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 Chapter 18 on Appeals and Grievances.
Click the selection that best matches your information needs. Please check back, as we will continue to update this page as manuals are revised.
- Chapter 1 - Introduction and General Provisions (v09.26.08) [PDF, 52KB]
- Chapter 5 - Benefits and Beneficiary Protection (v09.20.11) [PDF, 1MB]
- Chapter 6 - Part D Drugs and Formulary Requirements (v.01.19.16) [PDF, 434KB]
- Chapter 7 - Medication Therapy Management and Quality Improvement Program (v02.19.10) [PDF, 173KB]
- Chapter 9 - Compliance Program Guidelines [PDF, 313KB]
- Chapter 12 - Employer/Union Sponsored Group Health Plans (v11.10.08) [PDF, 261KB]
- Chapter 13 - Premium and Cost-Sharing Subsidies for Low-Income Individuals (v08.08.11) [PDF, 354KB]
- Chapter 14 - Coordination of Benefits (v8.23.2013) [PDF, 894KB]
- Guidance for Prescription Drug Plan (PDP) Renewals and Non-Renewals 4.2018 [PDF, 70KB]
- Page last Modified: 04/19/2018 1:56 PM
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