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SAS Name
GAP_COVERAGE_TYPE
Describes the type of gap coverage offered for Enhanced Alternative plans that offer additional gap coverage beyond the coinsurance in the gap for defined standard coverage.
| Code | Code value |
|---|---|
| 10 | Few Generics |
| 11 | Few Generics and Few Brands |
| 20 | Some Generics |
| 21 | Some Generics and Few Brands |
| 22 | Some Generics and Some Brands |
| 30 | All Preferred Generics |
| 32 | All Preferred Generics and Some Brands |
| 33 | All Preferred Generics and All Preferred Brands |
| 40 | All Generics |
| 41 | All Generics and Few Brands |
| 42 | All Generics and Some Brands |
| 43 | All Generics and All Preferred Brands |
| 44 | All Generics and All Brands |
| 50 | Many Generics |
| 51 | Many Generics and Few Brands |
| 52 | Many Generics and Some Brands |
| 55 | Many Generics and Many Brands |
| A | All Drugs on Your Formulary |
| N | No Gap Coverage |
| 9 | Not Applicable |
From 2009 - 2014, this value was expanded from 1 to 2-btyes. This variable was retired and did not appear in the 2015 Plan Base File; however the same information is available in the Plan Tier file (see GAP_TIER_DRUG_TYPE).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).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.