Prescription Drug Benefit Manual
Prescription Drug Benefit Manual
Please look through the Downloads area below for Chapters from the Part D Prescription Drug Benefit Manual (PDBM). The following chapters of the PDBM are available under Related Links below: Chapter 3 on Eligibility and Enrollment; Chapter 4 on Creditable Coverage and Late Enrollment Penalty; and Parts C & D Enrollee Grievances, Organization/Coverage Determinations, and Appeals Guidance.
Click the selection that best matches your information needs. Please check back, as we will continue to update this page as manuals are revised.
Downloads
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Chapter 5-Benefits and Beneficiary Protection (v9.20.11) (PDF) -
Chapter 6 - Part D Drugs and Formulary Requirements (v.01.19.16) (PDF) -
Chapter 7 - Medication Therapy Management and Quality Improvement Program (v02.19.10) (PDF) -
Chapter 9 - Compliance Program Guidelines (PDF) -
Chapter 12 - Employer/Union Sponsored Group Health Plans (v11.10.08) (PDF) -
Chapter 13 - Premium and Cost-Sharing Subsidies for Low-Income Individuals (v09 14 2018) (PDF) -
Chapter 14 - Coordination of Benefits (v.09 17 2018) (PDF) -
Guidance for Prescription Drug Plan (PDP) Renewals and Non-Renewals 4.2018 (PDF) -
Parts C & D Enrollee Grievances, Organization/Coverage Determinations, and Appeals Guidance (PDF)
Page Last Modified:
09/10/2024 06:21 PM