CMS-P-0015A Showcards and Reference Cards

Showcards &
Reference Cards
Medicare Current Beneficiary Survey

Version Information
Component: Community
Language: English

Introduction
This guide contains a comprehensive, up-to-date list of MCBS Showcards and
Reference Cards. Over time, we may make changes to your Showcards and
Reference Cards by updating the content, adding new cards, or eliminating existing
cards.
You can use this guide to ensure that you are using the most up-to-date set of cards.
To check if you are using the most recent versions, look at the date of the “Current
Version” in the table on the following pages and compare it with the date on the
bottom of your Showcards and Reference cards. If you’re missing updated versions
of Showcards or Reference cards, notify your Field Manager, who will arrange to
have them sent to you.
The Showcards are arranged in alphabetical order according to questionnaire
section name. However, some Field Interviewers prefer to arrange the Showcard
sections by the order in which the sections will appear during the interview.

Introduction
This guide contains a comprehensive, up-to-date list of MCBS Showcards and
Reference Cards. Over time, we may make changes to your Showcards and
Reference Cards by updating the content, adding new cards, or eliminating existing
cards.
You can use this guide to ensure that you are using the most up-to-date set of cards.
To check if you are using the most recent versions, look at the date of the “Current
Version” in the table on the following pages and compare it with the date on the
bottom of your Showcards and Reference cards. If you’re missing updated versions
of Showcards or Reference cards, notify your Field Manager, who will arrange to
have them sent to you.
The Showcards are arranged in alphabetical order according to questionnaire
section name. However, some Field Interviewers prefer to arrange the Showcard
sections by the order in which the sections will appear during the interview.

Introduction
This guide contains a comprehensive, up-to-date list of MCBS Showcards and
Reference Cards. Over time, we may make changes to your Showcards and
Reference Cards by updating the content, adding new cards, or eliminating existing
cards.
You can use this guide to ensure that you are using the most up-to-date set of cards.
To check if you are using the most recent versions, look at the date of the “Current
Version” in the table on the following pages and compare it with the date on the
bottom of your Showcards and Reference cards. If you’re missing updated versions
of Showcards or Reference cards, notify your Field Manager, who will arrange to
have them sent to you.
The Showcards are arranged in alphabetical order according to questionnaire
section name. However, some Field Interviewers prefer to arrange the Showcard
sections by the order in which the sections will appear during the interview.

MCBS Showcards
Quex Sections
ACQ
AVQ
CLQ
CPS
CPQ

DIQ

DVH

END
ENS
ERQ
HAQ

HFQ

Showcards
AC1
AC2
(None)
(None)
(None)
CP1
CP2
CP3
DI1
DI2
DI3
DI4
DI5
DI6
DVH1
DVH2
DVH3
DVH4
(None)
ENS1
(None)
HA1
HA2
HA3
HF1
HF2
HF3
HF4
HF5
HF6

Current Version
January 10, 2018
January 10, 2018
(None)
(None)
(None)
May 2019
May 2019
May 2019
July 28, 2014
July 28, 2014
July 28, 2014
July 28, 2014
July 28, 2014
August 1, 2015
January 2019
January 2019
January 2019
January 2020
(None)
July 24, 2017
(None)
July 28, 2014
July 28, 2014
July 28, 2014
August 1, 2015
August 1, 2015
August 1, 2015
August 3, 2016
August 3, 2016
August 3, 2016

MCBS Showcards
Quex Sections

HHQ

HIQ

IAQ

Showcards
HF7
HF8
HF9
HF10
HF11
HF12
HF13
HH1
HH2
HH3
HH4
HH5
HI1
HI2
HI3
HI4
HI5
HI6
HIT1
HIT2
IA1
IA2
IA3
IA4
IA5
IA6
IA7
IA8
IA9
IA10

Current Version
August 3, 2016
August 3, 2016
August 3, 2016
August 3, 2016
July 2020
July 2020
July 2020
July 28, 2014
July 28, 2014
July 28, 2014
July 28, 2014
July 28, 2014
February 17, 2015 & July 24, 2017

November 5, 2018
November 5, 2018
November 5, 2018
November 5, 2018
November 5, 2018
July 28, 2014
July 28, 2014
August 1, 2015
August 1, 2015
August 1, 2015
August 1, 2015
August 1, 2015
August 1, 2015
August 1, 2015
August 1, 2015
August 1, 2015
August 1, 2015

MCBS Showcards
Quex Sections

INQ
IPQ
IUQ
IRQ

Showcards
IA11
IA12
IA13
IA14
IA15
IA16
IA17
IA18
IA19
IA20
IA21
IA22
IA23
IA24
IA25
IA26
IA27
IA28
IA29
IA30
IA31
IA32
IA33
IA34
IA35
IA36
(None)
(None)
IU1
(None)

Current Version
August 1, 2015
August 1, 2015
August 1, 2015
August 1, 2015
August 1, 2015
August 1, 2015
August 1, 2015
August 1, 2015
August 1, 2015
August 1, 2015
August 1, 2015
August 1, 2015
August 1, 2015
August 1, 2015
August 1, 2015
August 1, 2015
August 1, 2015
August 1, 2015
August 1, 2015
August 1, 2015
August 1, 2015
August 1, 2015
May 3, 2017
May 3, 2017
May 4, 2016
May 4, 2016
(None)
(None)
January 10, 2018
(None)

MCBS Showcards
Quex Sections
KNQ

MBQ
MPQ

NAQ
NSQ
OMQ

OPQ
PMQ
PVQ
PMS and PVQ
RXQ

Showcards

Current Version

KN1
KN2
KN3
KN4
KN5
KN6
KN7
KN8
KN9
KN10
(None)
MP1
MP2
MP3
MP4
MP5
MP6

July 28, 2014
July 28, 2014
January 13, 2016
January 11, 2017
January 11, 2017
January 11, 2017
January 11, 2017
January 10, 2018
January 11, 2017
January 2020

NA1
(None)
OM1
OM2
OM3
OM4
OM5
(None)
PM1
PV1
(None)
RX1
RX2

August 3, 2016
(None)
July 28, 2014
July 28, 2014
July 28, 2014
July 28, 2014
July 28, 2014
(None)
July 24, 2017
July, 2019
(None)
July 28, 2014
July 28, 2014

(None)
January 2019
July 28, 2014
July 28, 2014
July 28, 2014
July 28, 2014
July 24, 2017

MCBS Showcards
Quex Sections

SCQ

STQ
USQ

Showcards
RX3
RX4
RX5
SC1
SC2
SC3
SC4
(None)
US1
US2
US3
US4
US5
US6
US7
US8

Current Version
July 28, 2014
July 28, 2014
May 2, 2018
July 28, 2014
July, 2019
July, 2019
July, 2019
(None)
January 10, 2018
January 10, 2018
January 10, 2018
January 10, 2018
January 10, 2018
January 10, 2018
January 10, 2018
January 2020

AC1
• Allergy/immunology (allergies, asthma)
• Anesthesiology
• Cardiology (heart)
• Dermatology (skin)
• Endocrinology/metabolism (diabetes, thyroid)
• Family practice
• Gastroenterology
• General practice
• General surgery
• Geriatrics (elderly)
• Gynecology – obstetrics
• Hematology (blood)
• Hospital residence
• Internal medicine (internist)
• Nephrology (kidneys)
• Neurology

(continued)
Updated January 10, 2018

AC1
• Nuclear medicine
• Oncology (tumors, cancer)
• Ophthalmology (eyes)
• Orthopedics
• Osteopathy (DO)
• Otorhinolaryngology (ear, nose, throat)
• Pain Management Specialist
• Pathology
• Physical med/rehab
• Physician’s Assistant
• Plastic surgery
• Podiatrist
• Proctology
• Psychiatry/psychiatrist
• Pulmonary (lungs)

(continued)

Updated January 10, 2018

AC1
• Radiology
• Rheumatology (arthritis)
• Thoracic surgery (chest)
• Urology
• Vascular Surgeon/Specialist

Updated January 10, 2018

AC2
• Allergy/Immunology
• Cardiology (Heart)
• Dermatology (Skin)
• Endocrinology/Metabolism (Diabetes, Thyroid)
• Gastroenterology
• General Surgery
• Geriatrics (Elderly)
• Gynecology - Obstetrics
• Hematology (Blood)
• Internal Medicine (Internist)
• Nephrology (Kidneys)
• Neurology
• Oncology (Tumors, Cancer)
• Ophthalmology (Eyes)
• Orthopedics

