Medicare Creditable Coverage Notices

According to Medicare guidelines any employee, retiree or dependent who is eligible for Medicare Part D and covered under, or who can apply for, your prescription drug coverage must be informed by November 15 (and at other times) of each year if their current prescription coverage is as good as, or creditable, to Medicare Part D.

TAI assists businesses with this requirement by offering the following downloadable notices. To determine the proper notice, you will need to know the drug coverage that you are providing to your Medicare eligible individual(s).

Click on the coverage below to open a Creditable Coverage notice:

Notice: You will need Adobe Reader to view these Creditable Coverage notices. Adobe Reader is a free program that can be downloaded here.

Companies that contract with a Part D plan to provide qualified prescription drug coverage are exempt from the disclosure to CMS requirement. This includes…

Please be aware, notice must also be given annually to the Centers for Medicare and Medicaid Services (CMS) via www.cms.hhs.gov/creditablecoverage. Use the link to the Creditable Coverage Disclosure Form towards the bottom of the page. Notice to CMS must be given by within 60 days after the beginning date of the Plan Year for which the entity is providing the Disclosure to CMS Form.

CMS requires that notices be distributed at various other times. Download our guidelines sheet here.

For complete guidance, visit the CMS website at www.cms.hhs.gov/creditablecoverage.

An individual is eligible for Part D if: 1. The individual is entitled to Medicare Part A and/or enrolled in Part B, as of the effective date of coverage under the Part D plan; AND 2. The individual resides in the service area of a prescription drug plan or of a Medicare Advantage plan that provides prescription drug coverage.

Note that in general, an individual becomes “entitled” to Medicare Part A when the person actually has Part A, and not simply when the person is first eligible. A person has Part A without being subject to monthly premiums if the person has attained age 65 and has monthly social security benefits or is a qualified railroad retirement beneficiary. Individuals under age 65 may become entitled to Medicare Part A if they receive at least 24 months of social security or railroad retirement benefits based on disability. An individual who is eligible for social security benefits but has not applied for such benefits becomes entitled to Medicare Part A only upon the filing of an application for Part A benefits. Detailed information about eligibility is provided in the CMS publication “Enrolling in Medicare.”