42 C.F.R. § 423.258
Definitions.
Cite as 42 C.F.R. § 423.258 (2026)
For the purposes of this subpart, the following definitions apply:
Full risk plan
means a prescription drug plan that is not a limited risk plan or a fallback prescription drug plan.
Limited risk plan
means a prescription drug plan that provides basic prescription drug coverage and for which the PDP sponsor includes a modification of risk level described in § 423.265(d) in its bid submitted for the plan. This term does not include a fallback prescription drug plan.
Standardized bid amount
means, for a prescription drug plan that provides basic prescription drug coverage, the PDP approved bid; for a prescription drug plan that provides supplemental prescription drug coverage, the portion of the PDP approved bid that is attributable to basic prescription drug coverage; for a MA-PD plan, the portion of the accepted bid amount that is attributable to basic prescription drug coverage.
- Cross-references to the CFR
- 423.265