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This variable is contained in the following files: Plan Characteristics File
SAS Name
COV_CRITERIA

This variable indicates whether the requirement that beneficiaries be entitled to Medicare Part A is waived.

The value will indicate whether beneficiaries with only Part B entitlement may enroll in the plan benefit package.

Comments

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)

CodeCode value
1
Part A/B (no waiver of Part A requirement)
2
Part B only
9
Not Applicable