Indicates Whether Part D Plan Offers Reduced Post Out-of-Pocket (OOP) Threshold Cost-Sharing Amounts

SAS Name

This variable indicates whether the plan offers reduced cost sharing in the post out-of-pocket threshold (catastrophic) phase of the Part D benefit.


This variable applies ONLY to the Enhanced Alternative Plans that offer reduced costsharing (i.e., where variable called REDUCED_COST_SHARE='Y').

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 plan sponsors to CMS’s Health Plan Management System (HPMS).

Source: CMS (HPMS Files)

Code Code value
Y Yes
N No
9 Not Applicable