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Will my employer's retiree drug coverage work with Medicare Part D prescription drug coverage?

Category: Employer Drug Coverage
Updated: Aug, 28 2022


Probably not.  In most cases, if your Employer (or Union) healthcare plan includes drug coverage, your plan will NOT work together with a Medicare Part D plan - and you probably will NOT be able to add Medicare Part D prescription drug coverage to your Employer plan.

Important:  In fact, if you enroll in a Medicare Part D plan when you already have Employer healthcare coverage, you may lose ALL of your Employer Healthcare coverage.

Hard-learned lessons from the beginning of the Part D program

Back in late-2005 and 2006, many people were adding one of the newly-introduced Medicare Part D drug plans to their existing employer drug coverage plan (thinking that they could use the additional drug coverage that cost as little as $1.87 per month) and suddenly, without warning, found that they had a Medicare Part D prescription drug plan, but had lost all of their employer healthcare coverage.  Again, these people lost - not just their employer drug coverage - but they lost all of their employer's healthcare coverage when enrolling a Part D plan.

Question:  How will I know whether my employer health plan drug coverage works with a Part D drug plan?

Contact your employer health plan administrator.  Your Medicare plan will send you information about your employer drug coverage and explain whether the drug coverage is "creditable" (or as good as Medicare Part D coverage) or whether your employer drug plan can work together with a Medicare drug plan.  If you don't remember receiving this information, you can telephone your employer health plan administrator for more details.

The Centers for Medicare and Medicaid Services (CMS or Medicare) notes:
Your current or former employer or union should have sent you information that lets you know how your current coverage compares to the standard Medicare drug coverage. This information is important because it can affect the decision you need to make about joining a Medicare drug plan. Do not make any decisions until you have reviewed this information. If you did not receive information from your employer or union, you should contact the employer/union or the benefits administrator for your current coverage

Your current or former employer or union must send you this information:

    1. before October 15th of each year.
    2. before your Initial Enrollment Period for Medicare.
    3. if you already have Medicare and you join an employer or union plan.
    4. if your employer or union terminates (ends) the drug coverage they offer.
    5. if your employer or union drug coverage changes so that it is no longer as good as, or becomes as good as, the standard Medicare prescription drug coverage.
    6. whenever you request it.
Question:  What is the Retiree Drug Subsidy and how does it affect Medicare drug coverage?

Medicare is offering help to employers and unions to encourage them to keep providing high quality prescription drug coverage. If your employer or union is claiming you for the retiree drug subsidy, you should first talk to your benefits administrator before making any changes to your current coverage.

If you try to join a Medicare drug plan, your benefits administrator and/or the Medicare drug plan may contact you to confirm your choice.

You may not be able to have both Medicare drug coverage and employer/retiree drug coverage if your employer is claiming you for the retiree drug subsidy. Your employer is responsible for telling you how their coverage works with Medicare.

(Sources include: U.S. Department of Health & Human Services [emphasis added])







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