Time to Distribute Medicare Part D notificition
Employers that currently provide prescription drug coverage to Medicare-eligible active employees and/or dependents, as well as Medicare-eligible retirees and/or dependents, must disclose to Medicare-eligible members and to CMS (Center for Medicare & Medicaid Services) whether the drug coverage they offer is creditable or non-creditable by October 15, 2026.
Most people think Medicare is only for a person over the age of 65. This certainly is the majority of Medicare recipients; however, the following is a list of potential Medicare triggering events:
- Retiree – age 65 or older, and spouse
- Active employee – age 65 or older, employee and/or spouse
- Person that is disabled (regardless of age) – employee, spouse and/or dependents
- Person with End Stage Renal Disease (regardless of age) – employee, spouse and/or dependents
All persons that fall into any of the above categories must receive a notice from their employer, prior to October 15th of every year indicating whether their prescription drug coverage is creditable or non-creditable.
What does it mean to have creditable coverage? Creditable coverage has been determined to be equal to or better than the prescription drug benefit mandated by the government under the Medicare Part D Rx benefit. In most cases prescription drug card plans that cover both brand and generic prescriptions and pay at least 60% of the member’s prescription drug expenses are considered creditable. Generally only clients that have a high deductible medical plan (HSA Plan) that subjects all expenses including prescriptions to a front-end deductible would possibly be considered not creditable. To date all AmeriHealth plans are considered creditable. Horizon will be sending letters by the end of September advising if the plan you offer is creditable or non creditable. Aetna does not proactively notify employers, however we have confirmed that all of our client Aetna plans are considered creditable. We are still waiting on creditable determination guidance from Independence Blue Cross.
I have attached the notice in Word format so you can easily adjust it to add your contact information. If you have done this in the past, the notice has not changed. It is the same document you have been using since April 2011 so no need to reinvent the wheel!
Submitted by: Amy R. Webb, RHU, CBC, President
Saratoga Benefit Services, LLC