(continued)
Updated January 10, 2018

AC2
• Osteopathy (DO)
• Otorhinolaryngology (Ear, Nose, Throat)
• Pathology
• Phys Med/Rehab
• Plastic Surgery
• Proctology
• Psychiatry/Psychiatrist
• Pulmonary (Lungs)
• Rheumatology (Arthritis)
• Urology
• Audiologist
• Chiropractor
• Dentist
• Optometrist
• Physical Therapist
• Psychologist

Updated January 10, 2018

CP1
● Never
● Some days
● Most days
● Every day

Updated May 2019

CP2
● A little
● A lot
● Somewhere in between a little
and a lot

Updated May 2019

CP3
● Not at all
● A little
● A lot
● Somewhere in between a little
and a lot

Updated May 2019

DI1
• Mexican, Mexican American, Chicano(a)
• Puerto Rican
• Cuban

Updated July 28, 2014

DI2
• American Indian or Alaska Native
• Asian
• Black or African American
• Native Hawaiian or other Pacific Islander
• White

Updated July 28, 2014

DI3
• Asian Indian
• Chinese
• Filipino
• Japanese
• Korean
• Vietnamese

Updated July 28, 2014

DI4
• Native Hawaiian
• Guamanian or Chamorro
• Samoan

Updated July 28, 2014

DI5
• No schooling completed
• Nursery school to 8th grade
• 9th-12th grade, no diploma
• High school graduate (high school
diploma or the equivalent)
• Vocational/technical/business/trade
school certificate or diploma (beyond the
high school level)
• Some college, but no degree
• Associate degree
• Bachelor's degree
• Master's, professional, or doctorate
degree
Updated July 28, 2014

DI6
Monthly Breakdown

Annual Income
A. Less than $5,000

A. Less than $417

B. $5,000 – less than $10,000

B. $417 – less than $834

C. $10,000 – less than $15,000

C. $834 – less than $1,250

D. $15,000 – less than $20,000

D. $1,250 – less than $1,667

E. $20,000 – less than $25,000

E. $1,667 – less than $2,084

F. $25,000 – less than $30,000

F. $2,084 – less than $2,500

G. $30,000 – less than $40,000

G. $2,500 – less than $3,334

H. $40,000 – less than $50,000

H. $3,334 – less than $4,167

I.

$50,000 – less than $66,000

I.

$4,167 – less than $5,500

J.

$66,000 – less than $109,000

J.

$5,500 – less than $9,084

K. $109,000 or more

K. $9,084 or more
Updated August 1, 2015

DVH1
● General exam, checkup or consultation
● Cleaning, prophylaxis, or polishing
● X-rays, radiographs, or bitewings
● Fluoride treatment
● Sealant (plastic coatings on back teeth)
● Fillings
● Inlays
● Crowns or caps
● Root canal
● Periodontal scaling, root planing, or gum
surgery
● Periodontal recall visit (periodic or
regular)
(Continued)
Updated August 1, 2015

DVH1
● Extraction, tooth pulled
● Implants
● Abscess or infection treatment
● Other oral surgery
● Fixed bridges
● Dentures or removable partial dentures
● Relining or repair of bridges or dentures
● Orthodontia, braces, or retainers
● Bond, whiten, or bleach
● Treatment for TMD or TMJ

Updated August 1, 2015

DVH2
● Eye Or Vision Exam
● Contact Lens Fitting
● Contact Lens Purchase
● Eye Glass Frame Fitting Or Adjustment
● Eye Glass Purchase
● Refractive Surgery (Corrective Vision
Surgery)
● Cataract Surgery
● Glaucoma Surgery
● Corneal Surgery
● Vitreo-Retinal Surgery
● Oculoplastic Surgery
● Eye Muscle Surgery
● Eye Removal
Updated January 2019

DVH3
● Hearing Aid Fitting/Evaluation
● Hearing Aid Purchase/Repair
● Hearing Exam
● Ear Wax Removal
● Ear Ventilation Tubes
● Tympanoplasty (Reconstruction of ear
drum)
● Cochlear Implant Surgery
● Hearing Rehabilitative Services

Updated January 2019

DVH4
In the Canal (ITC)

In the Ear (ITE)

Behind the Ear
(BTE)

