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This variable is contained in the following files:
SAS Name
PLAN_TYPE
This variable indicates the type of plan offered by the plan sponsor.
| Code | Code value |
|---|---|
| 01 | Health Maintenance Organization (HMO) |
| 02 | Health Maintenance Organization Point-of-Service (HMO POS) |
| 04 | Local Preferred Provider Organization (PPO) |
| 07 | Medical Savings Account (MSA) |
| 09 | PFFS |
| 18 | 1876 Cost |
| 20 | National Program of All-inclusive Care for the Elderly (PACE) |
| 29 | Medicare Prescription Drug Plan (PDP) |
| 30 | Employer/Union Only Direct Contract PDP |
| 31 | Regional PPO |
| 46 | Limited Income Newly Eligible Transition Program (LINET) |
| 48 | Medicare-Medicaid Plan, Health Maintenance Organization (MMP HMO) |
| 49 | Medicare-Medicaid Plan, Health Maintenance Organization Point-of-Service (MMP HMOPOS) |
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)