Medicare Part D Creditable Coverage Disclosure

Priority Health will be providing Medicare Part D Creditable Coverage Disclosure Notices to all of its fully-funded and self-funded clients. 

The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) added a new prescription drug program to Medicare. It is known as "Part D."  This prescription drug program under Medicare will be available starting January 1, 2006.  People with Medicare can enroll in a Medicare prescription drug plan from November 15, 2005 through May 15, 2006. However, if they have existing prescription drug coverage that, on average, is as good as Medicare coverage, they can choose to join a Medicare prescription drug plan at a later date without penalty. 

Pursuant to the MMA legislation, employers that offer prescription drug coverage have the legal obligation to inform their Medicare beneficiaries whether the prescription drug coverage they offer is as good as Medicare coverage  ("creditable" coverage) or not as good as Medicare coverage ("non-creditable" coverage).  This information must come in the form of a notice and the notice has specific timing and general content requirements. 

Priority Health will undertake this legal obligation for both our fully-funded and self-funded clients that purchase one of our group prescription drug plans.  We will send out the first notice to Medicare beneficiaries prior to the required date of November 15, 2005.  

We have a team analyzing the MMA requirements and determining how we will administer these notices.  With some notice requirements, we know that we will require the assistance of the employer (for example - the requirement that notices be provided as part of open enrollment materials for Medicare eligibles joining an employer’s prescription drug plan). 

Stay tuned for more news… 

We are currently outlining our plan and determining where we will need assistance from our employer groups.  Please feel free to share this good news with agents and employers as they contact you. We sent this notification to our agents today by email.  We intend to send a more formal letter about the Medicare Part D Creditable Coverage Disclosure Notices to our employers in the coming weeks. 

Please direct any questions on this matter to your account representative, or to Amy Chambers.