Guam Information for Alternative Method of Counting Creditable Coverage
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FAQ
To avoid paying the surcharge, your spouse or partner can enroll in his or her employer's medical plan. You'll want to compare coverage and total costs both ways to see what makes sense for your family.
The Notice of Creditable Coverage works as proof of your coverage when you first become eligible for Medicare. Those who have creditable coverage through an employer or union receive a Notice of Creditable Coverage in the mail each year. This notice informs you that your current coverage is creditable.
Creditable coverage is a health insurance, prescription drug, or other health benefit plan that meets a minimum set of qualifications. Types of creditable coverage plans include group and individual health plans, and student health plans, as well as a variety of government-sponsored or government-provided plans.
Prescription drug coverage is creditable if the actuarial value of the coverage equals or exceeds the actuarial value of standard prescription drug coverage under Medicare Part D, as demonstrated through the use of generally accepted actuarial principles and in accordance with Centers for Medicare and Medicaid Services
You should receive a notice from your employer or plan around September of each year, informing you if your drug coverage is creditable. If you have not received this notice, contact your human resources department, drug plan, or benefits manager.
An alternate design is a spousal surcharge approach. With a spousal surcharge program an employee must pay an additional cost to cover a working spouse who has the option to elect health coverage from his or her employer and has declined the coverage.
Notices of creditable/non-creditable coverage may be included in annual enrollment materials, sent in separate mailings or delivered electronically.
For a typical employer-sponsored benefits package, which includes medical, optical, dental, AD&D (Accident Death & Dismemberment), and possibly disability, the cost is 5,000- 7,000 Canadian Dollars per annum or about 420-580 Canadian Dollars per month.
Employers that offer prescription drug coverage must provide notices of "creditable" or "non-creditable" coverage to Medicare-eligible employees or covered dependents before each year's Medicare Part D annual enrollment period begins.
The notices can also be sent electronically in some instances. As a general rule, a single disclosure notice may be provided to the covered Medicare beneficiary and all of his or her Medicare Part D-eligible dependents covered under the same plan.
