True Out-of-Pocket Costs (TrOOP)
True out-of-pocket (TrOOP) costs are the drug expenses that count toward a Part D member's movement through the benefit phases toward catastrophic coverage. TrOOP can include amounts paid by the member, family, certain charities, the Low Income Subsidy, and qualifying State Pharmaceutical Assistance Programs.
Definition
True out-of-pocket (TrOOP) costs are the drug expenses that count toward a Part D member's movement through the benefit phases toward catastrophic coverage. TrOOP can include amounts paid by the member, family, certain charities, the Low Income Subsidy, and qualifying State Pharmaceutical Assistance Programs.
Why it matters
What counts as TrOOP determines how quickly a patient reaches catastrophic coverage and lower cost-sharing, affecting affordability across the year.
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