Your Responsibility: Medicare Part D Notification and Disclosure to CMS
What’s new: The Centers for Medicare & Medicaid Services (CMS) released changes to the 2025 standard Medicare Part D prescription drug benefit. They issued a fact sheet that describes the differences, which include the following:
- A standard benefit consisting of annual deductible, initial coverage, and catastrophic coverage
- A lower annual out-of-pocket threshold of $2,000, down from $8,000 in 2024
- A higher annual deductible of $590, up from $545 in 2024
- A Manufacturer Discount Program that replaces the Coverage Gap Discount Program
- Changes to the liability of enrollees, Part D sponsors, manufacturers, and CMS
Your responsibility: The Centers for Medicare & Medicaid Services (CMS) requires employers to notify their Medicare-eligible employees and dependents regarding whether their plan’s prescription drug coverage pays, on average, as much as the standard Medicare prescription drug coverage. Federal law also requires employer groups to notify CMS if their prescription drug coverage for Medicare beneficiaries is creditable. CMS requires employer groups to submit a Creditable Coverage Disclosure form each year or whenever any change is made that could affect whether the drug coverage offered is creditable.
Creditable coverage reports: The following creditable coverage status reports show 2024 health plans when compared to Medicare Part D 2025 threshold amounts. Creditable coverage status means that the health plan’s prescription drug coverage, on average, pays the same as standard Medicare prescription drug coverage.
- For businesses with 1–50 employees with a small group plan:
2024-2025 Small Group Creditable Coverage Status Report - For businesses with 51+ employees on a Preferred Choice plan:
2024-2025 Preferred Choice Creditable Coverage Status Report
More information: For more information on Medicare Part D notification and disclosure to CMS requirements, visit cms.gov: