Creditable Coverage
Creditable coverage refers to a plan with benefits and coverage equal to or better than Original Medicare Parts A and B or a Medicare Prescription Drug Plan. Employers and unions are required to inform the Centers for Medicare and Medicaid Services (CMS) whether or not the plans they offer are creditable. They're also required to send letters to their beneficiaries (those enrolled in their plans) every year as proof of having creditable coverage. It's important to maintain creditable coverage to avoid the late enrollment penalty (LEP) when you sign up for Medicare Part B or a Medicare Prescription Drug Plan. The LEP starts once you meet certain criteria, such as being eligible, being 65 or older, and not having creditable coverage.
All Medicare plans we offer are considered creditable coverage.
Letter, Notice, or Certificate of Creditable Coverage
The letter of creditable coverage (also called a notice or certificate of creditable coverage) contains information about who had coverage under the plan and the dates the plan took effect and ended.
You may receive a letter of creditable coverage if you have prescription drug coverage from an employer, union, or other group health plan. Typically, you receive this letter each year in September. It lets you know whether your group coverage is creditable. If you receive a letter of creditable coverage, keep it for future reference. When you enroll in new Medicare prescription drug coverage, you may be required to provide a copy of the letter to your new insurance carrier. These requests from new carriers are time-sensitive and important. You may not be covered if you don't provide proof of creditable coverage.
If the letter states that your coverage isn’t creditable, please call us at 1-866-322-2824 (TYY: 711) for assistance.
If you didn‘t receive a letter of creditable coverage from your employer, union, or other group health plan, you can request one from your previous insurance carrier or group health plan. You need to call the number provided on the back of your insurance card. If you don‘t have an insurance card, you can call your former employer or union benefits center. They should be able to provide you with the number.