2020 - 2021 Creditable coverage


According to the Medicare Modernization Act (MMA), the Center for Medicare and Medicaid Services (CMS) requires employers or unions who provide prescription drug coverage to Medicare-eligible beneficiaries to disclose whether their coverage is "creditable," meaning their coverage is expected to pay, on average, at least as much as Medicare's standard prescription drug coverage.

Priority Health is providing employers with tools and information to determine their plans' creditable coverage status including:

  • Confirming if their plan qualifies as creditable for 2020 and renewing in 2021
  • Notifying Medicare-eligible employees of their coverage status by Oct. 15, by providing sample letter templates. (Many employers choose to send notifications to all employees to ensure no one is missed) 
  • Reporting creditable coverage status to CMS

This information is available for you in the Agent Center and for your groups in the Employer Center. When reviewing the creditable coverage tables, please pay particular attention to plans that have a high-deductible health plan (HDHP) and/or with a 5-tier drug plan. You can also view model letters from CMS.

Questions? Contact your large group account manager or small group sales rep or call the small business department at 800.471.2504, option 4.