MAPD Help Desk

Medicare Advantage Prescription Drug (MAPD) Help Desk offers technical and functional support for the Medicare Advantage Health and Prescription Drug Coverage (Parts C and D) Programs.  This insurance coverage is provided by:

• Medicare Advantage (MA) Plans.
• Medicare Advantage Prescription Drug (MAPD) Plans.
• Medicare Prescription Drug Plans (PDPs)
• Third parties conducting data exchanges with CMS on behalf of MA/MAPD/PDPs.

Technical Support for Plan Connectivity and Access:

• Startup, testing and implementation for connectivity to CMS systems.
• Ongoing operational support for data exchanges and system problems.
• IDM - Identity Management for CMS system access and password reset inquires and issues.

MAPD Functional Support for Inquires and Issues:

• Coordination with CMS for beneficiary enrollment, disenrollment, payment and premium topics.
• MARx UI - Medicare Advantage Prescription Drug User Interface.
• eRPT - Electronic Retroactive Processing transmission.
• ELMO - Eligibility Enrollment Medicare Online.
• COB - Coordination of Benefits files.
• PRIS Plan Portal - Payment Recovery Information System Medicare Parts C & D Plan Portal.

For helpful information about the following topics, please click the link:

• Remote Identity Proofing (RIDP) (PDF)
• Common MARx UI Login Errors (PDF)
• Registering MFA Devices Quick Reference Guide (QRG) (PDF)

Important Notice: MAPD Help Desk Information Request Documents

• Please use the “MAPD Help Desk Information Request Form” when requesting information from the MAPD Help Desk. When supplying beneficiary information such as an SSN (Social Security Number) or an MBI (Medicare Beneficiary Identifier), the “SSN- MBI Spreadsheet” is required for any enrollment, entitlement, payment, or premium issues, and the “End Stage Renal Disease (ESRD) SSN- MBI template” is required for any ESRD status update requests. Having the information in these documents will help facilitate accurate and timely processing of your request. 

  Please Note: If you are emailing in the spreadsheets, they are to be password protected (PDF) to ensure they are following the CMS Security Policy for PHI/PII.

  All documents are provided in the Downloads section in the ZIP file entitled “MAPD Help Desk Information Request Documents”.

Bulletin Board of Current Plan Communications

• October 15, 2024 - October Plan Communications User Guide v18.1 Now Available

The Centers for Medicare & Medicaid Services has posted a new version (18.0) of the Plan Communications User Guide (PCUG) to the MAPD Help Desk website. Revisions to the Guide include the Medicare Prescription Payment Plan updates. Please see the Change Log at the beginning of the Guide for a detailed list of the updates and reference the MAPD Plan Communications User Guide page for the new PCUG.

• August 30, 2024 – August Plan Communications User Guide v18.0 Now Available

The Centers for Medicare & Medicaid Services has posted a new version (18.0) of the Plan Communications User Guide (PCUG) to the MAPD Help Desk website. Revisions to the Guide include updating Eligibility and Enrollment Transaction Reply Code 154 in Section 3.8 to include Transaction Code 76, moving former Section 3.4.5 Transaction Reply Code Types to Section 3.8, and updating the name of Layout 7-9 to Part C RA Model Output Detail Record Type M (PY2024 through PY2025). Please see the Change Log at the beginning of the Guide for a detailed list of the updates and reference the MAPD Plan Communications User Guide page for the new PCUG.

• June 28, 2024 – June Plan Communications User Guide v17.9 Now Available

The Centers for Medicare & Medicaid Services has posted a new version (17.9) of the Plan Communications User Guide (PCUG) to the MAPD Help Desk website. Revisions to the Guide include adding new record type ‘7’ (2025 Rx_18_19) in section 7.3 under Part D RA Model Output Detail/Beneficiary Record 7 (PY2025). Please see the Change Log at the beginning of the Guide for a detailed list of the updates and reference the MAPD Plan Communications User Guide page for the new PCUG.
 

• June 10, 2024 – Year 2025 MARx Plan Monthly Calendar Now Available

The MARx Plan Monthly Calendar has been updated to reflect 2025 Plan data due dates, report release dates, enrollment certification due dates, and file transmissions. The 2025 MARx calendar is available for Plans to review via the MAPD/MARx Calendars and Schedules link.

