Monthly cost sharing group under Part D low-income subsidy July
This variable indicates the beneficiary's Part D low-income subsidy cost sharing group for a given month (July). The Part D benefit requires enrollees to pay both premiums and cost-sharing, but the program also has a low-income subsidy (LIS) that covers some or all of those costs for certain low-income individuals, including deductibles and cost-sharing during the coverage gap.
CMS identifies beneficiaries with fully-subsidized Part D coverage by looking for individuals that have a 01, 02, or 03 for the month. Other beneficiaries who are eligible for the LIS but do not receive a full subsidy have a 04, 05, 06, 07, or 08. The remaining values indicate that the individual is not eligible for subsidized Part D coverage. There are 12 monthly variables - where the 01 through 12 at the end of the variable name correspond with the month (e.g., 01 is January and 12 is December).
This variable is coded, and will contain one of the following values.
| Value | Description |
|---|---|
00 |
Not Medicare enrolled for the month |
01 |
Beneficiary enrolled in Parts A and/or B, and Part D; deemed eligible for LIS with 100% premium subsidy and no copayment |
02 |
Beneficiary enrolled in Parts A and/or B, and Part D; deemed eligible for LIS with 100% premium subsidy and low copayment |
03 |
Beneficiary enrolled in Parts A and/or B, and Part D; deemed eligible for LIS with 100% premium subsidy and high copayment |
04 |
Beneficiary enrolled in Parts A and/or B, and Part D; enrolled in LIS with 100% premium subsidy and high copayment |
05 |
Beneficiary enrolled in Parts A and/or B, and Part D; enrolled in LIS with 100% premium subsidy and 15% copayment |
06 |
Beneficiary enrolled in Parts A and/or B, and Part D; enrolled in LIS with 75% premium subsidy and 15% copayment |
07 |
Beneficiary enrolled in Parts A and/or B, and Part D; enrolled in LIS with 50% premium subsidy and 15% copayment |
08 |
Beneficiary enrolled in Parts A and/or B, and Part D; enrolled in LIS with 25% premium subsidy and 15% copayment |
09 |
Beneficiary enrolled in Parts A and/or B, and Part D; no premium or cost sharing subsidy |
10 |
Beneficiary enrolled in Parts A and/or B, but not Part D enrolled |
13 |
Beneficiary enrolled in Parts A and/or B, but not Part D; employer receives RDS subsidy |
Null/missing |
Beneficiary was not found in cost sharing group data |
Some additional information on this variable: