Medicare Part D Creditable Coverage Notice

Entity Mandating Form: Centers for Medicare and Medicaid Services (CMS)

Applicability: Entities that provide prescription drug coverage to Medicare Part D-eligible individuals must disclose to those individuals whether their drug coverage is creditable or noncreditable prior to October 15 each year. This notice must also be provided at other times, such as when an individual joins the plan and upon the individual's request.

Obtaining This Form: An employer may download this notice directly from the CMS website.

Additional Resources

Centers for Medicare and Medicaid Services