Medicare Part D

Creditable Coverage Notice (2008)

Non-creditable Coverage Notice (2008)

 

Health plans that offer prescription drug coverage to their Medicare-eligible employees, retirees, and dependents must notify them by November 15, as to whether that coverage is "creditable" or "non-creditable."
This requirement is part of the Medicare Prescription Drug, Improvement and Modernization Act of 2003 (MMA), which added a new prescription drug program to Medicare known as the Part D drug benefit. Under the MMA, the Centers for Medicare & Medicaid Services (CMS) established two categories of prescription drug coverage – creditable and non-creditable coverage. Creditable coverage is defined as a prescription drug benefit that has an actuarial value as good as or better than the standard Part D drug benefit. A non-creditable prescription drug plan has an actuarial value that is not as good as the standard Part D drug benefit.


NOTIFICATION IS REQUIRED
Plan sponsors (employer groups/health and welfare funds) that provide prescription drug coverage to Medicare-eligible active employees, retirees, and dependents must disclose to them by November 15 of each year, whether the drug coverage they offer is creditable or non-creditable.


WHAT EMPLOYERS SHOULD DO
Determine whether their prescription drug coverage is creditable or non-creditable;
Disclose to their Medicare-eligible members (employees and their dependents) whether their prescription drug coverage is creditable or non-creditable prior to the Medicare Part D Annual Election period:
Notify CMS whether their prescription drug coverage qualifies as creditable or non-creditable;
Visit the CMS website at http://www.cms.hhs.gov/CreditableCoverage for further information on creditable coverage and a copy of the model creditable/non-creditable disclosure letters.


Please note:  Medicare beneficiaries who are not covered under creditable prescription drug coverage and who chose not to enroll in a Medicare Part D drug plan when they first became eligible for Medicare or during the initial enrollment period, will likely pay a higher premium permanently if they subsequently enroll in the Medicare Part D drug program (the premium is increased by 1 percent for each month without creditable coverage).

To certify Medicare Part D coverage, click here to go to the U.S. Department of Health and Human Services  Creditable Coverage Disclosure site.

 

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