If you’re over age 65 (or otherwise eligible for Medicare) and you have health insurance coverage through an employer, take note.  You should receive a Part D Notice of Creditable Coverage from your employer by October 15.

This notice must be sent to Medicare-eligible persons by the sponsor of their group healthcare plan, and it tells you whether your plan offers prescription drug coverage commensurate with that of a Medicare Part D plan. But just what does that mean? In 2022, “creditable coverage” means the plan provides the following:

• A deductible of $480
• An initial coverage limit of $4,430
• An out-of-pocket threshold of $7,050
• Coverage for brand name and generic prescriptions
• Reasonable access to retail providers and mail order coverage
• The plan pays on average at least 60% of prescription drug expenses

If your healthcare plan is “creditable”… You are maintaining coverage the qualifies you to exempt yourself from Medicare enrollment. That means you can continue to delay your enrollment until your group-sponsored plan coverage ends, or becomes “non creditable”, without the risk of incurring a penalty from Medicare for failing to enroll. However, you might wish to enroll in Medicare anyway, and enjoy the benefits of secondary insurance.

If your healthcare plan is not “creditable”… You must enroll in Medicare. If you fail to enroll on time, you will face a penalty in the form higher premiums for the rest of your life.

If it’s time to enroll in Medicare, remember that there are numerous options from which you can choose. You can go with Original Medicare, which is Parts A and B, and then add a Part D plan to help with the cost of your prescription medications. Or you can enroll in a Medicare Advantage plan, which rolls Parts A and B, and often Part D coverage, into one convenient plan that is easy to manage. These plans are managed by private health insurance providers, must meet certain Medicare standards, and operate through a network of providers.

We can help you sort through your Medicare options. Give us a call, and we can help you identify your priorities and then match you with a plan that meets those needs.