Medicare — Unknown Plan Type Manage Care Months

SAS Name
MDCR_MC_UNKNOWN_MOS

This variable is the number of months during the year when the beneficiary had some sort of managed care coverage, but there is no information available regarding the type of plan (i.e., the plan type code is missing).

Comments

We consider the beneficiary to have an unknown type of managed care coverage if the beneficiary had Medicare enrollment for the month, the monthly beneficiary HMO (Medicare Advantage) indicator code was a value other than '0' (Not a member of an HMO) or '4' (Fee-for-service participant in case or disease management demonstration project) (i.e., BENE_HMO_IND_MM NOT IN ('0' '4'), and the plan type code was (source variable called PTC_PLAN_TPE_CD_MM) was missing.

Values: 0-12, or null/missing (if no Medicare enrollment)

Source: MBSF (derived)