Medicare Part D Information

  • Learn how our prescription drug coverage compares to Medicare Part D and see the options we offer to support Medicare Part D testing for employers.

  • Premera Blue Cross offers employers two options to support their Medicare Part D testing obligations. The testing tells if the pharmacy plan you offer meets the creditable coverage standard as compared with Medicare Part D.

    The Centers for Medicare and Medicaid Services (CMS) says drug coverage is creditable if the actuarial value of the coverage equals or exceeds the actuarial value of standard Medicare prescription drug coverage.

    You have two choices for testing:

    • Premera can give you data to do your own testing.
    • Our underwriting team can test for you, for a fee, using General Guidance methods.

    The CMS website offers general Information about Medicare Part D.

    To learn more about Medicare Part D testing and to discuss your options, contact your producer or Premera account representative.

    Important reminders

    Premera no longer sends creditable coverage status notices to members on behalf of groups with pharmacy plans

    Employers will need to provide the notifications as required by the Medicare Modernization Act (MMA) to their Medicare-eligible employees and dependents. This act requires employers to inform their Medicare-eligible employees and dependents whether the prescription drug coverage pays on average as much as the standard Medicare prescription drug coverage.

    Additional information is found at the following pages of the Centers for Medicare & Medicaid Services:

    Submitting the CMS Medicare Part D Disclosure Form

    Federal law requires employer groups to notify the Centers for Medicare and Medicaid Services (CMS) if their prescription drug coverage for Medicare beneficiaries is creditable. CMS requires employer groups to submit a Creditable Coverage Disclosure Form each year or upon any change that could affect whether the drug coverage offered is creditable.

    More information on Medicare Part D Notification and Disclosure to CMS requirements is on cms.gov.