Medicare Part D Creditable Coverage Notice Reminder – Due by October 14, 2020

A Medicare Part D plan provides prescription drug coverage under Medicare. The Medicare Part D notice, required by the Medicare Modernization Act (MMA) at least once a year, provides information to individuals enrolled in Medicare about whether employer-provided prescription drug coverage is creditable and the consequences of failing to enroll in a Medicare Part D plan in a timely manner. Creditable coverage is coverage that is expected to pay on average as much as the standard Medicare prescription drug coverage.

Who Must Comply?

  • All sponsors of group health plans that offer prescription drug coverage.

When must an employer notify their members of the plan’s creditable coverage status:

  • Prior to an 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 so that it is no longer creditable or becomes creditable;
  • Prior to the Medicare Part D Annual Coordinated Election Period beginning on October 15 of each year; or
  • Upon the request of a beneficiary.

Who Must Receive?

  • all medicare eligible employees or dependents who are enrolled in your group health plan or who have applied for your group health plan
  • all eligible dependents whose last known address is different than that of the employee

Method of Delivery:

Notice can be delivered electronically:

  • to employees that have the ability to access electronic documents where they are reasonably expected to perform duties and need access to the company’s electronic information system as an integral part of their job;
  • and to individuals who consent to receiving the information electronically

Otherwise, notice must be provided in hard copy.

Sample Notices

  • Medicare Part D Creditable Coverage Model Notice – Click here for English. Click here for Spanish.
  • Medicare Part D Non-Creditable Coverage Model Notice – Click here for English. Click here for Spanish.