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Archives - Creditable Coverage Guidance and Notices

The documents on this page are for reference only. They have been superseded by other documents.

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Category Document Date
CC Model Notices for use after February 15, 2007 Model Individual Non-CC Disclosure Notice - PDF format 02/15/2007
CC Guidance Disclosure to CMS Guidance, Updated September 25, 2007 09/25/2007
CC Model Notices for use after February 15, 2007 Model Individual CC Disclosure Notice - Spanish - PDF format 02/15/2007
CC Model Notices for use after February 15, 2007 Model Individual CC Disclosure Notice - PDF format 02/15/2007
CC Model Notices for use after February 15, 2007 Model Individual Non-CC Disclosure Notice - Spanish - PDF format 02/15/2007
CC Model Notices for use after February 15, 2007 Model Individual Non-CC Disclosure Notice - Zipped Word format 02/15/2007
CC Model Notices for use after February 15, 2007 Model Personalized Individual Disclosure Notice - PDF format 02/15/2007
CC Model Notices for use after February 15, 2007 Model Personalized Individual Disclosure Notice - Spanish - PDF format 02/15/2007
CC Model Notices for use after February 15, 2007 Model Individual Non-CC Disclosure Notice - Spanish - Zipped Word format 02/15/2007
CC Medigap Notices for use prior to May 15, 2006 Medigap Creditable Coverage Notice 12/01/2005
CC Guidance Disclosure to CMS Guidance 01/10/2006
CC Model Notices for use after February 15, 2007 Model Personalized Individual Disclosure Notice - Zipped Word format 02/15/2007
CC Model Notices for use after February 15, 2007 Model Individual CC Disclosure Notice - Spanish - Zipped Word format 02/15/2007
CC Model Notices for use after February 15, 2007 Model Individual CC Disclosure Notice - Zipped Word format 02/15/2007
CC Model Notices for use prior to May 15, 2006 Model General Non-Creditable Coverage Notice - Spanish 12/01/2005
CC Guidance Documents for use prior to May 15, 2006 General Creditable Coverage Guidance - Spanish 01/04/2006
CC Model Notices for use prior to May 15, 2006 Model General Non-Creditable Coverage Notice 12/01/2005
CC Guidance and Model Disclosure Notices to be used after June 15, 2008 Model Individual Non-Creditable Coverage Disclosure Notice - PDF format 06/15/2008
CC Guidance Documents for use after May 15, 2006 Disclosure of Creditable Coverage to Medicare Part D Eligible Individuals Guidance 04/12/2006
CC Model Notices for use after May 15, 2006 Model Beneficiary Creditable Coverage Disclosure Notice Language for use on or after May 15, 2006 04/21/2006
CC Guidance Disclosure to CMS Form - User Guide 01/04/2006
CC Model Notices for use prior to May 15, 2006 Model General Creditable Coverage Notice 12/01/2005
CC Model Notices for use prior to May 15, 2006 Model General Creditable Coverage Notice - Spanish 12/01/2005
CC Model Notices for use after May 15, 2006 Model Beneficiary Personalized Disclosure Notice Language for use on or after May 15, 2006 04/21/2006
CC Guidance and Model Disclosure Notices to be used after June 15, 2008 Model Individual Creditable Coverage Disclosure Notice-Spanish - PDF format 06/15/2008
CC Guidance and Model Disclosure Notices to be used after June 15, 2008 Model Personalized Individual Disclosure Notice-Spanish - PDF format 06/15/2008
CC Guidance and Model Disclosure Notices to be used after June 15, 2008 Model Individual Creditable Coverage Disclosure Notice - Zipped Word format 06/15/2008
CC Guidance and Model Disclosure Notices to be used after June 15, 2008 Model Individual Non-Creditable Coverage Disclosure Notice - Zipped Word format 06/15/2008
CC Guidance and Model Disclosure Notices to be used after June 15, 2008 Guidance - Disclosure of CC to Medicare Part D Eligible Individuals Guidance - PDF format 02/15/2007
CC Guidance and Model Disclosure Notices to be used after June 15, 2008 Model Individual Non-Creditable Coverage Disclosure Notice-Spanish - PDF format 06/15/2008
CC Guidance and Model Disclosure Notices to be used after June 15, 2008 Model Individual Creditable Coverage Disclosure Notice-Spanish - Zipped Word format 06/15/2008
CC Helpful Hints Disclosure to CMS Form Commonly Asked Questions and Helpful Hints 01/04/2006
CC Model Notices for use after May 15, 2006 Model Beneficiary Non-Creditable Coverage Disclosure Notice Language for use on or after May 15 04/21/2006
CC Guidance Documents for use prior to May 15, 2006 Creditable Coverage Guidance 01/04/2006
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