Calculator · CY2026 rules

Creditable Coverage Checker

Pick the coverage a client had, or has now, and get two answers side by side. Does it protect them from the Part B penalty? Does it protect them from the Part D penalty? The two parts ask different questions.

What it answers

Whether job-based coverage lets them delay Part B, including the under-20-employee and disability rules that make Medicare pay first
Why COBRA, retiree coverage, Marketplace plans and VA care never delay Part B
Whether the drug coverage is creditable for Part D: VA, TRICARE, FEHB, Indian Health Service, Medicaid and Extra Help, and plans that depend on their annual notice
What to do next: CMS-L564, the creditable coverage notice, the HSA cut-off, and the COBRA deadline trap

For example: COBRA → no for Part B; yes for Part D if the plan’s notice says creditable.

How it's worked out

Part B asks one question: is the coverage a group health plan from current employment (theirs or a spouse’s)? That is what opens the 8-month Special Enrollment Period and keeps months out of the penalty.

Part D asks a different question: is the drug coverage expected to pay at least as much as standard Part D? Plans must say so in a notice every year before October 15.

Sources

Free tools for licensed insurance agents. Not for use by Medicare beneficiaries. Figures are CMS’s published amounts; Social Security, CMS and the plan make the final determination.

Enrollment Period Finder · IRMAA Estimator · Part B Late Enrollment Penalty Calculator · Part D Late Enrollment Penalty Calculator · Combined Medicare Penalty Calculator · All Agent Tools