Catastrophic Coverage Code

SAS Name
CTSTRPHC_CVRG_CD

This variable indicates whether the PDE occurred within the catastrophic benefit phase of the Medicare Part D benefit, according to the source PDE.

When the value equals C (above attachment point), then the PDE is in the catastrophic phase. When the value equals A (attachment point), the PDE has caused the beneficiary to move into the catastrophic phase (i.e., this is the “triggering” PDE).

Source: PDE 

Comments

This variable was required for all PDEs through the end of 2010, and became optional starting in 2011. 

Note that the value may differ from the more detailed BENEFIT_PHASE variable, which is a CCW-derived field that is available for all years.

Code Code value
A Attachment point met on this event
C Above attachment point
N Attachment Point met; TrOOP subsequently reduced below the OOP threshold due to payment amounts from non-EGWP other payers reported in PLRO (reported by EGWPs only)
Blank Attachment point not met