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Submitted URL: https://click.info.higginbotham.com/?qs=ffe258598fbd9345499663e221b0259d1081d5e08cb19924e1231333db1a576441f4c41849e4e7198c366c6be223...
Effective URL: https://www.cms.gov/Medicare/Prescription-Drug-Coverage/CreditableCoverage/CCDisclosureForm
Submission: On January 24 via api from US — Scanned from DE
Effective URL: https://www.cms.gov/Medicare/Prescription-Drug-Coverage/CreditableCoverage/CCDisclosureForm
Submission: On January 24 via api from US — Scanned from DE
Form analysis
2 forms found in the DOMGET /search/cms
<form action="/search/cms" method="get" id="search-block-form" accept-charset="UTF-8" class="search-form search-block-form" data-drupal-form-fields="edit-keys--2">
<div class="js-form-item form-item js-form-type-search form-type-search js-form-item-keys form-item-keys form-no-label">
<label for="edit-keys--2" class="visually-hidden">Search</label>
<input title="Enter the terms you wish to search for." placeholder="Search CMS" aria-label="Search CMS" data-drupal-selector="edit-keys" type="search" id="edit-keys--2" name="keys" value="" size="15" maxlength="128" class="form-search">
</div>
<div data-drupal-selector="edit-actions" class="form-actions js-form-wrapper form-wrapper" id="edit-actions--2"><input data-drupal-selector="edit-submit" type="submit" id="edit-submit--3" value="Search" class="button js-form-submit form-submit">
</div>
</form>
POST https://public.govdelivery.com/accounts/USCMS/subscribers/qualify
<form accept-charset="UTF-8" action="https://public.govdelivery.com/accounts/USCMS/subscribers/qualify" id="email-footer-form" method="post" data-drupal-form-fields="email,email-submit">
<div aria-label="Enter your email address for email updates" id="email-form">
<label for="email" class="visually-hidden">Enter your email address</label>
<input aria-label="Enter your email address:" id="email" name="email" placeholder="type your email here" type="text">
<input id="email-submit" name="email-footer-submit" type="submit" value="Submit">
</div>
</form>
Text Content
Skip to main content An official website of the United States government Here’s how you know Here’s how you know The .gov means it’s official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site. The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely. HEADER * Home * About CMS * Newsroom * Archive * Help * Print Search SITE * Medicare * Medicaid/CHIP * Medicare-Medicaid Coordination * Private Insurance * Innovation Center * Regulations & Guidance * Research, Statistics, Data & Systems * Outreach & Education BREADCRUMB * Home * Medicare * Creditable Coverage * Disclosure to CMS Form CMS MAIN NAVIGATION * CREDITABLE COVERAGE * * Disclosure to CMS Form * Disclosure to CMS Guidance and Instructions * Disclosure to CMS Form * Model Notice Letters * Archives - Creditable Coverage Guidance and Notices DISCLOSURE TO CMS FORM Disclosure to CMS Form Page Last Modified: 12/01/2021 08:00 PM Help with File Formats and Plug-Ins Home A federal government website managed and paid for by the U.S. Centers for Medicare & Medicaid Services. 7500 Security Boulevard, Baltimore, MD 21244 CMS & HHS WEBSITES * Medicare.gov * Medicaid.gov * InsureKidsNow.gov * HealthCare.gov * HHS.gov/Open TOOLS * Acronyms * Archive * Contacts * Glossary HELPFUL LINKS * Web Policies & Important Links * Careers * For Developers * Plain Language * Privacy Policy * Privacy Settings * Freedom of Information Act * No Fear Act * Nondiscrimination/Accessibility * HHS.gov * Inspector General * USA.gov * Help with file formats & plug-ins RECEIVE EMAIL UPDATES Enter your email address CONNECT WITH CMS * Twitter link * Youtube link * Facebook link * Linkedin link * RSS Feed link