Updated January 2020. Image Source: CR Hearing Aid Buying Guide

ENS1
• Iraq or Afghanistan Conflict (2001 –
Present)
• Persian Gulf War (Aug 1990 – March
1991)
• Vietnam Era (Aug 1964 – May 1975)
• Korean Conflict (June 1950 – Jan 1955)
• World War II (Sept 1940 – July 1947)
• Peace time (all other times)

Updated July 24, 2017

HA1
• One-family, detached
• Two-family or duplex
• Apartment or condominium building
• Mobile home, trailer
• Rowhouse, townhouse
• “mother-in-law” apartment

Updated July 28, 2014

HA2
• Retirement community
• Senior citizens housing
• Assisted living facility
• Continuing care community
• Staged living community
• Retirement apartments
• Church-provided housing
• Personal or residential care home

Updated July 28, 2014

HA3
• Prepared meals
• Housekeeping, maid, or cleaning services
• Laundry services
• Help with medications
• Transportation
• Recreational services

Updated July 28, 2014

HF1
• Much better now than one year ago
• Somewhat better now than one year ago
• About the same
• Somewhat worse now than one year ago
• Much worse now than one year ago

Updated August 1, 2015

HF2
• It will get much better
• It will get somewhat better
• It will not change
• It will get somewhat worse
• It will get much worse

Updated August 1, 2015

HF3
• No difficulty at all
• A little difficulty
• Some difficulty
• A lot of difficulty
• Not able to do it

Updated August 1, 2015

HF4
• Bladder
• Blood
• Bone
• Brain
• Breast
• Cervix
• Colon (bowel)
• Esophagus
• Gall Bladder
• Kidney
• Larynx (windpipe)
• Leukocytes (Leukemia)
• Liver
(continued)
Updated August 3, 2016

HF4
• Lung
• Lymph Nodes (Lymphoma)
• Mouth/Tongue/Lip
• Ovary
• Pancreas
• Prostate
• Rectum
• Soft Tissue/Fat
• Stomach
• Testis
• Throat
• Thyroid
• Uterus

Updated August 3, 2016

HF5
• Type 1
• Type 2
• Borderline
• Pre-Diabetes
• Gestational (Pregnancy-related)

Updated August 3, 2016

HF6
• All of the time
• Most of the time
• Some of the time
• A little of the time
• None of the time

Updated August 3, 2016

HF7
• Just about everything you need to know
• Most of what you need to know
• Some of what you need to know
• A little of what you need to know
• Almost none of what you need to know
about managing Diabetes

Updated August 3, 2016

HF8
HF9
HF8
• Not at all
• Several days
• More than half the days
• Nearly every day

Updated August 3, 2016

HF9
HF10
HF9
HF8
• Not at all difficult
• Somewhat difficult
• Very difficult
• Extremely difficult

Updated August 3, 2016

HF10
• More than once a week
• About once a week
• 2-3 times a month
• About once a month
• Every 2-3 months
• Once or twice a year
• Not at all

Updated August 3, 2016

HF11

Updated 2019

HF12

Updated 2019

HF13

Updated 2019

HH1
Home Help by Health or Medical
Professionals
• Nurse (visiting nurse, private duty nurse,
etc.)
• Doctor
• Social worker
• Therapist
• Hospice worker

Updated July 28, 2014

HH2
Medical or Nursing Treatment
• Applying sterile bandages or dressings
• Giving medications
• Taking blood pressure
• Giving shots or injections

Updated July 28, 2014

HH3
Help With Daily Needs
• Using the telephone
• Doing housework
• Preparing meals

Updated July 28, 2014

HH4
• Bathing
• Showering
• Dressing
• Eating
• Walking
• Using the toilet

Updated July 28, 2014

HH5
Personal Care or Help with Daily Needs
from Persons Who Do Not Live with You
• Home health aides
• Homemakers
• Friends
• Neighbors
• Relatives

Updated July 28, 2014

HI1
Health Insurance Coverage Options
 “Original” Medicare
 “Medicare Advantage” (MA) plan
o with Prescription Drug Plan (MA-PD) or
without
 Medicaid
 TRICARE/TRICARE for Life
 Public Programs (other than Medicaid)
 Medicare Part D Prescription Drug Plan (PDP)
 Private/Supplemental Insurance Plan
o Purchased directly from an insurance
company, or
o Obtained through an employer, union, or
other group, such as AARP

Updated February 17, 2015

HI1
ORIGINAL MEDICARE

MEDICARE ADVANTAGE

 You have your choice of doctors and hospitals.
 Generally, you or your supplemental coverage pay
deductibles and coinsurance.
 If you want drug coverage, you must join a standalone Medicare prescription drug plan –a
separate policy just for drugs.
 You can buy a Medigap plan, which can help pay
expenses not covered by Medicare.

