How Part D Initial Coverage Limit (ICL) is applied
SAS Name
ICL_APPLY
Indicates whether plan applies the Medicare-defined Part D Initial Coverage Limit (ICL) Amount.
Comments
The Initial Coverage Limit (ICL) phase of the Part D benefit is also referred to as the coverage gap. The CCW constructs the Plan Characteristics File from information submitted by Part D plan sponsors to CMS’s Health Plan Management System (HPMS). Employer and National Program of All-inclusive Care for the Elderly (PACE) plans are waived from reporting Plan Benefit Package information. For those plans that did not report, the value of this variable will be blank.
The Initial Coverage Limit (ICL) phase of the Part D benefit is also referred to as the coverage gap. The CCW constructs the Plan Characteristics File from information submitted by Part D plan sponsors to CMS’s Health Plan Management System (HPMS). Employer and National Program of All-inclusive Care for the Elderly (PACE) plans are waived from reporting Plan Benefit Package information. For those plans that did not report, the value of this variable will be blank.