Medicare Part D Notice Required Before October 15th

This is a reminder that the deadline to distribute the Annual Notice of Creditable Coverage required under Medicare Part D is rapidly approaching. This notice informs participants whether the prescription drug coverage offered under your health plan constitutes creditable or noncreditable coverage. As the Medicare Part D annual enrollment period now runs from October 15 to December 7, you must distribute the notices before October 15.

Employers who sponsor a health plan offering prescription drug benefits must provide an annual notice to all Medicare-eligible participants that explains whether the prescription drug benefits offered under the plan are at least as good as the benefits offered under the Medicare Part D plan. The only employers exempt from this requirement are those that establish their own Part D plan or contract with a Part D plan.

The Centers for Medicare and Medicaid Services (CMS) has posted forms and instructions for providing this notice. The forms were last updated in 2011. They are available, both in English and Spanish.

The Notice of Creditable Coverage must be provided:

• At least once a year before October 15 (the start of the annual Medicare Part D enrollment period)
• Whenever a Medicare-eligible employee, spouse or dependent enrolls in your health plan
• Whenever there is a change in the creditable or non-creditable status of your health plan’s prescription drug coverage
• Whenever an individual requests the notice

Because it is difficult to keep track of which employees (and their spouses or dependents) are eligible for Medicare benefits, you may want to consider making the Notice a part of your new-hire enrollment materials and your annual open enrollment materials. If distributed before October 15, this should take care of the first two bullet points above.

Remember that you must also submit a Disclosure to CMS Form each year, reporting whether your prescription drug coverage is creditable or non-creditable. This form must be submitted electronically within 60 days of the beginning of each plan year (i.e. if you are on a calendar year, you must submit the form by March 1, 2014).

Reminder: Medicare Part D Creditable Coverage Notice

Employers must provide a creditable or non-creditable coverage notice at least once a year to all Medicare eligible individuals who are covered under, or who apply for, the group’s prescription drug plan. This notice must be provided to both active employees and retirees who are eligible for Medicare Part D.

The Medicare Modernization Act mandates that all employers offering prescription drug coverage disclose to all Medicare eligible individuals with prescription drug coverage under the plan whether the coverage is “creditable”. This information is essential to the Medicare eligible’s decision whether to enroll in a Medicare Part D prescription drug plan.

Employers are required by the Centers for Medicare and Medicaid Services (CMS) to provide creditable coverage at least once a year and at the following times:

• Prior to the Medicare Part D Election Period beginning October 15th of each year

   

• Prior to the individual’s initial enrollment period

   

• Prior to the effective date of coverage for any Medicare-eligible individual that joins your plan

   

• Whenever prescription drug coverage ends or changes

This notice does not need to be a separate mailing and can be included with other plan information materials either printed or electronic. Employers are required to provide this notice and to provide CMS with your plan’s creditable or non-creditable coverage status annually via online form within 60 days of the beginning of each plan year.

Please contact our office for assistance in determining if your prescription drug plan is considered creditable or non-creditable coverage or if you need a copy of the model notice for employees.