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When Will Enrollment in Medicare Part D Cause A Participant to Lose Medical Coverage?

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I am working with an employer that has a plan that covers eligible retired employees. If the coverage is considered creditable, would a retiree's enrollment in Medicare Part D result in the retiree's loss of coverage under the employer's medical plan? What if the coverage is non-creditable and the employee enrolls in Medicare Part D. Would this result in the retiree's loss of coverage under the employer's plan? Can you provide a citation to a US Code provision or a regulation citation that supports your position?


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  • 2 weeks later...

When they are enrolled in a Medicare Advantage Plans that requires that type of MAPD Part D Coverage (Coordinated Care, (PPO, POS, HMO) or Medicare / Medicare (MMP), Special Needs Plan SNP, Disabilty-SNP,....

Not aware of any loss of an employer's group health plan when enrolling in Part D coverage other than if mandated by the employers group health plan.  There are Employer/Union Medicare Waiver Plans which may have Rx Coverage, so check with the employer's retirement group coverage carrier or plan sponsor to confirm their rules.

This is per AHIP Medicare MAPD/PDP Certification for 2020.  If you want a copy of the Module that applies to this question send me an email sdavis@keystoneinsgrp.com request.



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