Part D Coverage -
(Posted on 10/12/22)
Somehow it’s October again, and it’s time to start thinking about fun things like Part D notifications and 2022 products.

We’ll start with Medicare Part D since that information is already available.

First, let’s remember that the process isn’t as painful as the myriad of questions make it seem. The carriers send out notifications to the group, so all the group has to do is send out the completed sample notice, which you can find on the CMS website. My recommendation is to send it to all employees, you never know who has a Medicare eligible dependent that you don’t know about, and it’s better to cover your bases.

Groups also need to confirm their status with CMS, which is done in the same link as the sample letters. They have super detailed instructions, and it’s not very difficult, so that should be no problem for your clients.

Horizon has once again confirmed that all of their small group ACA plans are creditable. If you have a Horizon pre-ACA that is non-creditable, we will let you know! There are only two cards that are not creditable, and groups have been sent notification.

Oscar has also confirmed that their plans are creditable.

Oxford does not publish a list of creditable plans, but you can use the tool UHC releases to determine a group’s status.

We get a lot of the same questions every year, and I am sure you do too. First is always “If I drop the Rx coverage, can I re-enroll?”. The answer to that is that members can return to the group plan at open enrollment, or if they experience a triggering event. We also get a lot of “Is there coordination of benefits with the group plan and Part D?” Generally, Rx plans don’t have coordination of benefits, so you could have both, but it won’t do you any good.

I’m sure that we’ll experience the same thing as we do every year- a myriad of questions for a couple of weeks, and then we put it to rest until next year. But as always, if you need help, please reach out to our team!