WHAT
Medicare Part D Creditable vs. Non-Creditable Status Lists and Information by Carrier
WHEN
The Employer Medicare Part D Notice is required to be provided prior to October 15, 2022.
BACKGROUND INFORMATION
Medicare Part D Creditable and Non-Creditable status determination is the employer's responsibility when the employer is the plan sponsor. If the carrier states that the health plan is non-creditable, the benefits may still be creditable if the employer has an HRA arrangement. The employer would have to override the carrier notice. Therefore, it is the employer's responsibility to examine all of the benefits that the employer is providing and determine the creditability of the prescription coverage. The carrier is only providing notification regarding the creditability of the coverage that the carrier provides.
For details on the Medicare Part D Employer Notification Requirements, visit our broker reference guide.
CARRIER SPECIFIC INFORMATION In an effort to assist you when consulting with our mutual clients, below is a list of the small group carriers and their Medicare Part D Creditable and Non-Creditable status determination information: Aetna (NY/NJ/PA/DE) Note: Aetna does not proactively notify employers about the creditable coverage status of their plan/s and does not have a list of Medicare Credible plan for 2023. Instead, brokers can send a request to the Aetna Answer Team to test a specific plan to: NEAAT@Aetna.com. Aetna will need the Group Name, Group Number, the size of the group, and the State the plan is written in so the plan may be tested. (Aetna 9.13.22) AmeriHealth (NJ) All 2022 and 2023 AmeriHealth NJ standard and fixed funding plans are credible and letters to groups are mailing in a couple of weeks. (AmeriHealth 9.15.22) EmblemHealth (NY) All EmblemHealth 2023 plans are creditable. (Emblemhealth 9.23.22) Empire BCBS (NY) Pending carrier release. Florida BCBS (FL) Pending carrier release. Healthfirst Insurance Company, Inc. (NY) All commercial EPO plans are creditable. (Healthfirst 9.12.22) HealthPass (NY) Employers should use the Medicare Part D status information of the carrier’s plan they are enrolled in, as if they were enrolled with the carriers directly. Highmark (PA/DE) Pending carrier release. Horizon BCBSNJ (NJ) All fully insured small groups were deemed credible with the exception of P1610 which is deemed NON creditable. Information for Level Funding plans are still pending. (Horizon BCBSNJ 9.29.22) Independence Blue Cross (PA) All Independence BC 2022 and 2023 Qualified Health Plans for small groups are creditable. All 2022 and 2023 standard large group plans are creditable. (IBC 9.23.22) NY Health Alliance / MVP Plans (NY) Pending carrier release. Oscar (NY/NJ) Pending carrier release. Oxford (NY/NJ) UnitedHealthcare and Oxford group’s 2023 Medicare Part D Creditable status data is available on UnitedHealthcare’s Medicare Part D Creditable Coverage page: https://www.uhc.com/employer/employer-resources/medicare-part-d-creditable-coverage.
Oxford plans do not have separate medical and prescription (Rx) codes.
UHC 2023 Small Group Plan Lookup - If your browser does not allow you to use the "open" feature, please select "save" or "save as" to view the tool.
UHC 2023 Larger Fully Insured Plans, Level Funded & Older Plans Lookup - If your browser does not allow you to use the "open" feature, please select "save" or "save as" to view the tool.
Small Business is defined as group size 1-50 in all states except CA, CO, NY where small group is also defined as group size 1-100.
Note: Be sure to enable editing AND content once the link opens, and before using the tools below. These tools require the input of detailed group data to obtain the plan status.
UnitedHealthcare (PA/DE)
UnitedHealthcare and Oxford group’s 2023 Medicare Part D Creditable status data is available on UnitedHealthcare’s Medicare Part D Creditable Coverage page: https://www.uhc.com/employer/employer-resources/medicare-part-d-creditable-coverage.
Oxford plans do not have separate medical and prescription (Rx) codes.
UHC 2023 Small Group Plan Lookup - If your browser does not allow you to use the "open" feature, please select "save" or "save as" to view the tool.
UHC 2023 Larger Fully Insured Plans, Level Funded & Older Plans Lookup - If your browser does not allow you to use the "open" feature, please select "save" or "save as" to view the tool.
Small Business is defined as group size 1-50 in all states except CA, CO, NY where small group is also defined as group size 1-100.
Note: Be sure to enable editing AND content once the link opens, and before using the tools below. These tools require the input of detailed group data to obtain the plan status.
Comments