Medicare Advantage Applications
Guidance for the application process for Part C Medicare Advantage plans (HMO/HMOPOS, PPO, RPPO, PFFS, MSA, EGWP and SNP).
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: November 15, 2019
This page provides important information on the application process for Part C Medicare Advantage plans (HMO/HMOPOS, PPO, RPPO, PFFS, MSA, EGWP and SNP). Please use the Medicare Prescription Drug link in the “Related Links Inside CMS” section below to access Medicare Prescription Drug application materials.
Medicare Contract Applications - Organizations that are interested in applying for a Medicare Advantage contract can download and complete the appropriate application.
All Medicare Advantage applicants must download the payment information form below and submit it with their application.
HPMS LISTSERVS
While HPMS plan users are automatically subscribed to the HPMS list serv, prospective plan applicants and other interested parties without access to the system may request to join the listserv’s supplemental mailing list to stay abreast of the agency’s communications on the Medicare Advantage (MA) and Part D programs.
To facilitate this process, CMS has implemented an online form that can be used to join one or more HPMS listservs, modify your current listserv access, or delete your current listserv access.
CMS makes additions and modifications to the HPMS listserv on a weekly basis.
CMS is also publishing HPMS memos on the CMS public website on a weekly basis. The HPMS-Memos-Archive may be found in the related links section below.
Medicare Advantage Network Adequacy Review Overview
The Medicare Advantage Network Adequacy Review overview video is available on CMS’ official YouTube page. This video provides information about the standards and regulatory requirements related to network adequacy reviews, including a high-level review of the Health Services Delivery table submission and the Exception Request processes, as set forth at 42 CFR 422.116. You can find the link to the video recording below under “Related Links”.
HHS is committed to making its websites and documents accessible to the widest possible audience, including individuals with disabilities. We are in the process of retroactively making some documents accessible. If you need assistance accessing an accessible version of this document, please reach out to the guidance@hhs.gov.
DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.