Get Medicare Creditable Coverage Notice Fillable

The Disclosure should be completed annually no later than 60 days from the beginning of a plan year (contract year, renewal year), within 30 days after termination of a prescription drug plan, or within 30 days after any change in creditable coverage status.

The disclosure notice must be given to all Medicare eligible individuals who are covered under, or apply for, your prescription drug plan. This includes active employees, disabled employees, retirees, COBRA qualified beneficiaries, covered spouses, and dependents.

ANNUAL DISCLOSURE Each year, employers with health plans that provide prescription drug coverage to Medicare-eligible individuals must disclose to CMS whether that coverage is creditable or non-creditable. The annual disclosure must be provided within 60 days after the start of the plan year.

This notice has information about your current prescription drug coverage with your employer and about your options under Medicare's prescription drug coverage. This information can help you decide whether or not you want to join a Medicare drug plan.

In addition to emailing the notice to the individual, the sponsor must also post the notice (if not personalized) on its website. Plan sponsors that provide prescription drug coverage to Medicare-eligible individuals must also disclose to CMS annually whether the coverage is creditable or non-creditable.

The first disclosure requirement is to provide a written disclosure notice to all Medicare eligible individuals annually who are covered under its prescription drug plan, prior to October 15th each year and at various times as stated in the regulations, including to a Medicare eligible individual when he/she joins the ...

Electronic Delivery. Creditable coverage disclosure notices may be sent electronically under certain circumstances.