Out-of-Pocket (OOP) Threshold Amount

SAS Name
OOPT_AMT

This variable is the dollar amount of the Medicare-defined Part D annual Out-of-Pocket (OOP) Cost Threshold. This field is blank for Fixed Capitated Reinsurance Demonstration Projects.

Comments

The width of this value changed from 12 to 8 in 2009. The CCW constructs the Plan Characteristics File from information submitted by Part D plan sponsors to CMS's Health Plan Management System (HPMS).  Employer and National Program of All-inclusive Care for 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.