Each year, employers must notify Medicare-eligible employees covered under the employer’s prescription drug plans as to whether the employee’s current prescription drug coverage is creditable or non-creditable. Creditable coverage means it expects to pay on average as much as the standard Medicare prescription drug coverage.
Medicare Part D is a program for Medicare-eligible individuals created by the Medicare Modernization Act of 2003. Medicare Part D provides eligible individuals with prescription drug coverage. This voluntary program is open to anyone enrolled in Medicare Part A and/or Part B.
Blue KC tests prescription drug plans to determine creditable/non-creditable coverage
Employers must send notices to employees by October 16 before the Medicare Part D Annual Coordinated Election Period. To assist employers, Blue KC has tested each employer’s prescription drug plan that we administer to determine if it is creditable or non-creditable. Here is an overview of our findings:
Large and small group plans. All large and small group employer plans are creditable, except for:
- Large group BlueSaver plan with deductible of $5,500 or more and no cost sharing on Rx coverage
- AffordaBlue
Small group ACA plans. Due to guidelines provided by CMS and changes to the cost sharing of these plans, the small group ACA products below were determined to be non-creditable. Please note that this will not impact members enrolled in these plans in prior years.
- First PCB Bronze
- Value PCB Bronze
- Traditional BSP Bronze
- Value BSP Bronze
Letter will mail mid-September to employer groups
Blue KC will mail employers about whether their plans are creditable or non-creditable in mid-September. The letter includes a link to sample required notices, which employers may personalize and use to communicate with their employees. Editable versions of the creditable or non-creditable model disclosure notices are also available at cms.hhs.gov/CreditableCoverage.
Blue KC employer letters include:
- Large Group Creditable Plans
- Small Group Creditable Plans
- Large Group Non-Creditable Plans
- Small Group Non-Creditable Plans
- Small Group ACA Non-Creditable Plans
If you have questions about the letter your clients will receive, please contact your Blue KC representative.