This variable identifies the beneficiary co-payment amount for a one day supply of the drugs on this tier, using an in-network pharmacy (INP; also known as a standard retail pharmacy) during the coverage gap phase of the Part D benefit.
Comments
The coverage gap is technically referred to as the initial coverage limit (ICL) for the Part D benefit.
Starting in 2016, CMS changed how they describe pharmacy networks. The INP are currently referred to as standard retail pharmacies. There is no change in the meaning of the variable, and the data values are the same over time.
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.
The coverage gap is technically referred to as the initial coverage limit (ICL) for the Part D benefit.
Starting in 2016, CMS changed how they describe pharmacy networks. The INP are currently referred to as standard retail pharmacies. There is no change in the meaning of the variable, and the data values are the same over time.
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)