
- Name and address to whom and where the certificate should be sent
- Signature of the requester
2. Call the DSO directly at any time to request or check the status of your certificate.
- Phone: 1-800-538-9552
- TTY/TDD: 1-866-363-2883
The recorded message will prompt you to say "C-O-C-C" and connect you with a live representative.
Certificates can take about three weeks to process, however if your request is urgent you can request that our processing be expedited and your certificate can be faxed directly to a particular number.
What do you call it?
The "certificate of creditable coverage" may also be called "statement of service," "proof of coverage," "evidence of coverage," or "letter of creditable coverage."
Is your address correct in DEERS?
Your certificate of creditable coverage will be sent to the address listed in DEERS.
Last Modified:September 21, 2012
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Certificate of Creditable Coverage
Toll-free: 1-800-538-9552
TTY/TTD: 1-866-363-2883
Fax: 1-831-655-8317
