Medicare Part D Members and Creditable Coverage

When enrolling into a Medicare part d plan, there are always questions about creditable coverage and if it’s necessary to sign up. There are some that have been eligible for Medicare part D plans and haven’t signed up because they still had other coverage or didn’t know they should sign up. Questions about creditable coverage normally come when people are looking at their options for healthcare insurance and Medicare options, especially Medicare part D choices.

The first thing people want to know is what creditable coverage is. Creditable coverage is healthcare insurance coverage that is as good as or better than Medicare insurance. When it comes to Medicare part D, creditable coverage would have to include prescription drug coverage that is as good as or better than the prescription coverage offered by Medicare part D plans. It’s very easy to understand once it has been explained properly.

I Have Coverage. Is It Creditable?

There are some people that are Medicare part D eligible but they don’t know if their coverage is as good as or better than Medicare part D. There are some healthcare plans with prescription coverage that is just as good as Medicare part D or better. When thinking of changing plans, it’s best to start with the coverage that is already in effect.

Centers for Medicare and Medicaid Services know there are certain plans that are offered and considered creditable coverage. These programs have been put together and operated by federal employees and CMS has a great understanding of what benefits are offered.

  • Federal Employee Health Benefits Program
  • Veteran’s Benefits
  • TriCare
  • Indian Health Services

These programs are all automatically considered creditable coverage when it comes to prescription drug coverage. For more information on what prescriptions are covered and how much the copays and coinsurance payments are, it’s best to contact that provider to get a better understanding.

I Don’t Have Creditable Coverage… What Now?

Unfortunately there are some people that don’t have creditable coverage and they didn’t know they were eligible to sign up for a Medicare part D prescription drug plan. Because of that misinformation, there are some people that don’t have any prescription drug coverage. Those that don’t have any creditable coverage and went for a period of time without prescription drug coverage may be assessed a Medicare part D late enrollment penalty.

The Medicare part D late enrollment penalty is determined by the Centers for Medicare and Medicaid Services. When these penalties are decided, Medicare members are notified when they enroll into a Medicare part D plan. Their penalty is paid along with the premium they pay for their prescription drug plan. Anyone that had creditable coverage and receives notice of a penalty can have that penalty removed with proof of coverage.

Creditable coverage is something that most Medicare members have before they enroll into a part D plan. Those that question if they had it should contact their previous provider and ask for a creditable coverage letter for their records.

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