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This variable is contained in the following files: Plan Characteristics File
SAS Name
POST_OOPT_COPAY_AMT

This variable identifies the beneficiary copay amount that drugs on the tier are subject to during the post out-of-pocket threshold (catastrophic) phase of the Part D benefit.

Comments

This variable was new in 2007. This field is only populated if the Medicare-defined Post Threshold Cost Shares do not apply. Plans that use a coinsurance percentage rather than a co-payment amount will not have a value in this field; see instead the corresponding co-payment variable called (POST_OOPT_COINS_AMT). The catastrophic coverage phase is also referred to as the post-out-of-pocket threshold phase for the Part D benefit.

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 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.