What is it?
You'll get this notice if you're eligible for Medicare and Medicaid and already have qualifying creditable prescription drug coverage through an employer or union. This notice alerts you that you automatically qualify for Extra Help, and can join a Medicare Prescription Drug Plan at no cost to you.
When should I get it?
You may get this notice at any time.
Who sends it?
What should I do if I get this notice?
Contact your employer or union plan to learn how joining a Medicare drug plan may affect your current coverage.
Employer or union health coverage refers to health coverage from your, your spouse's, or other family member's current or former employer or union. If you have prescription drug coverage based on your current or previous employment, your employer or union will notify you annually about whether your prescription drug coverage is creditable. Keep the information you get from them for future reference.
Call your benefits administrator for more information before making any changes to your coverage.
If you join a Medicare Prescription Drug Plan, you, your spouse, or your dependents may lose your employer or union health coverage.
Download a sample of this document
Get this notice in Spanish [PDF, 610 KB].
Publication, product, or other number
Product No. 11334
Not available at this time