Health, Vision and Dental Insurance
Medicare Prescription Drug Coverage Changes
In an effort to keep our clients updated on the upcoming changes in Medicare Prescription coverage, we have summarized below some of the key dates and changes taking place. Additional information will be forthcoming from both the insurance carriers and USI Colburn. At any time if you have questions on Medicare Part D coverage, please contact our Client Services Center at (800) 265-2876.
It is important to understand that notice of creditable or non-creditable status is an employer group responsibility and must be provided to active employees or their spouses who are covered by an employer's group health plan and who are also covered by Medicare because of their age, disability, or end-stage renal disease. We have provided sample letters you can use for employee notification of Creditable and Non-Creditable plans.
As the initial effective date for Medicare Prescription Drug Coverage ("Part D") approaches, please be aware of these two items:
- Employer groups or other health plan sponsors that want to pursue the federal retiree drug subsidy need to have freestanding drug coverage. If you currently have drug benefits that are integrated with major medical or comprehensive medical coverage, they need to change to a "freestanding drug program" if they want to pursue the federal subsidy. This will enable the carrier to provide the detailed drug data that's needed for ongoing reports to the Centers for Medicare and Medicaid Services (CMS).
- Employers and other plan sponsors that provide prescription drug coverage to Medicare beneficiaries must provide a notice to these beneficiaries by November 15, 2005, as to whether this coverage is as good as the new standard Medicare prescription drug benefit. Medicare beneficiaries must receive this notice - also known as the "creditable coverage notice" - by November 15, according to CMS regulations. Sample language for this notice is available online at http://www.cms.hhs.gov/medicarereform/credcovrg.asp and sample letters you can use for employee notification are also available on this site - both Creditable and Non-Creditable plans.
- Here's a quick summary of important upcoming dates for Part D coverage:
- October 1, 2005: Part D plans can begin marketing efforts
- November 15, 2005: Medicare beneficiaries can begin to enroll for Part D coverage
- January 1, 2006: Medicare Part D coverage begins (earliest coverage effective date)
- May 15, 2006: Initial enrollment period for Medicare Part D coverage ends. Medicare beneficiaries who do not enroll in Part D coverage by this date - and do not have creditable coverage - will not be able to enroll until the next general open enrollment period, November 15 - December 31, 2006. Also, these "late enrollees" may be penalized 1% per month for each month they delay enrolling.
If you or your clients have questions about Medicare Part D coverage, here are some government Web sites you may find useful:
Find out more...
|
Professional
Liability