South Dakota 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
A certificate of Creditable Coverage (COCC) is a document provided by your previous insurance carrier that proves that your insurance has ended. This includes the name of the member to whom it applies as well as the coverage effective date and cancelation date.
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.
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.
Typically, COBRA is not creditable drug coverage for Part D. However, if your plan is an exception, you'll have a Special Enrollment Period to join a Part D plan without a penalty. Refer to your plan administrator to confirm the creditability of your current drug 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.
Acceptable documentation includes: pay stubs that reflect a premium deduction, explanation of benefit forms (EOBs), a benefit termination notice from Medicare or Medicaid, and verification by a doctor or a former health care benefits provider of the individual's prior health coverage.
Group health plan sponsors are required to disclose to CMS whether their prescription drug coverage is creditable or non-creditable. This disclosure is required regardless of whether the health plan's coverage is primary or secondary to Medicare.
Evidence of Coverage (EOC) is a notice you receive from your Medicare Advantage or Part D plan in late September. It lists the plan's costs and benefits that will take effect on January 1 of the upcoming year. Review the EOC to see if the plan will meet your health care needs in the next year.
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.
The Medicare Modernization Act (MMA) requires entities (whose policies include prescription drug coverage) to notify Medicare eligible policyholders whether their prescription drug coverage is creditable coverage, which means that the coverage is expected to pay on average as much as the standard Medicare prescription
