Medicare Part D Notice

Medicare Part D Notice

It’s that time again! Medicare Part D open enrollment for the 2024 plan year begins on October 15, 2023, and ends on December 7, 2023. Plan sponsors must provide the annual Creditable (or Non-creditable) Coverage Disclosure Notice to all Medicare-eligible individuals, in advance of the enrollment period, i.e., before October 15.

“Medicare-eligible individuals” includes any current and former employees, and dependents of current and former employees, who are covered by the plan or who become eligible to enroll in the plan.

Form and Manner of Notice

The notice must be in writing. It can be delivered in paper, or under certain conditions, electronically.

If delivered in paper, the notice can be included along with other plan materials, as long as the disclosure notice is prominently displayed, in bold typeface in font size 14 or greater, and in a separate text box, on the first page of the plan participant information. The notice can be delivered by hand or mail.

For electronic delivery, the plan sponsor must post the notice on its website in addition to distributing the notice by email to each individual. The individual must affirmatively consent to receiving the disclosure notice electronically and must provide a valid email address to the plan sponsor. The plan must also inform the Medicare-eligible individual of the following:

  • The individual’s right to obtain the disclosure in paper format.
  • The individual’s right to withdraw consent to electronic delivery.
  • How the individual should update their address information.
  • Any hardware/software requirements to access and retain the disclosure notice.

Model Notice Letters | CMS are available on the CMS website.

Timeline for Notice Delivery

Plan sponsors must provide this notice:

  • annually before the start of the Medicare Part D enrollment period
  • prior to each Medicare-eligible individual’s initial enrollment in Medicare Part D
  • prior to the effective date of cover of any Medicare-eligible individual that joins the plan
  • when prescription drug coverage ends
  • when coverage changes from creditable or non-creditable, or vice versa
  • upon an individual’s request

Disclosure Notice to Participants v. Disclosure Notice to CMS

The Medicare Part D Disclosure Notice discussed in this article is distinct from the annual Medicare Part D disclosure that plan sponsors must make to the Centers for Medicare and Medicaid Services (CMS). As per the CMS website, “entities that provide prescription drug coverage to Medicare Part D eligible individuals must disclose to CMS whether the coverage is "creditable prescription drug coverage".  This disclosure is required whether the entity's coverage is primary or secondary to Medicare.”

The disclosure must be made using the online Disclosure to CMS Form. The disclosure must be made within 60 days of the beginning of the plan year (generally, by March 1 for calendar year plans). Plan sponsors must also complete a CMS disclosure within 30 days (1) upon events such as the cancellation of a prescription drug benefit is cancelled, or (2) if any material change in the prescription drug benefits that causes the coverage to change status from creditable to non-creditable, or vice versa.

The Disclosure to CMS Guidance and Instructions | CMS is available on the CMS website.  

The information contained in this Benefit Beat is not intended to be legal, accounting, or other professional advice, nor are these comments directed to specific situations. This information is provided as general guidance and may be affected by changes in law or regulation. This information is not intended to replace or substitute for accounting or other professional advice. You must consult your own attorney or tax advisor for assistance in specific situations. This information is provided as-is, with no warranties of any kind. CBIZ shall not be liable for any damages whatsoever in connection with its use and assumes no obligation to inform the reader of any changes in laws or other factors that could affect the information contained herein.

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