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US · guidance

CMS Pub. 100-16, ch. 9, § 30.8

Simultaneous Enrollment in an MA Local or Regional Coordinated

activein force · 2026-08-25 – presentas-observed

Care Plan and a Stand-Alone PDP

(Rev. 111, 05-03-13, Effective: 05-03-13, Implementation: 05-03-13)

Members of 800-series regional PPO EGWPs and local coordinated care plan EGWP enrollees

may enroll in 800-series stand-alone PDPs, provided that separate medical and prescription drug

vendors work closely together with the employer/union sponsor to provide coordinated care and

disease management services between the MA and the PDP portion of the benefit. Prior to

extending this waiver to regional coordinated care EGWPs, simultaneous enrollment in MA

plans and PDPs was limited to local coordinated care plan enrollees.

History

(Rev. 111, 05-03-13, Effective: 05-03-13, Implementation: 05-03-13)

Provenance

Source
cms.gov
Retrieved
2026-08-25
Edition
iom-2026-08-25
Content hash
b7d1b2929e9619d6fbe414227e7d22ca0f938e6e2b53eafbee8fd7ed9151dd30
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