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SAS Name
GAP_TIER_PARTIAL
For Part D plans with some cost sharing in the gap (gap_tier = Yes), this variable indicates whether or not the the cost sharing applies to a partial list of drugs. If only a limited number of drugs on the tier are covered through the gap then the value will be 'Y'. If all drugs on the tier are covered through the gap then the value will be 'N'.
| Code | Code value |
|---|---|
| Y | Yes |
| N | No |
| 9 | Not Applicable |
This variable was new in 2008. This variable applies only to enhanced plans with gap coverage. This variable also appears in the Plan Characteristics - Base File (see GAP_PARTIAL_TIER_01 - GAP_PARTIAL_TIER_07). The coverage gap is technically referred to as the initial coverage limit (ICL) for the Part D benefit. The CCW constructs the Plan Characteristics File from information submitted by Part D plan sponsors to CMS’s Health Plan Management System (HPMS).