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Interoffice Communication To: NRA Retiree Date: From: David Campbell, SPUR Senior Human Resources Generalist / Benefits Subject: Important

How to fill out medicare creditable coverage notice

To fill out the Medicare Creditable Coverage Notice, follow these steps:

1. Start by gathering the necessary information. This includes the name and address of the employer or plan sponsor, the plan's name, contact information, and the policy or group number.
2. Determine if the coverage provided by the employer's plan is considered creditable or non-creditable. This information can usually be obtained from the employer or plan administrator.
3. Next, determine who needs to receive the notice. The notice is required to be sent to all Medicare-eligible individuals who are covered or are seeking coverage under the employer's plan. This includes employees, retirees, and dependents.
4. Fill in the personal information section of the notice. This includes the name, date of birth, and Medicare number (if available) of the individual receiving the notice.
5. Indicate whether the plan's coverage is creditable or non-creditable. If the coverage is creditable, it means that the plan's prescription drug coverage is expected to pay on average as much as the standard Medicare prescription drug coverage. If it is non-creditable, the plan's coverage is expected to pay less than the standard Medicare prescription drug coverage.
6. Include the start and end dates of the creditable coverage period. This information helps Medicare-eligible individuals understand when their coverage is considered creditable.
7. Sign and date the notice. This certifies that the information provided is accurate to the best of your knowledge.

Who needs the Medicare Creditable Coverage Notice?

The Medicare Creditable Coverage Notice should be sent to all Medicare-eligible individuals who are covered or are seeking coverage under the employer's plan. This includes employees, retirees, and dependents who are eligible for Medicare. By providing this notice, individuals can make informed decisions regarding their Medicare coverage options and avoid late enrollment penalties, if applicable.

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What is medicare creditable coverage notice?

Medicare creditable coverage notice is a notice provided by an employer to inform employees whether their prescription drug coverage is at least as good as the coverage provided by Medicare Part D.

Who is required to file medicare creditable coverage notice?

Entities that provide prescription drug coverage to Medicare-eligible individuals must file Medicare creditable coverage notice.

How to fill out medicare creditable coverage notice?

Employers can fill out the Medicare creditable coverage notice by completing the required fields on the disclosure form provided by the Centers for Medicare & Medicaid Services (CMS).

What is the purpose of medicare creditable coverage notice?

The purpose of Medicare creditable coverage notice is to help individuals make informed decisions about whether to enroll in Medicare Part D based on the quality of their existing prescription drug coverage.

What information must be reported on medicare creditable coverage notice?

Medicare creditable coverage notice must include details about the prescription drug coverage offered by the employer, such as whether it is creditable or non-creditable.