Sept. 21, 2016

Medicare Prescription Drug Coverage Creditable/Non-creditable Notifications Update

The annual communication to members informing them whether their plan’s prescription drug coverage is creditable or non-creditable to Medicare Part D prescription drug coverage begins in mid-October.

Creditable coverage is defined by the Centers for Medicare & Medicaid Services (CMS) as “prescription drug coverage (e.g., from an employer or union) that's expected to pay, on average, at least as much as Medicare’s standard prescription drug coverage.”

For group plans, the employer, not Blue Cross and Blue Shield of Texas (BCBSTX), is responsible for notifying its group health plan members, as well as notifying CMS of its plan members’ creditable coverage status.

A letter is now available for groups to assist with the determination of whether or not their prescription drug coverage is creditable or non-creditable.

If you have any questions, contact your BCBSTX Relationship Sales Manager.

Groups who have additional questions about this reporting responsibility may visit for more information.