Indicates Whether Excluded Drugs are Covered on this Tier in the Gap Phase

SAS Name
EXCLUDED_TIER_GAP

For Enhanced Alternative plans that cover excluded drugs as a supplemental benefit, this variable Indicates whether the Part D plan provides coverage on this tier during the coverage gap phase.

Comments

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 plan sponsors to CMS’s Health Plan Management System (HPMS).

Source: CMS (HPMS Files)

Code Code value
Y Yes
N No
X Unknown