Medicare Part D Notice of Creditable Coverage
ARE YOU, OR A FAMILY MEMBER, MEDICARE ELIGIBLE (OR ABOUT TO BECOME MEDICARE ELIGIBLE? IF SO, PLEASE READ AND KEEP FOR YOUR RECORDS!
We have determined that the prescription drug coverage provided under The Lebanon School District Health and Welfare Plan is expected to pay out, on average, the same or more than what the standard Medicare prescription drug coverage will pay. This is known as CREDITABLE COVERAGE as defined by the Medicare Modernization Act (MMA).
Why This is Important
When someone first becomes eligible to enroll in a government-sponsored Medicare “Part D” prescription drug plan, enrollment is considered timely if completed by the end of his or her “Initial Enrollment Period” which ends 3 months after the month in which he or she turned age 65.
Unfortunately, if you choose not to enroll in Medicare Part D during your Initial Enrollment Period, when you finally do enroll you may be subject to a late enrollment penalty added to your monthly Medicare Part D premium. Specifically, the extra cost, if any, increases based on the number of full, uncovered months during which you went without either Medicare Part D or else without CREDITABLE prescription drug coverage from another source (such as ours).
It is important for those eligible for both Medicare and our group health plan to look ahead and weigh the costs and benefits of the various options on a regular, if not annual, basis. Based on individual facts and circumstances some choose to elect Medicare only, some choose to elect coverage under the group health plan only, while some choose to enroll in both coverages. When both are elected, please note that benefits coordinate according to the Medicare Secondary Payer Rules. That is, one plan or the other would reduce payment and prevent you from being reimbursed the full amount from both sources. Your age, the reason for your Medicare eligibility and other factors determine which plan is primary (pays first, generally without reductions) versus secondary (pays second, generally with reductions).
Eligible individuals can enroll in a Medicare Part D prescription drug plan during Medicare’s Annual Coordinated Election Period (a.k.a. Open Enrollment Period) running from Oct. 15 through Dec. 7 of each year, as well during what is known as a Medicare Special Enrollment Period (which is triggered by certain qualifying events, such as the loss of employer/union-sponsored group health coverage).
Those who miss these opportunities are generally unable to enroll in a Medicare Part D plan until another enrollment period becomes available. Finally, please be cautioned that even if you elect our coverage, you could be subject to a payment of higher Part D premiums if you subsequently experience a break in coverage of 63 continuous days or longer before enrolling in the Medicare Part D plan. Carefully coordinating your transition between plans is therefore essential.
If you are unsure as to whether or when you will become eligible for Medicare, or if you have questions about how to get help to pay for it, please call the Social Security Administration at (800) 772-1213 or visit socialsecurity.gov.
Specific questions about our prescription drug coverage should be directed to the customer service number on your ID card, if enrolled, or to Benefits at (717)-270-6762 or [email protected]
Keep this notice of Creditable Coverage. If you decide to join one of the Medicare drug plans, you may be required to provide a copy of this notice when you join to show whether you have maintained creditable coverage and, therefore, whether you are required to pay a higher premium (a penalty).