Medicare Deadline Reminder: Annual CMS Medicare Part D Notification Reminder – send by October 15, 2012

09/06/2012

The Centers for Medicare and Medicaid require employers that offer prescription drug coverage to notify their Medicare eligible participants of the creditability status of the prescription drug plan.

This notification must take place by October 15th of every year. While the legislation requires the notice only be sent to the Medicare eligible population, our recommendation is to send the document to all participants in the plan. This includes COBRA participants and those in the COBRA election period.

The purpose of this notice is two-fold: first, it informs the participant of the prescription drug plan status as a creditable or non-creditable plan. This information is vital to the employee who is contemplating a Medicare Part D Prescription Drug plan during the Medicare Open Enrollment period. The notice also provides proof of coverage, if, at a later date, the participant chooses to enroll in a Medicare Part D plan. The proof of coverage allows the participant to enroll into the Part D plan without a surcharged premium. The chart below highlights the Medicare Part D Standard Benefit Plan design for 2013:

Plan Feature 2013 Limit   (2012 Limit)
Initial Deductible Up to $325  ($320)
Initial Coverage Limit $2,970         ($2,930)
Out-of-Pocket Threshold $4,750         ($4,700)
Discount on brand-name drugs while in the donut hole 52.5%          (50%)
Co-pay on generic drugs while in the donut hole Up to 79%   (86%)

The links are here for the Creditable Coverage Notice and the Non Creditable Coverage Notice:http://www.cms.gov/Medicare/Prescription-Drug-Coverage/CreditableCoverage/Model-Notice-Letters.html . Please note, changes beyond those areas bolded or italicized are not recommended.

For assistance determining the creditability of the offered prescription drug plan, please contact your WGA Client Executive or Client Service Manager.