At the end of each year, the MAPD Help Desk issues the MARx Monthly Calendar for the coming year. The calendar is available in the Downloads section in both a color and plain text format and identifies the following dates:

• CMS Holidays
• MARx Monthly Reports Available
• Plan Submission Cut-Off
• Payment due to Plan
• Annual Election Period Begin and End dates
• MA Full-Dual Notification File (transmitted only to MA Organizations and Cost Plans)
• Biweekly LIS Report
• NoRx File
   
• May 31, 2024 – May Plan Communications User Guide v17.8 Now Available

The Centers for Medicare & Medicaid Services has posted a new version (17.8) of the Plan Communications User Guide (PCUG) to the MAPD Help Desk website. Revisions to the Guide include adding new value into description in Special Election Period (SEP) Status column and SEP Status field (L-Postal Service Reform Act (PSRA) SEP in section 8.3; updating Transaction Code (TC) 61 Enrollment Effective Dates with clarification note on simultaneous enrollment in section 3.2.6; changes to Risk Adjustment Suite of Systems (RASS) Model Output Report file naming conventions in section 7.10; and updated title and definition for the Transaction Reply Code (TRC) 403 in section 3 Eligibility and Enrollment. Please see the Change Log at the beginning of the Guide for a detailed list of the updates and reference the MAPD Plan Communications User Guide page for the new PCUG.

• April 30, 2024 – February Plan Communications User Guide v17.7 Now Available

The Centers for Medicare & Medicaid Services has posted a new version (17.7) of the Plan Communications User Guide (PCUG) to the MAPD Help Desk website. Revisions to the Guide include updating Transaction Reply Code (TRC) 131 to include transaction code 54 in section 3.8 Eligibility and Enrollment. Please see the Change Log at the beginning of the Guide for a detailed list of the updates and reference the MAPD Plan Communications User Guide page for the new PCUG.

• February 29, 2024 – February State User Guide v12.0 Now Available

The Centers for Medicare & Medicaid Services has posted a new version (12.0) of the MAPD State User Guide to the MAPD Help Desk website. The guide contains a new SEP Status column to the Entitlement Information section and new Table 3-8: SEP Status Codes. Also, 2024 IRA LIS changes were made to the MMA Response File Detail Layout. Please reference the MAPD State User Guide (SUG) page for the new Guide: MAPD State User Guide (SUG) | CMS

• February 29, 2024 – February Plan Communications User Guide v17.6 Now Available

The Centers for Medicare & Medicaid Services has posted a new version (17.6) of the Plan Communications User Guide (PCUG) to the MAPD Help Desk website.  Updates to the Guide include revisions to item 19 in the MARx Batch Input Detail - Disenrollment Transaction - TC 51 or 54 layout and item 26 in the MARx Batch Input Detail - Enrollment Transaction - TC 61 layout and the Daily Transaction Reply Report (DTRR) to include availability. Changed TRC-Type 404R to reflect 402A in the Eligibility and Enrollment TRC Grouping and added new TRC 406 PLAN/SCC SERVICE AREA REDUCTION. Updated Figure 8-22 Beneficiary: Eligibility (M232) Screen (with Eligibility Information) screenshot and changed Exception Condition to SEP Status column and description in Table 8-9: Beneficiary: Eligibility (M232) Field Description table. Also, added new section 8.3.16 Status Detail (M257), Figure 8-44: Status Detail Part A (M257) Screen, Figure 8-45: Status Detail Part A (M257) Screen and Table 8-25: Status Detail Part A and B (M257) Field Description. Please see the Change Log at the beginning of the Guide for a detailed list of the updates and reference the MAPD Plan Communications User Guide page for the new PCUG.

• January 31, 2024 – January 31, 2024 Plan Communications User Guide v17.5 Now Available

The Centers for Medicare & Medicaid Services has posted a new version (17.5) of the Plan Communications User Guide (PCUG) to the MAPD Help Desk website.  Updates to the Guide include revisions to SEP Reason Code 94 in the Election Type “S – Special Election Period (SEP)” Reason Code Table, an updated screenshot of Figure 8-22: Beneficiary: Eligibility (M232) Screen (with Eligibility Information), updates to the Entitlement Status column description and the addition of “Exceptional Condition SEP column” under Entitlement Information in the Beneficiary: Eligibility (M232) Field Description table. Please see the Change Log at the beginning of the Guide for a detailed list of the updates and reference the MAPD Plan Communications User Guide page for the new PCUG.

• January 4, 2024 – Updated November 2023 Plan Communications User Guide v17.4 Now Available

The Centers for Medicare & Medicaid Services has posted an update to version 17.4 of the Plan Communications User Guide, which is now available on the MAPD Help Desk website.  The revised version of the guide has the removal of heading 7.8 – Long Term Institutionalized (LTI) Resident Report File in the Outbound Files and Miscellaneous section. Please see the Change Log at the beginning of the Guide for a detailed list of the updates and reference the MAPD Plan Communications User Guide page for the revised PCUG.

