Employers: Deadline for Medicare Part D Notices of Creditable Coverage is Near

Employers, it’s that time of year again. In order to maintain compliance with the Medicare Prescription Drug, Improvement, and Modernization Act in 2003, you are required to send Medicare Part D Notices of Creditable Coverage to all Medicare-eligible employees. These notices are due by October 15, so start putting them together now.

Who is a “Medicare-eligible” employee?

  • Retirees (and their dependents, if any)
  • Active Medicare-eligible employees (over age 65) and their dependents, if any
  • All COBRA participants

Some employers choose to simply include the notice of creditable coverage to all employees, or in packets of information on group benefits that are sent to everyone. The reason for this is that it saves you time deciding which employees are Medicare-eligible or not, and you don’t run the risk of overlooking anyone.

“Creditable coverage” means that a healthcare plan offers coverage at least equal to the standard Medicare Part D (prescription) plan. Currently, standard coverage under Medicare  includes:

  • A deductible of $480
  • An initial coverage limit of $4,430
  • An out-of-pocket threshold of $7,050

Your group healthcare plan would be considered creditable if it provides:

  • Coverage for brand and generic prescriptions
  • Reasonable access to retail providers and mail order coverage
  • Payment, on average, of at least 60% of prescription drug expenses

If you wish to send electrconic notices of creditable coverage rather than paper copies, you will be required to follow certain strict guidelines. If that is your preference, please call our office to discuss the correct procedures, as electronic notices can get a big more complicated. We can also answer any other questions you might have about Part D Notices of Creditable Coverage.

And remember: These notices are due by October 15. Get started now, so that you can be sure to comply with the law without delay.


Posted by PGIA
2 years ago / August 17, 2022

Filed Under: Medicare Info