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Proposed 2026 Creditable Coverage Changes

Group health plans are required to notify Medicare eligible participants and the Centers for Medicare & Medicaid Services (CMS) if the prescription drug coverage offered is creditable coverage or not creditable coverage. This notification is important for active participants who are Medicare-eligible because when they retire and select a Medicare Part D plan, they may face a late enrollment penalty if their active coverage is considered non-creditable. This penalty is calculated based on the national base beneficiary premium and the number of months without creditable coverage.


A summary final rules can be viewed at the link below.





Please contact your Horizon Actuarial consultant or use the "contact" page if you have any questions.

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