Medicare Part D Creditable Coverage Notice

Background


The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 requires group health plans that provide prescription drug coverage to disclose to individuals eligible for Medicare Part D whether the plan's coverage is "creditable," i.e., whether it is at least actuarially equivalent to the Medicare Part D coverage.

Importantly, individuals who do not enroll in Medicare Part D when first eligible and who have gone 63 days or longer without creditable coverage generally will have to pay higher premiums permanently if they subsequently enroll. Thus individuals need to know the status of their coverage in order to make an informed decision about enrolling in Part D.

Notice


This notice applies to you if you are eligible for Medicare. Please read this notice carefully and keep it where you can find it. This notice has information about your current prescription drug coverage with Maricopa County and about your options under Medicare's prescription drug coverage. This information can help you decide whether or not you want to join a Medicare drug plan. If you are considering joining, you should compare your current coverage, including which drugs are covered at what cost, with the coverage and costs of the plans offering Medicare prescription drug coverage in your area. Information about where you can get help to make decisions about your prescription drug coverage is at the end of this notice.

Important Details


There are two important things you need to know about your current coverage and Medicare's prescription drug coverage:
  • Medicare prescription drug coverage became available in 2006 to everyone with Medicare. You can get this coverage if you join a Medicare Prescription Drug Plan or join a Medicare Advantage Plan (like an HMO or PPO) that offers prescription drug coverage. All Medicare drug plans provide at least a standard level of coverage set by Medicare. Some plans may also offer more coverage for a higher monthly premium.
  • Maricopa County has determined that the prescription drug coverage offered by the Employee Benefit Plan is, on average for all plan participants, expected to pay out as much as standard Medicare prescription drug coverage pays and is therefore considered Creditable Coverage. Because your existing coverage is Creditable Coverage, you can keep this coverage and not pay a higher premium (a penalty) if you later decide to join a Medicare drug plan.

Additional Information


For more information about this notice or your current prescription drug coverage, please contact the Maciropa County Department of Employee Benefits and Health:
Maricopa County Department of Employee Benefits and Health
Employee Benefits
301 West Jefferson Street
Suite 3200
Phoenix, AZ 85003
602-506-1010

Medicare Plans


More detailed information about Medicare plans that offer prescription drug coverage is in the "Medicare and You" handbook. You’ll get a copy of the handbook in the mail every year from Medicare. You may also be contacted directly by Medicare drug plans.

Medicare Prescription Drug Coverage


Find more information about Medicare prescription drug coverage at one of the following.
  • Visit the Medicare website.
  • Call your State Health Insurance Assistance Program (see the inside back cover of your copy of the “Medicare & You” handbook for their telephone number) for personalized help.
  • Call 800-Medicare (1-800-633-4227). TTY users should call 1-877-486-2048.
If you have limited income and resources, extra help paying for Medicare prescription drug coverage is available. For information about this extra help, visit the Social Security website, or call them at 1-800-772-1213 (TTY Phone: 1-800-325-0778).

Important Notice


Keep this Creditable Coverage notice. If you decide to join one of the Medicare drug plans, you may be required to provide a copy of this notice when you join to show whether or not you have maintained creditable coverage and, therefore, whether or not you are required to pay a higher premium (a penalty).

Contact Information


Maricopa County Department of Employee Benefits and Health
Employee Benefits
301 West Jefferson Street
Suite 3200
Phoenix, AZ 85003
602-506-1010