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Medicare Part D Creditable Coverage Notices

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Jaxine L. Wintjen, CP
Foster Swift Employment, Labor & Benefits Quarterly
Summer 2011

Group health plans that offer prescription coverage to Medicare eligible participants must provide notices to participants advising them whether their drug coverage is creditable or non-creditable. Such notice must be provided to participants:

  • Before the beginning of the Medicare Part D annual enrollment period;
  • Before an individual is first eligible for Medicare Part D;
  • Before the effective date of coverage for any Medicare eligible individual who joins the plan;
  • Whenever prescription drug coverage ends or changes so that it is no longer creditable or becomes creditable; and
  • Upon the individual’s request.

The Center for Medicare and Medicaid Services ("CMS") provides Model Notices that may be used by Plan Administrators to comply with the notice requirements. Plan Administrators may modify the Model Notices as necessary to reflect the provisions of their individual plans.  Download copies of the Model Notices below:

CMS has revised the date by which the Medicare Part D annual enrollment Notice must be provided. Previously, the annual notice must have been provided by November 15 of each year.  Effective in 2011, the annual Notice must be provided by October 15 of each year.

Please contact your Foster Swift employee benefits professional for further information.