
Nearly all persons enrolled in Medicare Part D prescription drug plans (PDPs), except those with the most generous subsidies or those in high-end plans, are subject to co-pays and deductibles. CMS has provided for a central reporting mechanism for recording these out-of-pocket expenditures. The amount a beneficiary must spend on Part D drugs to reach the catastrophic coverage provision is being called "true out-of-pocket," or TrOOP, expenditure. In 2006, persons covered by a PDP are eligible for catastrophic coverage after they have paid $3,600 in TrOOP cost. The threshold can change annually as provided by the Medicare Modernization Act (MMA).