Part D Plan definition
Examples of Part D Plan in a sentence
The response record shows if the enrollee is a Part D beneficiary; if the BCRC applied the record to the MBD; if the record was not applied to the MBD, and why (e.g., the record contained errors or the record did not provide enough information about the enrollee), in which Part D plan the beneficiary is enrolled, and other Part D enrollment information.
If MA-PD Sponsor has demonstrated that it historically fills 98% or more of its enrollees' prescriptions at pharmacies owned and operated by the MA-PD Sponsor (or presents compelling circumstances that prevent the sponsor from meeting the 98% standard or demonstrates that its Part D plan design will enable the sponsor to meet the 98% standard during the contract year), this provision does not apply to MA-PD Sponsor's plan.
The MBD will send daily updates of all prescription drug coverage of Part D beneficiaries to the Transaction Facilitation Contractor and to the Part D plan that the beneficiary is enrolled in.
Although Contractor may be determined qualified to renew its addendum under this Article, if Contractor, CMS, and EOHHS cannot reach agreement on the Part D plan benefit package under Subpart F of 42 C.F.R. Part 423, no renewal takes place, and the failure to reach agreement is not subject to the Appeals provisions in Subpart N of 42 C.F.R. Parts 422 or 423.
Members who are also eligible for Medicare Part D can remain covered and will not be subject to Medicare-imposed late enrollment penalties should they decide to enroll in a Medicare Part D plan at a later date; however, the Member could be subject to payment of higher Part D premiums if the Member subsequently has a break in creditable coverage of 63 continuous days or longer before enrolling in a Part D plan.
All Enrollees must be successfully enrolled in a Part D plan prior to termination of the Demonstration.
If Contractor intends to participate in the Part D program for the next program year, Contractor agrees to submit the next year’s Part D plan benefit package including all required information on benefits and cost-sharing, by the applicable due date, as provided in Subpart F of 42 C.F.R. Part 423 so that CMS, EOHHS and Contractor may conduct negotiations regarding the terms and conditions of the proposed benefit plan renewal.
Where a match occurs, the CMS shall annotate its Medicare Part D enrollment files to identify the Patient Assistance Program as a supplemental prescription drug payer to the Medicare Part D plan for these Patient Assistance Program covered individuals.
In the event you offer a Medicare Advantage plan that includes Part D drug benefits, if the low income premium subsidy amount for which a Member is eligible is less than the portion of the monthly premium paid by the Member, then you should communicate to the enrollee the financial consequences for the Member enrolling in your Medicare Advantage plan as compared to enrolling in another Part D plan with a monthly premium equal to or below the low income premium subsidy amount.
The response record will indicate if the enrollee is a Part D beneficiary, whether or not the BCRC applied the record to the MBD and if the record was not applied to the MBD, why not (e.g., the record contained errors or the record did not provide enough information about the enrollee); what Part D plan the beneficiary is in enrolled in; and other selected Part D enrollment information.