NEWSROOM

If you offer prescription drug coverage through a group health plan, Medicare regulations require you to inform CMS and Medicare-eligible employees (sometimes retirees) annually at case install or renewal within 60 days window whether their employer-sponsored coverage is considered "creditable" under Medicare guidelines.

Coverage is considered creditable if it meets or exceeds the value of the standard Medicare Part D prescription drug plan.

It’s important to note that pharmacy plans within a high-deductible health plan (HSA-compatible) can be either creditable or non-creditable, depending on whether Medicare is the primary or secondary payer.

This guide highlights Medical plans that are classified as non-creditable. Any plans not listed in this guide are considered creditable.

California Small Group
 

Carrier	Response
	Non-Creditable Plans: CA Bronze HMO $85/125 8550 CA Bronze HMO $85/125 8550 wINF CA Bronze MC 100 7200 HSA M CA Bronze MC 100 7200 HSA wINF CA Bronze MC 50/50 8300 CA Bronze MC 50/50 8300 wINF CA Bronze MC 60/50 6250 CA Bronze MC 60/50 6250 wINF CA Bronze MC Savings Plus 100 7200 HSA M CA Bronze MC Savings Plus 100 7200 HSA wINF CA Bronze MC Savings Plus 50/50 8300 CA Bronze MC Savings Plus 50/50 8300 wINF AFA – View the list of plans that Aetna has determined may not be Medicare Creditable.
	Non-Creditable Plans: Anthem Bronze PPO 40/6200/40% Anthem Bronze PPO 70/6600/35% Anthem Bronze Select PPO 40/6200/40% Anthem Bronze Select PPO 70/6600/35% View Anthem's Creditable Coverage PDF for ACA Plans. View Anthem's Creditable Coverage PDF for ABF Plans.
	Non-Creditable Plans: View a list of all Blue Shield Small Business off-exchange plans that contain creditable prescription drug coverage, except where noted. Bronze Full PPO 4500/65 OffEx Bronze Tandem PPO 4500/65 OffEx Bronze Full PPO 7500/65 OffEx Bronze Tandem PPO 7500/65 OffEx Bronze Access+ HMO 7000/70 OffEx Bronze Local Access+ HMO 7000/70 OffEx Bronze Trio HMO 7000/70 OffEx Silver Access+ HMO 2300/70 OffEx Silver Local Access+ HMO 2300/70 OffEx Silver Trio HMO 2300/70 OffEx Silver Access+ HMO 2750/70 OffEx Silver Local Access+ HMO 2750/70 OffEx Silver Trio HMO 2750/70 OffEx Virtual: Bronze Tandem PPO 7500/75 OffEx Bronze Full PPO 6850/55 OffEx Bronze Tandem PPO 6850/55 OffEx Bronze Full PPO 6250/65 OffEx Bronze Tandem PPO 6250/65 OffEx Blue Shield Bronze 60 PPO 6300/60 + Child Dental View Blue Shield of California's Creditable and Non-creditable Coverage Page.
	Non-Creditable plans: Bronze PPO 50/6250/3 Bronze PPO HSA PRx 5000 PPO Bronze PPO HSA PRx 6500 PPO View CalCPA's Medicare Part D Creditable Coverage flyer.
	Non-Creditable plans: Sharp Health Plan: Performance Bronze HMO B View the CaliforniaChoice Medicare Part D Flyer:
	All Cigna plans are fully customizable and cannot provide general statements about what is credible or non-credible coverage.
	All Health Net Small Group plans are considered creditable for the 2026 plan year.
	All Kaiser Permanente Small Group plans are considered creditable for the 2026 plan year. View Kaiser's Medicare Part D Creditable Coverage PDF.
	All MediExcel Small Group plans are considered creditable for the 2026 plan year. View MediExcel's Disclosure Notice.
	Non-Creditable Plans: CalChoice Bronze HDHP NG 3
	All SIMNSA Small Group plans are considered creditable for the 2026 plan year.
	Non-Creditable Plans: SD23 HDHP HMO View Sutter Health Plan's 2026 Small Group creditable coverage plans.
	All United Health Care Small Group plans are considered creditable for the 2026 plan year View UHC's Medicare Part D Creditable Coverage.
	All Western Health Advantage Small Group plans are considered creditable for the 2026 plan year.

California Large Group

 

Carrier	Response
	Non-Creditable Plans: Plan H Plus Rx (closed plan) Plan I Plus Rx (closed plan) Golden Coronet Senior Plus Rx (closed plan) Coronet Senior Plus Rx (closed plan) View Blue Shield of California's Creditable and Non-creditable Coverage Page.
	Non-Creditable plans: Bronze PPO 50/6250/3 Bronze PPO HSA PRx 5000 PPO Bronze PPO HSA PRx 6500 PPO Click here to access CalCPA's list of Creditable Plans.
	Kaiser Permanente plans are often customized. Each plan should be tested to determine whether it is Medicare creditable. Contact your W&B representative to request verification of prescription coverage and to determine if it is actuarially equivalent to standard prescription drug coverage under Medicare Part D.
	All MediExcel Large Group plans are considered creditable for the 2026 plan year View MediExcel's Creditable Coverage Notice.
	All Sharp Health Plan Large Group plans are considered creditable for the 2026 plan year.
	Creditable Status will depend on several factors: In-network Deductible In-network Out-of-Pocket Maximum In-network Copays and/or Coinsurance Preventive Drug List (Core or Expanded, if applicable) Employer contribution for HRA plans To determine Creditable/Non-Creditable status refer to UHC's Medicare Part D Creditable Coverage Lookup Tool or contact Creditable.Coverage@optum.com
	All Western Health Advantage Large Group plans are considered creditable for the 2026 plan year.

The information herein was collected from sources deemed reliable including information from various carriers. We have not verified nor can we guarantee the accuracy, timeliness or completeness of such information, which is provided on an “AS-IS” basis. It is solely your responsibility to verify this information before making decisions or incurring costs based on such information.  Further, you should contact the carrier for full details regarding the products and programs contained herein.