Helpful Links

This page provides additional resources for Plans to obtain information regarding the Medicare Advantage and Prescription Drug program.

Printable List of Plan Resources:

In response to questions frequently posed by Plans, the MAPD Help Desk has compiled a list of resources where the answers may be obtained. This list is provided in the Downloads section below. Topics include:

•   Resolving system errors
•   Requesting IACS password resets
•   Obtaining information on user accounts
•   Updating Plan contact information
•   Identifying enrollment file transmissions
•   Obtaining enrollment system guidance

The Related Links sections below provide resources where Plans may obtain other relevant information both within the CMS website and on related websites for CMS external business partners.

Medicare Advantage and Prescription Drug Program Resources:

•    Health Plans - General Information: This site contains operational and regulatory information related to Medicare Advantage (MA) and Medicare Advantage-Prescription Drug (MA-PD) organizations, Cost-Based Plans, and stand-alone Prescription Drug Plans (PDPs). A link to this CMS site is provided under the Related Links Inside CMS section below.

•    Medicare Managed Care Eligibility and Enrollment: This site contains enrollment information relevant to Medicare Advantage (MA) organizations and Cost Plans, including enrollment/disenrollment guidance and content related to the transmission of beneficiary enrollment and payment information to CMS. A link to this CMS site is provided under the Related Links Inside CMS section below.

•   Medicare Prescription Drug Eligibility and Enrollment: This site contains enrollment information relevant to Prescription Drug Plans (PDPs), including enrollment/disenrollment guidance, content for Part D plans receiving auto-enrollment, and guidance related to creditable coverage period determinations and the late enrollment penalty. A link to this CMS site is provided under the Related Links Inside CMS section below.

•    Prescription Drug Plan Contracting: This site provides specific information of particular importance to Prescription Drug Plans (PDPs), including detailed information on PDP application/renewal requirements, marketing guidelines, formulary requirements, coordination of benefits, plan reporting and oversight, and other special guidance. A link to this CMS site is provided under the Related Links Inside CMS section below.

Other Resources:

•   Medicare Exclusion Database (MED) Newsletter and Manual: The MED Newsletter and MED Manual contain updated information on the MED file distribution and accessing the web based online MED. The newsletter and manual are provided in the Downloads section below.

•    Beneficiary Eligibility Portal: The CMS Applications Portal is a gateway offered to CMS Business Partners to access a number of systems related to Medicare Advantage and Prescription Drug and other CMS programs. A CMS-issued user ID is required in order to access data via this portal. A link to this CMS site is provided under the Related Links Inside CMS section below.

•    Coordination of Benefits (Part D): This site provides background information, documentation, and forms related to the Coordination of Benefits (COB) contract, which consolidates Medicare benefit coordination activities from various Medicare contractors to a single point of contact. A link to this CMS site is provided under the Related Links Inside CMS section below.

•    Retiree Drug Subsidy (RDS) Program: This website serves as a comprehensive resource center for the Retiree Drug Subsidy (RDS) Program. A link to this website is provided under the Related Links Outside CMS section below.

•    TrOOP Facilitation Coordinator: The True Out of Pocket (TrOOP) Eligibility Facilitator Service (Enhanced E1) provides data and tools to assist pharmacists and pharmacies with processing beneficiary prescriptions. A link to this website is provided under the Related Links Outside CMS section below.

•    Customer Service and Support Center (CSSC): This website provides comprehensive information on the Risk Adjustment Processing System (RAPS) and the Prescription Drug Information Center (PDIC). A link to this website is provided under the Related Links Outside CMS section below.