CY2021 Medicare Plan Finder Summary Data

Overview

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. 
While these files may contain more benefits than what is currently displayed on the CY 2021 MPF, they do not represent the entire Plan Benefit Package (PBP) submitted by the plan organization to CMS.  The complete PBP data is available at: https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/MCRAdvPartDEnrolData/Benefits-Data.html

CY2021 Medicare Plan Finder Benefit Summary 20201027

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.


CY2021 MPF Optional Supplemental Benefit Summary 20201027

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