Medicare Part D — Facts


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Your essential checklist

  1. Medicare Part D coverage became effective on January 1, 2006. 
  2. It provides certain prescription drug benefits to those eligible for Medicare.
  3. Medicare Part D is an annual benefit that provides extensive coverage for outpatient prescription drugs with few drug exclusions, such as drugs used for hair growth and cosmetic purposes.
  4. Eligible beneficiaries can enroll annually from November 15 through December 31. Initial enrollment for beneficiaries who are newly eligible begins three months prior to their eligibility and continues during their month of eligibility and three months following.
  5. Medicare Part D requires that all eligible Medicare beneficiaries obtain creditable coverage upon initial eligibility or face late enrollment penalties.
  6. The retiree drug subsidy (RDS) is a federal program that provides tax-free reimbursement to plan sponsors for a portion of the pharmacy costs incurred by Medicare-eligible retirees in their drug programs.
  7. The RDS program is only for Medicare-eligible retirees, not current employees.
  8. The RDS application is due 90 days prior to the start of your plan year.
  9. An attestation of actuarial equivalence is a required part of the RDS application.
  10. The requirement to annually disclose creditable coverage applies to all plan sponsors with Medicare-eligible actives or retirees, not only those with retiree coverage offerings.
  11. Whether or not you are filing for the RDS, you need to determine the creditable status of your plan for Medicare-eligible participants.
  12. The creditable coverage status of your plan must be communicated to Medicare-eligible participants prior to the annual open enrollment for Medicare Part D beginning on November 15 of each year.

Any questions? Contact us.

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