Updated research request forms and data security approval requirement effective 4/24/23
SAS Name
GAP_TIER_PARTIAL
For Part D plans with some cost sharing in the coverage gap phase (i.e., those where the variable GAP_TIER = Y [yes]), this variable indicates whether or not the cost sharing applies to a partial list of drugs. If only a limited number of drugs on the tier are covered during the coverage gap phase then the value will be 'Y'. If all drugs on the tier are covered during the gap then the value will be 'N'.
| Code | Code value |
|---|---|
| Y | Yes |
| N | No |
| 9 | Not Applicable |
This variable applies only to enhanced plans with gap coverage.. 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)