Part D Creditable Coverage 2025

[MedicareWAA]

For 2025, no one seems to know the answer on what is creditable or not.

CMS already spoke about this. It’s not an issue in 2025 - that’s very clear now. They’ll use the old definition. They suggested this will roll out in 2026.

See page 3 under the subhead credible coverage: https://www.cms.gov/files/document/final-cy-2025-part-d-redesign-program-instructions.pdf

Walter

 

[GoPokes]

CMS already spoke about this. It’s not an issue in 2025 - that’s very clear now. They’ll use the old definition. They suggested this will roll out in 2026.

See page 3 under the subhead credible coverage: https://www.cms.gov/files/document/final-cy-2025-part-d-redesign-program-instructions.pdf

Walter

Thanks for sharing

 

[Special Agent]

Has CMS ever checked to see if their coverage was credible? I imagine most just mark they had employer coverage from when they turned 65 until their Medicare Part B started and no one questions it.

I wonder about if they actually check but i believe they may because if a rx plan from an employer is creditable those employer plans get federal subsidies so it seems easy for them to verify.I know many clients who only gave their best guess as far as dates and carriers when attesting to creditable prior coverage and they didn't have any issues .

 

[kgmom219]

CMS already spoke about this. It’s not an issue in 2025 - that’s very clear now. They’ll use the old definition. They suggested this will roll out in 2026.

See page 3 under the subhead credible coverage: https://www.cms.gov/files/document/final-cy-2025-part-d-redesign-program-instructions.pdf

Walter

I agree today.

Not when I posted the thread

 

[Duaine]

Very good update here for the Spooky Part D Math:

 

[somarco]

I am not sure that DC is through diddling with the 2025 Part D provisions. Pretty sure I read that final final revisions are now due 9/29/2024.

And the 2 finals is intentional . . .