Pre-ICL In-Network Preferred Pharmacy Coinsurance for 1 month Supply
SAS Name
PRE_ICL_INPP_COPAY_1M
This variable identifies the beneficiary co-insurance percentage for a 1 month supply of the drugs on this tier, using an in-network preferred pharmacy (INPP) during the pre-initial coverage limit (ICL) phase of the Part D benefit.
Comments
This variable was new in 2007. Plans that use a co-payment amount rather than a coinsurance percentage will not have a value in this field; see instead the corresponding co-payment variable called (PRE_ICL_INPP_COPAY_1M). This variable also appears in the Plan Characteristics - Base File (see PRE_ICL_INPP_1M_COINS_TIER_01 - PRE_ICL_INPP_1M_COINS_TIER_08). The CCW constructs the Plan Characteristics File from information submitted by Part D plan sponsors to CMS’sHealth 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.
This variable was new in 2007. Plans that use a co-payment amount rather than a coinsurance percentage will not have a value in this field; see instead the corresponding co-payment variable called (PRE_ICL_INPP_COPAY_1M). This variable also appears in the Plan Characteristics - Base File (see PRE_ICL_INPP_1M_COINS_TIER_01 - PRE_ICL_INPP_1M_COINS_TIER_08). The CCW constructs the Plan Characteristics File from information submitted by Part D plan sponsors to CMS’sHealth 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.