Under regulations issued by the Centers for Medicare & Medicaid Services (CMS), Medicare Part D-eligible individuals must be notified whether their current coverage is "creditable prescription drug coverage" each year. The following are definitions of creditable and non-creditable coverage:
Employers must notify Medicare-eligible members whether their current plan is or is not creditable prescription drug coverage by October 15. Members in Blue Shield plans that have been determined as creditable do not need to do anything if they're satisfied with the drug coverage they have through these plans.
Members in Blue Shield plans that have been determined to have coverage that is non-creditable may:
The list below denotes which Blue Shield of California plans offer creditable prescription drug coverage and which do not. Effective January 1, 2022.
Plan Type | Creditable Plans | Non-Creditable Plans |
---|---|---|
IFP |
$0 Cost Share PPO AI-AN |
Minimum Coverage PPO |
IFP: closed plans | GI Shield Spectrum 5000-G Shield Savings 1800/3600-G, 3500/7000-G including alumni; and 4000/8000-G including alumni; 5200/10400-G Vital Shield℠ 900-G and 2900-G Vital Shield℠ Plus Generic Rx 900-G |
Active Start℠ Plan 35-G Balance℠ Plans 1000-G, 1700-G and 2500-G |
Medicare Supplement | Creditable Plans | Non-Creditable Plans |
---|---|---|
Plan H Plus Rx (closed plan)
|
Plan Family |
Creditable Plans |
Non-Creditable Plans |
---|---|---|
|
All plans except those listed in the non-creditable plans column |
2022: 2021: |
Group | Creditable Plans | Non-Creditable Plans |
---|---|---|
Midsize & Large Group |
All plans except those listed in the non-creditable plans column
No creditability changes from 2021 to 2022. |
All custom plans with a combined Rx/Medical deductible and out-of-pocket maximum must be certified individually.** |
** Please contact your Blue Shield account representative for assistance with individual plan certification.
Web Resources - Medicare Part D
To learn more about Medicare Part D and how it can affect your Medicare-eligible retirees, please visit the following:
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Page last updated: 10/1/2021
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