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.
- CY 2014 OOPC Plan Model Version 1 (04.05.2013) [ZIP, 3MB]
- CY 2013 OOPC Model Medicare Plan Finder Plan Version 1 (01.22.2013) [ZIP, 3MB]
- CY 2013 OOPC Model Version 2 (v.05.23.2012) [ZIP, 4MB]
- CY 2012 OOPC Model Version 4 (v.01.13.12) [ZIP, 3MB]
- CY 2012 OOPC Model Version 3 (v09.28.11) [ZIP, 3MB]
- CY 2012 OOPC Model User's Guide [PDF, 360KB]
- CY 2012 OOPC Model Methodology [PDF, 799KB]
- CY 2012 OOPC Model Frequently Asked Questions [PDF, 57KB]
- CY 2012 OOPC Model Presentation: March 23,2011 User Call [PDF, 116KB]
- CY 2011 OOPC Methodology (v11.08.10) [PDF, 801KB]
- Page last Modified: 04/05/2013 6:53 AM
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