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June 27, 2023, Attn: Melissa Kluchurosky UNIV OF PITTSBURGH 200 CRAIG HALL Pittsburgh, PA 15260RE: Creditable Coverage Notification for Commercial Prescription Drug Plans Dear Valued Customer: UPMC
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How to fill out creditable coverage notificat
How to fill out creditable coverage notificat
01
Gather relevant information such as plan name, group number, and coverage dates.
02
Fill out the employer section with the company's name, address, and contact information.
03
Provide information on the type of coverage being offered (e.g. medical, dental, prescription drugs).
04
Include details on any prescription drug coverage provided by the plan.
05
Sign and date the form before submitting it to the appropriate parties.
Who needs creditable coverage notificat?
01
Employers who offer group health plans that provide prescription drug coverage to Medicare-eligible individuals.
02
Insurance carriers that provide prescription drug coverage to Medicare-eligible individuals.
03
Medicare Part D eligible individuals who have creditable prescription drug coverage through an employer's group health plan.
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What is creditable coverage notification?
Creditable coverage notification is a notice provided to individuals who are covered under a group health plan, informing them whether the plan's coverage is considered creditable under Medicare.
Who is required to file creditable coverage notification?
Employers or plan sponsors offering group health plans that provide prescription drug coverage are required to file creditable coverage notification.
How to fill out creditable coverage notification?
Creditable coverage notification can be filled out online using the Centers for Medicare & Medicaid Services (CMS) website or by mailing a hard copy to the address provided by CMS.
What is the purpose of creditable coverage notification?
The purpose of creditable coverage notification is to inform individuals whether their current prescription drug coverage is creditable under Medicare, so they can make informed decisions about enrolling in Medicare Part D.
What information must be reported on creditable coverage notification?
Creditable coverage notification must include details about the plan's prescription drug coverage, such as whether it meets the minimum standards set by Medicare for creditable coverage.
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