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Creditable Coverage


The Medicare Modernization Act (MMA) imposes a late enrollment penalty on individuals who do not maintain Creditable Coverage for a period of 63 days or longer following their initial enrollment period for the Medicare prescription drug benefit. MMA mandates that certain entities offering prescription drug coverage, including employer and union group health plan sponsors, disclose to all Medicare eligible individuals with prescription drug coverage under the plan whether such coverage is "creditable." This information is essential to an individual's decision whether to enroll in a Medicare Part D prescription drug plan.

This page provides guidance documents relating to Creditable Coverage requirements for employer and union-sponsored plans and model notice documents.



Updated Guidance - Disclosure of Creditable Coverage to Medicare Part D Eligible Individuals Guidance (PDF, 113KB)

Creditable Coverage Simplified Determination (PDF, 12KB)

Employers/Unions & Medigap Issuers Guidance - Which Notice of Creditable Coverage to Provide? (PDF, 37KB)

Account-Based Arrangement Guidance  (PDF, 55KB)

Overview of Creditable Coverage Issues for Plan Sponsors (PDF, 17KB)

Do You Have a Medigap Policy with Prescription Drug Coverage? (PDF, 398KB)

Entities Required to Provide Disclosure (PDF, 36KB)

What is Creditable Coverage (PDF, 14KB)

Related Links Inside CMS

Disclosure to CMS Form

Employer & Union Plan Sponsor Information Overview Page

Employer & Union Retiree Drug Subsidy Overview Page

Employer Group Waiver Plans Overview Page
Related Links Outside CMSExternal Linking Policy

There are no Related Links Outside CMS


Page Last Modified: 04/16/2008 2:51:55 PM
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