Medicare Part D Creditable Coverage Online Reporting Requirement

Employers that offer prescription drug coverage must make sure to comply with MedicarePart D reporting requirements. In addition to notifying Medicare-eligible individuals about their coverage status, employers must also complete an annual online disclosure to the Centers for Medicare and Medicaid Services (CMS). This reporting requirement applies regardless of whether the employer’s coverage is primary or secondary to Medicare.

What is the Medicare Part D Disclosure to CMS?

The MedicarePart D Creditable Coverage Disclosure is an online filing that informs CMS whether the prescription drug coverage offered under an employer’s group healthplan is considered creditable or non-creditable.

• Creditable coverage means the plan is expected to pay, on average, at leastas much as the standard Medicare Part D prescription drug benefit.
• Non-creditable coverage means the plan does not meet that standard.

This distinction matters because Medicare-eligible individuals who do not have creditable coverage may be subject to a late enrollment penalty if they delay enrolling in Medicare Part D.

Who must file the disclosure?

All employers that offer prescription drug coverage to active employees, retirees, or their dependents must file the disclosure annually. This requirement applies to both fully insured and self-funded plans and applies regardless of how manyMedicare-eligible individuals are actually covered under the plan.

When is the disclosure due?

The disclosure must be submitted to CMS within 60 days after the start of the plan year. For calendar year plans, the deadline is March 1, 2026.

In addition to the annual filing, employers must submit an updated disclosure if:

• The plan is terminated
• Prescription drug coverage is added or dropped
• The creditable status of the coverage changes

How to complete the CMS online disclosure

Employers must submit the disclosure using the CMS online Disclosure to CMS Form, available on the CMS Medicare Part D Creditable Coverage website.

The online form requires the following information:

Employer and contact information

• Legal name of the organization
• Employer tax identification number
• Address, phone number, and designated contact person

Coverage details

• Whether prescription drug coverage is creditable or non-creditable
• Type of plan offered
• Whether coverage applies to active employees, retirees, or both

Plan year information

• Start and end dates of the group health plan year
• Number of Medicare-eligible individuals covered

Plan funding

• Whether the plan is fully insured or self-funded
• Confirm the plan’s creditable status each year, often provided by the insurance carrier for fully insured plans
• Calendar the CMS disclosure deadline and the October 15 notice deadline
• Maintain documentation of disclosures and notices for at least three years
• Update CMS promptly if coverage changes during the year

Once submitted, employers should retain confirmation of the disclosure for their records.

Important reminder about employee notices

The CMS online disclosure is separate from the required written notice toMedicare-eligible individuals. Employers must still provide a creditable or non-creditable coverage notice to all Medicare-eligible employees and dependents each year by October 15.

Both steps are required to meet Medicare Part D compliance obligations.

Best practices for compliance

To stay compliant and reduce risk, employers should:

Staying on top of the CMS Part D disclosure requirement helps employers maintain compliance, reduce audit risk, and ensure prescription drug coverage is reported accurately each year.

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This article is for informational purposes only and is not intended as legal, tax, or benefits advice. Readers should not rely on this information for taking (or not taking) any action relating to employment, compliance, or benefits. Always consult with a qualified professional before making decisions based on this content.