Medicare Part D Creditable Coverage Notice

The Medicare Modernization Act (MMA) requires employers whose policies include prescription drug coverage to provide a written disclosure notice to all Medicare eligible policyholders of whether such coverage is creditable. Creditable coverage means that the coverage is expected to pay, on average, as much as the standard Medicare prescription drug coverage.

 This disclosure must be provided prior to October 15th, 2015 (and at various times as stated in the regulations) to:

  • Medicare eligible active working individuals and their dependents (including a Medicare eligible individual when he or she joins the plan);
  • Medicare eligible COBRA individuals and their dependents;
  • Medicare eligible disabled individuals covered under an employer’s prescription drug plan; and
  • Any retirees and their dependents.

Model notices are available from the Centers for Medicare & Medicaid Services.

Please note, if your policy is an unfunded  high deductible health plan, your group policy is probably not credible for part D purposes and those members should receive the proper notice and may want to consider adding a Medicare Part D plan at open enrollment.

Please contact your Total Benefit Solutions, Inc account manager at (215)355-2121 should you have any further questions or concerns.

 Additional Disclosure Requirements
Under the law, employers must also complete an online disclosure to CMS to report the creditable coverage status of their prescription drug plan at certain intervals. Click here for more information