Medicare Part D Notices Are Due By October 15

Employers sponsoring group health plans that include prescription drug coverage should make sure their annual Medicare Part D creditable coverage notices are ready for distribution. For 2026, the annual notice must be provided to Medicare Part D-eligible individuals before October 15, when Medicare’s annual enrollment period begins.

What Is the Medicare Part D Notice?

The Medicare Part D creditable coverage requirement has been in place since the Medicare prescription drug benefit was established. Employers and other entities that provide prescription drug coverage must determine whether that coverage is “creditable,” meaning that it is expected to pay, on average, at least as much as standard Medicare prescription drug coverage.

Medicare-eligible individuals need this information when deciding whether to enroll in Medicare Part D or remain covered under another prescription drug plan.

The distinction is important because an individual who goes without Medicare Part D or other creditable prescription drug coverage for a continuous period of 63 days or more after becoming eligible may be subject to a late enrollment penalty if the individual later enrolls in Part D.

Who Must Receive the Notice?

The disclosure requirement applies to Medicare Part D-eligible individuals covered under an employer’s prescription drug plan. This population can include more than Medicare-eligible active employees.

Depending on the employer’s plan population, notices may need to reach Medicare-eligible:

• Active employees and their covered dependents
• COBRA participants and their covered dependents
• Disabled individuals
• Retirees and their covered dependents

Because employers may not always know which covered individuals are eligible for Medicare, many employers choose to provide the notice to all individuals covered under the applicable prescription drug plan.

When Must the Notice Be Provided?

The notice must be provided annually before October 15, the beginning of Medicare’s annual Part D enrollment period. Disclosure may also be required at other times, including before a Medicare-eligible individual’s initial Part D enrollment period, before the effective date of coverage when a Medicare-eligible individual joins the plan, when the plan’s creditable coverage status changes, and upon request. Employers should review their notice procedures to make sure these timing requirements are addressed.

How Can Employers Provide the Notice?

CMS provides model creditable and non-creditable coverage notices that employers can use and customize for their plans.

The notice may be provided separately or, if applicable requirements are satisfied, incorporated into other plan communications, such as open enrollment materials. Electronic delivery may also be permitted when applicable CMS electronic disclosure requirements are met.

Generally, one notice may cover a Medicare-eligible individual and Medicare-eligible dependents residing at the same address. If the employer knows that a Medicare-eligible spouse or dependent resides at a different address, a separate notice should be provided to that individual.

Don’t Forget the Separate Disclosure to CMS

Providing the participant notice does not complete all of the employer’s Medicare Part D disclosure responsibilities.

Plan sponsors that provide prescription drug coverage to Medicare Part D-eligible individuals generally must also report the plan’s creditable or non-creditable coverage status to CMS. The online CMS disclosure generally must be completed within 60 days after the beginning of the plan year. Additional disclosures are required within 30 days after termination of a prescription drug plan or within 30 days after a change in its creditable coverage status.

This is a separate requirement from the notice provided to employees and other Medicare-eligible individuals.

What Should Employers Do Now?

With October 15 approaching, employers should confirm whether each prescription drug plan option is creditable or non-creditable, obtain the appropriate CMS notice, and make sure it is distributed to the appropriate population before the deadline.

Employers should also review how Medicare Part D notices are incorporated into their ongoing benefits administration procedures. The annual October notice is important, but employers also need processes for newly eligible individuals, changes in creditable coverage status, and the separate annual disclosure to CMS.

Taking a few minutes to review these requirements now can help employers meet their Medicare Part D disclosure responsibilities and, just as importantly, provide employees and their families with information they may need when making Medicare enrollment decisions.