Modern Part D Creditable Coverage Determinations
Creditable automates Medicare Part D Creditable Coverage Determinations for employer prescription drug plans. We test each plan for accuracy, generate compliance documentation, and give brokers, TPAs, and HR teams one simple platform to manage every determination with speed, consistency, and confidence.
Smarter, Faster, More Compliant.
What Are Part D Creditable Coverage Determinations?
Every year, employers must determine whether their prescription drug plan is “creditable” under Medicare Part D, meaning it’s expected to pay at least as much as a standard Medicare drug plan.
If the plan isn’t creditable and an employee delays enrolling in Part D, they can face lifetime penalties. Because of this, CMS requires employers to test their plan and send official Creditable Coverage Notices every year.
Most employers rely on brokers, TPAs, PBMs, or carriers to figure this out and that’s where things get messy.
Why Part D Determinations Are Confusing & Overlooked
Niche
A tiny corner of compliance and problem too specialized for HR and too small for carriers to care.
Constantly Changing
New thresholds and new rules every year. What was creditable last year may not be today.
Time-consuming
Gather data, run numbers manually, back and forth with carriers, draft notices, repeat
Expensive
If using an actuary or third party, often charges thousands of dollars per determination
Often Inaccurate
Spreadsheets miss details, carriers do a one size fits all approach. Most results? Wrong or outdated.
It’s a high-stakes compliance requirement… with no easy way to do it right.
What We Do
Creditable makes Part D determinations:
Simple: We handle the entire process for you
Accurate: Actuarial-grade testing built into the platform
Fast: Results in seconds, not weeks
Affordable: No more overpaying actuaries
Compliance: Official documentation generated for you and your teams
You focus on serving your clients.
We handle the compliance.
How Creditable Works
Step 1:
Input your client or company’s information
Step 2:
Enter the specific information of the plan you are wanting to test (Plan type, deductible, copays, etc.)
Step 3:
Click “Save & Evaluate”
Step 4:
Instantly receive your plan determination with a detailed determination report
Bonus:
Store all historic plan information and determinations for years to come - all in one, easy to use platform
Key Benefits
Speed
Run a complete Part D creditable coverage determination in seconds - not days or weeks.
Compliance
Every result aligns with CMS 42 CFR 423.56 and the latest Medicare Part D standards, keeping you fully audit-ready.
Accuracy
Built on actuarial logic and verified methodology to ensure every plan is tested correctly - every time.
Transparency
Clear inputs, clear outcomes. Know exactly how each plan was evaluated and retain documentation for your records.
Testimonials
That couldn’t have been easier.
Ready To Transform Your Part D Determination Process?
Streamline your workflow, reduce errors, and ensure compliance.
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