What Do I Need to Know?

If you are an employer offering health insurance to your employees you may have already received a notice from your carrier reminding you about Medicare Part D Creditable Coverage Notices. We’ve broken down everything you need to know here.

What is it?

The Medicare Modernization Act (MMA) requires entities (whose policies include prescription drug coverage) to notify Medicare-eligible policyholders whether their prescription drug coverage is creditable coverage, which means that the coverage is expected to pay, on average, as much as the standard Medicare prescription drug coverage.

Who Must Comply?

Employers who offer group health insurance with prescription drug coverage to Medicare-eligible individuals.

How Do I Comply?

By sending out one of two model notices found here:

Model 1

Model 2

Who Must I Send These To?

All Medicare-eligible individuals (whether due to age or disability) and their dependents who are either active or on cobra/continuation through your plan.

By When Must I Send These?

The annual deadline to send the notices to your employees is October 15th. You must also provide this notice upon initial eligibility for your plan.

So is My Plan Creditable or Non-Creditable?

In most cases, your carrier will tell you. Click here for a simplified explanation of how to tell if your plan is creditable. If your plan is considered non-creditable it’s ok! You just need to make sure you are sending out the correct notice.

Please feel free to reach out to us at any time for assistance with this or other compliance issues.