Groups to Receive Notice of Creditable/Non-Creditable Coverage Letters

September 2022

Each year, employers must notify Medicare-eligible employees covered under their prescription drug plans as to whether their 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

Employers must send notices by October 15 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, with the exception of:

  • $2,000 and $2,500 deductible Preferred-Care Blue plans (with a $12 generic-only pharmacy benefit)
  • AffordaBlue plan

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.

  • Value PCB Bronze
  • Value BSP Bronze
  • Value BSP Silver
  • Spira Care BSP EPO Bronze
  • Spira Care BSP EPO Silver

Letter mailed this week to employer groups

This week, Blue KC will send a mailing to employers about whether their plans are creditable or non-creditable. The letters include examples of the 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

See Blue KC letters to employers:

Large Group All Creditable Plans – To large groups with all plans providing creditable coverage

Large Group Non-Creditable Plans –To large groups with a non-creditable plan

Small Group ACA Non-Creditable Plans – To ACA small groups in Kansas and Missouri with non-creditable plans

Small Group All Creditable Plans – To small groups with all plans providing creditable coverage

Small Group Non-Creditable Plans – To small groups with a non-creditable plan

If you have questions about the notice of creditable coverage your clients will be receiving, please contact your Blue KC representative.