Carolina Benefits

Part D Creditable Coverage Notices

Employer Groups Must Send to Their Plan Participants by October 15

Date: 09/23/2013

The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) requires groups that currently provide prescription drug coverage to Medicare beneficiaries to disclose whether the entity’s coverage is “creditable prescription drug coverage”.  If a beneficiary doesn’t have creditable coverage through the group and delays their enrollment in a Medicare Part D plan, they are required to pay a late-enrollment penalty.

Here are a few key points regarding the MMA requirement:

  • The employer group must communicate their creditable or non-creditable status to their members.
  • The determination is mandatory at least once a year and the deadline for completion is October 15.
  • The employer groups, not BCBSNC, send creditable coverage notices to members.

It is the employer group’s responsibility to provide member notification of their plan’s status as creditable or non-creditable under Medicare Part D. Notices of creditable and non-creditable coverage to Part D eligible individuals must now be made prior to October 15, 2013. We recommend that groups consult the CMS website for updates.

Here is an model Credible Coverage Notice.