Nevada Information for Alternative Method of Counting Creditable Coverage
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How to fill out Information For Alternative Method Of Counting Creditable Coverage?
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FAQ
Non-creditable coverage: A health plan's prescription drug coverage is non-creditable when the amount the plan expects to pay, on average, for prescription drugs for individuals covered by the plan in the coming year is less than that which standard Medicare prescription drug coverage would be expected to pay.
Under §423.56(a) of the final regulation, 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 CMS actuarial
If you joined Medicare Advantage when you first became eligible for Medicare, but decided to switch to Original Medicare within the first 12 months, you have Medicare Supplement guaranteed issue rights for 60 days before your plan ends and 63 days after you switch.
As of now, there is no cap when calculating the Medicare Part B late enrollment penalty. However, legislation has been introduced to cap the Medicare Part B penalty at 15% of the current premium, regardless of how many 12-month periods the beneficiary goes without coverage.
Medicare Advantage plans must offer benefits that are at least as comprehensive as Medicare Parts A and B. Therefore, all Medicare Advantage plans have creditable coverage.
You may qualify to have your penalty waived if you were advised by an employee or agent of the federal government for example by Social Security or 1-800-MEDICARE to delay Part B. Asking for the correction is known as requesting equitable relief.
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.
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.
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.
If you go 63 days or more in a row without Medicare drug coverage or other creditable prescription drug coverage, you may have to pay a penalty if you sign up for Medicare drug coverage later.
