Contract Year (CY) 2020 Medicare Plan Finder (MPF) Benefit Summary

These files provide a summarized view of the CY 2020 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 2020 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 

The Excel file named CY2020_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 CY2020_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 

