Deadline to Issue Medicare Part D Creditable Coverage Disclosure

• Group health plans that provide prescription drug coverage to Part D-eligible individuals
  • Excludes individuals covered under a Part D plan.

This calendar reminder is based upon a plan year effective 1/1.

Notice of Creditable Coverage should be provided annually by the Plan Sponsor:

1. prior to annual Part D open enrollment period (10/15 – 12/7)
2. prior to individual’s initial enrollment period for Part D
3. prior to effective date of coverage for any Part D-eligible individual who joins plan
4. when plan no longer offers drug coverage or when coverage changes so it is no longer creditable
5. upon request by individual

For plans that provide notice to ALL participants annually as a part of their annual disclosures, Centers for Medicare & Medicaid Services (CMS) will consider #1 and #2 above to be met. In the above list, “prior to” means within the past 12 months.

No filing requirement.

Plan participants and beneficiaries eligible for Part D.

Written notice stating whether a group health plan’s prescription drug coverage is, on average, at least as good as standard prescription drug coverage under Medicare Part D.

Entities that provide prescription drug coverage to Medicare Part D eligible individuals must notify these individuals whether the drug coverage they have is creditable or non-creditable.

Entities may modify the Model Disclosure Notices provided on this page under “Downloads” to notify affected individuals whether their drug coverage is creditable or non-creditable.