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Compliance Overview: Determining Whether Prescription Drug Coverage is Creditable

This “Compliance Bulletin” outlines methods for determining whether a group health plan’s prescription drug coverage is considered creditable. The coverage creditability must be reported to individuals eligible for Medicare Part D and the Centers for Medicare and Medicaid Services (CMS). Links to, both, the model creditable coverage notices for individuals and the online disclosure form for CMS are available in this article. While there is no fee or penalty for offering prescription drug coverage that is non-creditable, individuals with this coverage who fail to enroll in Part D during their initial enrollment period can be subject to an additional Part D premium, if they enroll in Part D at a later date.

Contact your Cowden representative for more information on this or other compliance issues.

Read Compliance Overview PDF here