Out-of-Pocket (OOP) Threshold Amount in the Part D Plan

SAS Name

This variable is the dollar amount of the Medicare-defined Part D annual Out-of-Pocket (OOP) Cost Threshold.

This field is blank for Fixed Capitated Reinsurance Demonstration Projects


The CCW constructs the Plan Characteristics File from information submitted by 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.

Source: CMS (HPMS Files)