Medicare Prescription Drug Coverage and Your Rights (CMS-10147)

OMB 0938-0975

OMB 0938-0975

Pursuant to 42 CFR 423.562(a)(3) and 423.128(b)(7)(iii), Part D plan sponsors must arrange with their network pharmacies to provide a printed copy of the standardized pharmacy notice to enrollees (beneficiaries) at the point of sale when an enrollee's prescription cannot be filled.

The latest form for Medicare Prescription Drug Coverage and Your Rights (CMS-10147) expires 2021-02-28 and can be found here.

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