If you offer prescription drug coverage through a group health plan, Medicare regulations require you to inform CMS and Medicare-eligble 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.

Anthem Blue Cross Blue Shield

Small Group ACA

Non-Creditable Plans:

• Anthem Bronze Guided Access HMO 8000/0%/8000 w/HSA
• Anthem Link Bronze PPO 6000/8000 w/HSA
• Anthem Convenient Care Bronze Guided Access HMO 5000/8000 w/HSA
• Anthem Bronze PPO 8000/0%/8000 w/HSA
• Anthem Bronze Choice PPO 6000/25%/8000 w/HSA

Association Health Plan – Small Group AHP

Anthem Convenient Care HMO 8200/40%/900 RX $0/$10/$60/$125/$400 Lean Rx

Association Balance Funding – Small Group ABF

Non-Creditable Plans:

• Anthem Link Balanced PPO 5000/8700 Lean Rx
• Anthem Balanced Choice PPO 6000/25%/8000 w/HSA
• Anthem Balanced Choice PPO 1000/20%/7500 Lean Rx
• Anthem Convenient Care Balanced Guided Access HMO 50/9200 Lean Rx
• Anthem Convenient Care Balanced Guided Access HMO 4500/7000 Lean Rx
• Anthem Link Balanced Guided Access HMO 25/8700 Lean
• Anthem Link Balanced PPO 25/8700 Lean Rx
• Anthem Balanced Choice PPO 5500/30%/9200 Lean Rx
• Anthem Link Balanced Guided Access HMO 3500/9200 Lean Rx

Hometown Health

Non-Creditable Plans:

• Bronze Plus HMO/EPO/PPO
• Bronze HSA HMO/EPO/PPO
• Bronze Value HMO/EPO/PPO

Prominence Health Plan

Non-Creditable Plans:

• Prominence HMO 26 Bronze
• Prominence HMO 29 Bronze
• Prominence HMO 30 Bronze
• Prominence Freedom 30 Bronze
• Prominence POS 23 Bronze
• Prominence PPO 30 Bronze

Association Health Plans

All Prominence Health Plan Small Group Association Health Plans are considered creditable for the 2025 plan year.

Total Benefit Solutions

All Total Benefit Solutions Small Group plans are considered creditable for the 2025 plan year.