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MEDICARE PARTD - CREDITABLE COVERAGE Q&A
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Question |
Answer |
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What does "creditable coverage"
mean? |
Creditable
coverage is prescription drug coverage that is, on average
for all plan participants, expected to pay as much as the
standard Medicare prescription drug coverage. In other words,
it is at least as good as Medicare standard prescription drug
coverage. |
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Why is it important to know if my current
coverage is creditable coverage? |
Generally, if a person does not enroll in
a Medicare Part D plan when they first become eligible, they
will have to pay a late enrollment penalty if they enroll
at a later date. The penalty is 1% of the premium for every
month the person was eligible for but was not enrolled in
a Medicare Part D plan. People who have creditable coverage
from another source, such as an employer or union sponsored
prescription drug plan, can enroll in a Medicare Part D plan
later and will not have to pay the late enrollment penalty
for the period of time they had the creditable coverage. |
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Is my coverage through the PBA creditable
coverage? |
Yes, coverage through the Retiree Health
and Welfare Fund of the Patrolmen's Benevolent Association
of the City of New York (the "Fund") is creditable coverage. |
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Can I enroll in a Medicare Part D plan even
though I have creditable coverage through the PBA? |
Yes, you can enroll in a Medicare Part D
plan even though you have creditable coverage through the
Fund. Your Retiree Health and Welfare Fund coverage would
become secondary to Medicare. |
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Should I enroll in a Medicare Part D Plan
even though PBA coverage is creditable? |
We cannot advise you to enroll or not to
enroll in a Medicare Part D plan. Some people may find it
beneficial to enroll in a Medicare Part D plan and others
will not. Available Medicare Part D plans will be offered
by various carriers and will differ in premiums, deductibles,
coverage gaps, and other areas. Below is a summary of coverage
provided by the Fund. More detailed information can be found
in the Fund's Plan Description. |
Summary of Coverage Provided Through the
Retiree Health and Welfare Fund |
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Monthly Member Premium |
None (COBRA enrollees must pay a premium.) |
| Annual Deductible |
None |
| Coinsurance |
- Generic: Greater of 25% or $20 (not to exceed cost of
drug)
- Formulary: Greater of 25% or $40 (not to exceed cost of
drug)
- Non-Formulary: Member pays 100% of Caremark discounted
cost of drug.
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Benefit Limits |
- Annual Limit: $10,000
- Lifetime Limit: $120,000
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