OOPC Resources
Guidance for Medicare Advantage Organizations (MAOs) and Stand-alone Prescription Drug Plans (PDPs) providing required tools to calculate their OOPC values for each of their contract year (CY) plan offerings.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: April 16, 2020
This page contains information on providing plans with the necessary information to meet the needs of Medicare beneficiaries that are important to CMS. Each year CMS examines benefit offerings to ensure meaningful differences existing between plans using the Out-of-Pocket Cost (OOPC) values. The OOPC model calculates the total monthly out-of-pocket cost for the average Medicare beneficiary over a calendar year. For 2012, CMS is making the OOPC model available so that Medicare Advantage Organizations (MAOs) and Stand-alone Prescription Drug Plans (PDPs) have the required tools to calculate their OOPC values for each of their 2012 contract year (CY) plan offerings. All documentation and instructions associated with running the OOPC model are posted on this page.
This overview page provides links to important information on the OOPC model.
Please check back, as we will continue to update these resources regularly.
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DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.