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: 10.09.2024
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, 2024.
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, New York, Pennslyvania, Delaware, Connecticut) |
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. |
|---|---|
| AmeriHealth (New Jersey) | All 2024 and 2025 Qualified Health Plans for small groups, fully insured and level funded, are creditable. All 2024 and 2025 “standard large group plans” are also creditable. Access the chart on page 3 that shows the cost-sharing of our 2025 standard large group prescription drug plans. (AmeriHealth 9.20.24) |
| Anthem BCBS (Connecticut) | |
| Anthem / Empire BCBS (New York) | The credibility status of the 2025 PY can be found on pages 2 and 3: (Anthem 9.4.24) |
| Cigna (New Jersey, New York, Pennslyvania, Delaware, Connecticut, Florida) | As a courtesy, Cigna Healthcare publishes materials on the creditability of standard plan designs to assist in determining creditable coverage. |
| EmblemHealth (New York) | EmblemHealth Bronze H.S.A. and EmblemHealth Bronze Premier plans have both been determined to be non-creditable. (EmblemHealth 9.17.24) |
| Florida BCBS (Florida) | A list of the Florida Blue Non-Creditable plans by year can be found HERE. 2025 PY information has been posted. (FL Blue 9.16.24) |
| HealthPass (New York) | Guidelines for Medicare Part D plan status is the same policy as each of their carrier partners; EmblemHealth, Anthem BCBS and UnitedHealthcare/Oxford. (HealthPass 9.4.24) |
| Highmark (Delaware New York, West Virginia and Pennslyvania) | A list of Non-Creditable Plans and sample Creditable and Non-Creditable Notice Templates for clients headquartered in Delaware, Northeastern Pennsylvania, Western New York, Western Pennsylvania and West Virginia can be found here. (Highmark 10.24) |
| Horizon BCBSNJ (New Jersey) | Based on additional guidelines and guidance received from CMS on Thursday October 10, 2024, regarding the process/calculation of deeming plans credible/non credible for 2025, Horizon BCBSNJ has determined that all of our Mid-Size groups (51-500) have been deemed credible for the upcoming year. All Savoy Small Employer groups, with the exception of 3 Level Funded Plans, have been deemed credible as well. The brokers assigned to the 3 non credible groups will be notified. Groups that previously received a non- credible notice will be sent a revised notice via email or first-class mail on Tuesday October 15, 2024 . The three groups with level funded plans that were deemed non-credible:
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| Independence Blue Cross (Pennsylvania) | All 2024 and 2025 Qualified Health Plans (for small groups) are creditable. All 2024 and 2025 “standard large group plans” are also creditable. Access the chart on page 3 that shows the cost-sharing of our 2025 standard large group prescription drug plans. (IBC 9.20.24) |
| NY Health Alliance / MVP Plans (New York) | All MVP Health plans through NY Health Alliance plans are Medicare Part D Creditable for both 2024 and 2025. (NY Health Alliance 9.17.24) |
| UnitedHealthcare / Oxford (New York, New Jersey, Pennsylvania, Delaware, Connecticut) | 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. (UHC 9.4.24) |
