What is Creditable Coverage?
Prescription drug coverage is creditable if the actuarial value of the coverage equals or exceeds the actuarial value of standard prescription drug coverage under Medicare Part D. In general, the actuarial equivalence test measures whether the expected amount of paid claims under the employer's prescription drug coverage is at least as much as the expected amount of paid claims under the standard Part D benefit. The criteria in the test changes annually as the baseline Medicare Part D benefits change.
Visit the Centers for Medicare and Medicaid’s (CMS) Creditable Coverage website for more information about creditable coverage, including access to model disclosure communication templates. Check this site often for the most up-to-date information.