The Cost Threshold is a Federally-defined amount of out-of-pocket expenses paid by, or on behalf of, the beneficiary. The amount up to the Cost Threshold is not eligible for subsidy. It is adjusted in the same manner as the annual Medicare Part D deductible and the annual Medicare Part D out of pocket threshold and is adjusted annually as defined in 42 C.F.R. §423.104(d)(1)(ii) and (d)(5)(iii)(B), respectively. The Cost Threshold is calculated based on Plan Year End Date. For more information on Cost Threshold amounts, refer to Cost Threshold and Cost Limit by Plan Year.
Answer ID
2000-06