Medicare Part D Creditable vs. Non-Creditable Coverage | Information by Carrier
To better assist your clients, Savoy compiled a list of carriers and their Medicare Part D Creditable and Non-Creditable status information.
Published: 10.12.2023
WHATMedicare 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, 2023.
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 (New Jersey) |
AFA Plans
Brokers can send a request to the Aetna Answer Team to test a specific plan if it is not listed to: NEAAT@Aetna.com, or call the Answer Team at 1-855-319-7290 . The Group Name, Group Number, the size of the group, and the State the plan is written in must be provided to be able to test the plan. (Aetna 9.20.23) |
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| Aetna (New York) | ACA Plans Aetna does not proactively notify employers about the creditable coverage status of their plans. Brokers can send a request to the Aetna Answer Team to test a NY specific plan to: NEAAT@Aetna.com or call the Answer Team at 1-855-319-7290. The Group Name, Group Number, the size of the group, and the State the plan is written in must be provided to be able to test the plan. (Aetna 9.20.23) |
| Aetna (Pennsylvania and Delaware) | ACA/AFA Plans Aetna does not proactively notify employers about the creditable coverage status of their plans. The chart below that provides 2023 through Jan 2024 PA/DE National AFA Plan status. Brokers can send a request to the Aetna Answer Team to test a specific plan if it is not listed to: NEAAT@Aetna.com, or call the Answer Team at 1-855-319-7290. The Group Name, Group Number, the size of the group, and the State the plan is written in must be provided to be able to test the plan. (Aetna, 09.20.23) |
| AmeriHealth (New Jersey) | All 2023 and 2024 small group ACA Qualified Health Plans are creditable. All 2023 and 2024 standard large group plans are creditable. The chart below shows the cost-sharing of AmeriHealth's (AHNJ) 2024 standard large group prescription drug plans. Important Note: If your large group has a plan that is not a standard plan shown on the chart and you would like AHNJ to test it to determine if it is creditable or non-creditable, please contact your AHNJ account executive. (AmeriHealth NJ Market Edge 9.14.23) Small Group Fixed Funding: All small group level funded plans are creditable. |
| EmblemHealth (New York) | A dedicated employer mailing will be released towards the beginning of October. Creditable Status by Plan Name
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| Empire BCBS (New York) | Q1 2024 rate sheets below contain a line-item indicating whether each plan is creditable or non-creditable.
Please note: Bronze Plans that fail creditability status. (Empire 9.20.23) |
| Florida BCBS (Florida) | A list of the Florida Blue Non-Creditable plans by year can be found HERE. (Florida Blue 9.27.23) |
| Healthfirst Insurance Company (New York) | Pending Carrier Response |
| HealthPass (New York) | Guidelines for Medicare Part D plan status is the same policy as each of their carrier partners; EmblemHealth, Empire BCBS and UnitedHealthcare/Oxford. (HealthPass 9.27.23) |
| Highmark (Delaware) | Highmark has determined that all of its 2023 and 2024 Small Group prescription drug plans qualify as “creditable coverage." Group administrators may provide the below notice to employees who need the creditable coverage notification: Highmark Blue Cross Blue Shield Delaware Creditable Coverage Notice |
| Horizon BCBSNJ (New Jersey) | All Small Group ACA and Level Funded plans are creditable, except for groups deemed non-creditable due to their grand-mothered status and the product they chose before the ACA came in effect. All IHC plans are creditable. Savoy did not have any groups that were deemed non-creditable. All the standard midsize products including the 50% HSA plans are considered credible coverage. (Horizon BCBSNJ 9.20.23) |
| Independence Blue Cross (Pennsylvania) | All 2023 and 2024 small group ACA Qualified Health Plans are creditable. All 2023 and 2024 standard large group plans are also creditable. The chart and sample letter below shows the cost-sharing of our 2024 standard large group prescription drug plans.
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| NY Health Alliance / MVP Plans (New York) | Forms and information regarding Medicare D Creditable prescription plan status are available on MVP’s website under Employer Forms HERE. Be sure to select the Plan Year for the plan that the employer is reporting on. (Healthfirst 9.27.23) |
| UnitedHealthcare / Oxford (New York, New Jersey, Pennsylvania, Delaware) | A Medicare Part D Creditable prescription plans status data tool is available on UnitedHealthcare’s Medicare Part D Creditable Coverage website HERE. Small Business is defined as group size 1-50 in all states except CA, CO, and NY where small group is defined as group size 1-100. All fully insured and level funded small group plans should use the tool below. If your plan is not small group plan, please use the tool below. Be sure to click on “Enable Editing” before attempting to use these tools or they will not work properly. Additional training resources for both small and large group, along with instructions can be found at the bottom of the UHC website page HERE. |