• December 21, 2023 - MAPD Help Desk Holiday Availability Schedule

Please be advised that the MAPD Help Desk’s availability for the upcoming holiday schedule is as follows:  

• In observation of Christmas Eve, the MAPD Help Desk will be open from 8:00 AM - 4:00 PM ET on Friday, December 22.
• In observation of Christmas Day, the MAPD Help Desk will be closed on Monday, December 25. 
• In observation of New Year’s Eve, the MAPD Help Desk will be open from 8:00 AM - 4:00 PM ET on Friday, December 29. 
• In observation of New Year’s Day, the MAPD Help Desk will be closed on Monday, January 1. 
• November 30, 2023 – November 2023 Plan Communications User Guide v17.4 Now Available

The Centers for Medicare & Medicaid Services has posted a new version (17.4) of the Plan Communications User Guide (PCUG) to the MAPD Help Desk website.  Updates to the Guide include new Transaction Reply Code (TRC) 403-F and Special Election Period (SEP) reason codes: 42 & 43.  Also, SEP reason codes: 23, 34, 95 & 96 were updated and the heading to the Election Type “S – Special Election Period (SEP)” Reason Code Table to reflect MA/MA-PD. Please see the Change Log at the beginning of the Guide for a detailed list of the updates and reference the MAPD Plan Communications User Guide page for the new PCUG.

• November 20, 2023 - MAPD Help Desk Closed on Thanksgiving Day, Thursday, November 23, 2023

Please be advised that the MAPD Help Desk will be closed on Thursday, November 23, 2023 due to the Thanksgiving holiday.  The MAPD Help Desk will be open from 8:00 AM until 4:00 PM (ET) the following day on Friday, November 24, 2023.  The MAPD Help Desk will resume operating under its usual hours of 8:00 AM through 6:00 PM (ET) on Monday, November 27, 2023.    

• October 31, 2023 – October 2023 Plan Communications User Guide v17.3 Now Available

The Centers for Medicare & Medicaid Services has posted a new version (17.3) of the Plan Communications User Guide (PCUG) to the MAPD Help Desk website.  Updates to the Guide include the addition of codes 345, 346 & 347 to the Daily Transition Reply Report (DTRR) Detail Record, updated verbiage to codes 289, 345, 346 & 347 in the Eligibility and Enrollment Transaction Reply Codes table and an updated Payment Information form. Please see the Change Log at the beginning of the Guide for a detailed list of the updates and reference the MAPD Plan Communications User Guide page for the new PCUG.

• August 31, 2023 – Year 2024 MARx Plan Monthly Calendar Now Available

The MARx Plan Monthly Calendar has been updated to reflect 2024 Plan data due dates, report release dates, enrollment certification due dates, and file transmissions. The 2024 MARx calendar is available for Plans to review via the MAPD/MARx Calendars and Schedules link.

At the end of each year, the MAPD Help Desk issues the MARx Monthly Calendar for the coming year.  The calendar is available in the Downloads section in both a color and plain text format and identifies the following dates:

• CMS Holidays
• MARx Monthly Reports Available
• Plan Submission Cut-Off
• Payment due to Plan
• Annual Election Period Begin and End dates
• Plan Submission Cut-Off
• Payment due to Plan
• MA Full-Dual Notification File (transmitted only to MA Organizations and Cost Plans)
• Biweekly LIS Report
• NoRx File

Quick Reference Guide (QRG) MAPD Help Desk Common Issues

The MAPD Help Desk receives thousands of inquiries each month and in an effort to better assist our growing user community, we have consolidated information regarding issues we most commonly support.  Please refer to the Quick Reference Guide of MAPD Help Desk Common Issues in the download section below which provides users with easy access to common issues and solutions in a quick and easy format.

Topics covered include:

• Initial Setup
• Remote Identity Proofing (RIDP)
• Account Issues
   
• Important Notice: MAPD Help Desk Information Request Documents

Please use the MAPD Help Desk Information Request Form, and when applicable the Health Insurance Claim Number (HICN) – Medicare Beneficiary Identifier (MBI) Template, and the End Stage Renal Disease (ESRD) Template when requesting information from the MAPD Help Desk.  Use of the form and spreadsheets will help facilitate accurate and timely processing of your request.  Please note that if emailing the spreadsheets they are to be password protected to ensure they are following the CMS Security Policy for PHI/PII.

All documents are provided in the Downloads section in the ZIP file entitled MAPD Help Desk Information Request Documents.

Regularly Scheduled Maintenance

As a reminder, the MARx UI may be unavailable due to Regularly Scheduled Maintenance during the following timeframes:

Daily: 11:00 PM to 12:30 AM ET.

Weekly: Sunday evening at 6:00 PM to Monday morning at 6:00 AM ET.

Also, GENTRAN/TIBCO may be unavailable due to Weekly System Backup during the following timeframe:

Weekly: Sunday Morning at 1:00 AM to approximately 3:00 AM ET.

Holiday Hours

The MAPD Help Desk is closed on New Year’s Day, Memorial Day, Independence Day, Labor Day, Thanksgiving, and Christmas.

MARx UI Submission Cut Off Dates

Please reference the following table for the upcoming 2024 Plan Data Due dates for MARx transaction submissions.  Cutoff for the submission of MARx transaction files is 8:00 PM (Eastern Time) on the dates listed below:

Contacting the MAPD Help Desk

Phone: 1-800-927-8069
E-mail: mapdhelp@cms.hhs.gov
Hours of Operation: Monday-Friday 7:00 AM to 7:30 PM ET.