Contract Year (CY) 2021 Medicare Plan Finder (MPF) Benefit Summary
These files provide a summarized view of the CY 2021 Part C benefits offered by Medicare Advantage, 1876 Cost, and demonstration organizations as displayed on MPF. These files exclude PACE and employer-only plans.
The Excel file named CY2021_MPF_benefit_summary contains the following columns:
Org_Name Organization marketing name for the contract
Contract_ID CMS-issued contract number
Plan_ID CMS-issued ID for the plan benefit package offered under this contract
Segment_ID CMS-issued ID for the segment under this contract/plan
Plan_Type_Desc Type of plan benefit package
Contract_Year Contract year
Category_Name Benefit category
Service_Name Name of the service
Limit_Flag Indicates whether the plan has placed a cap on the benefit (0, 1, blank)
Authorization_Flag Indicates whether the medical service must be pre-approved by the plan (0, 1, 2, blank)
Referral_Flag Indicates whether a referral is required by the plan for the medical service (0, 1, 2, blank)
Network_Description In-network, out-of-network, or blank (not applicable)
Cost_Share Copayment and/or coinsurance for the benefit
Valid Values
Limit Flag:
0 - There are no limits.
1 - Limits may apply.
Blank - Not applicable. This benefit category or plan type does not ask about limits.
Authorization:
0 - Authorization is not required.
1 - Authorization is required.
2 - Not applicable.
Blank - Not applicable. This benefit category does not ask about authorization.
Referral:
0 - Referral is not required.
1 - Referral is required.
2 - Not applicable.
Blank - Not applicable. This benefit category does not ask about referrals.
The Excel file named CY2021_MPF_optional_supplemental_benefit_summary contains the following columns:
Org_Name Organization marketing name for the contract
Contract_ID CMS-issued contract number
Plan_ID CMS-issued ID for the plan benefit package offered under this contract
Segment_ID CMS-issued ID for the segment under this contract/plan
Plan_Type_Desc Type of plan benefit package
Contract_Year Contract year
Package_Description CMS-issued identifier for the optional supplemental benefit package
Category_Description Benefit category
Type_of_Cost_Sharing Monthly premium or deductible
Cost_Share Amount for the monthly premium or deductible