Medicare Part D Notice

UHA Employer-Sponsored Prescription Drug Plans – Notification of Creditable Coverage (Medicare Part D)

UHA periodically reviews the group-sponsored plans to ensure that they meet or exceed the requirements necessary to be considered creditable coverage under the Medicare Modernization Act (MMA).

Important: As an organization offering a group-sponsored drug plan to Medicare-eligible individuals, you are required under MMA to provide a similar notice to all your Medicare-eligible beneficiaries. To assist you, UHA has provided a model notice Creditable Coverage Notice Sample Letter (updated April 1, 2011), which can be completed and distributed to applicable individuals.

Most entities (Employer Groups) that currently provide prescription drug coverage to Medicare Part D eligible individuals must disclose to the Centers for Medicare & Medicaid Services (CMS) whether the coverage is “creditable prescription drug coverage” (Disclosure Notice). A disclosure is required whether the entities’ coverage is primary or secondary to Medicare. Entities that must comply with these provisions are listed at the CMS website.

Entities are required to provide the Disclosure Notice through completion of the disclosure form on the CMS Creditable Coverage Disclosure web page. As you answer the questions on the electronic Disclosure to CMS form, an additional box will appear where you should enter the required disclosure information. This method of transmission is convenient and will take minimal time to complete, and is the sole method for compliance with this annual requirement.

Visit the CMS website for information and required forms for creditable coverage.

As a reminder, within the year there are creditable coverage “trigger events” that will require employers to provide the credibility notice. The trigger events are:

  • Before the Medicare Part D annual coordinated election period (Oct. 15 – Dec. 7) each year.
  • Within the 12 months before an individual’s Initial Enrollment Period for Medicare.
  • Before the effective date of coverage for a Medicare-eligible individual beginning participation in the employer-sponsored group health plan.
  • When the plan’s prescription drug coverage ends or is no longer creditable.
  • Upon a beneficiary’s request.

If you have any questions regarding creditable coverage and the required notifications, please contact your dedicated UHA Account Representative.