 May either require you to see medical providers in
their network or let you choose and pay more of
the costs.
 You usually pay a copay or coinsurance for
covered services.
 If you want drug coverage, you must join a plan that
includes drug coverage. This will give you all of
your coverage in one plan.
 A Medigap plan is not available.

MEDICAID

TRICARE/TRICARE FOR LIFE

 Public health care plan that helps make Medicare
affordable for beneficiaries with low incomes and
modest assets.
 Medicare beneficiaries who are also enrolled in
Medicaid are referred to as “dual eligibles.”
 Will be automatically enrolled in a Medicare
prescription drug plan and be eligible for a lowincome subsidy or “extra help.”

 Covers active-duty service members, retirees, and
their families.
 TRICARE generally pays the fees left outstanding
after Medicare has made their payment.

Updated July 24, 2017

(continued)

HI1
PRIVATE HEALTH INSURANCE

MEDICARE PART D PRESCRIPTION DRUG PLAN

 Includes supplemental or Medigap plans, plans that
are provided by a former or current employer, and
 Separate policies that cover only prescribed
other plans purchased directly through a private
medicines.
company, union, association, or other group.
 Beneficiaries pay a monthly premium and copay or
 Cover the cost of hospital or doctor visits, prescribed
coinsurance for their required prescriptions.
medicines, or dental care.
 Standalone plans are only available to beneficiaries
 Common type: Medicare Supplement Insurance
who are covered by Original Medicare; otherwise
(Medigap), which is available to recipients of
drug coverage is available as part of Medicare
Original Medicare and helps pay some of the health
Advantage plans.
care costs that Original Medicare doesn't cover, like
copayments, coinsurance and deductibles.
PUBLIC PROGRAMS (OTHER THAN MEDICAID)
 Include state, county, or city-based programs such as a pharmacy program, where the local government
provides at least partial coverage for the cost of prescribed medicines.
 Insurance comes from a public source other than Medicare or Medicaid.

Updated July 24, 2017

Created on 11/05/2018

1

HI2
MEDICARE ADVANTAGE PLANS
Alabama (AL)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
1

Aetna Medicare (Aetna Medicare)

2

Aetna Medicare Value Plan (Aetna Medicare)

3

Blue Advantage (Blue Advantage (PPO))

4

Bright Advantage (Bright Health)

5

Humana Gold Choice (Humana)

6

Humana Gold Plus (Humana)

7

Humana Value Plus (Humana)

8

HumanaChoice (Humana)

9

AARP MedicareComplete Plan
(UnitedHealthcare)

10

VIVA Medicare (VIVA Medicare)
(continued)

Created on 11/05/2018

2

HI2
MEDICARE ADVANTAGE PLANS
Alabama (AL)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
11

WellCare Value (WellCare)

Created on 11/05/2018

1

HI3
MEDICAID PROGRAM NAMES
Alabama (AL)
1

Medicaid

Created on 11/05/2018

1

HI4
MEDICAID HMOs
Alabama (AL)
1

Mercy Life of Alabama

2

Maternity Program

3

Health Homes

4

Patient 1st

Created on 11/05/2018

1

HI5
HEALTHCARE MARKETPLACE PLANS
Alabama (AL)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
1 Blue Cross Select [Tier] (Blue Cross and Blue Shield
of Alabama)
2 Blue Protect (Blue Cross and Blue Shield of Alabama)
3 Blue Saver [Tier] (Blue Cross and Blue Shield of
Alabama)
4 Blue Value [Tier] (Blue Cross and Blue Shield of
Alabama)
5 Blue [Tier] (Blue Cross and Blue Shield of Alabama)
6 [Tier] (Bright Health Insurance Company)
7 [Tier] Perks (Bright Health Insurance Company)

Created on 11/05/2018

1

HI6
PUBLIC ASSISTANCE PLANS
Alabama (AL)
1 Alabama AIDS Drug Assistance Program
2 Alabama Senior Rx (Partner for Medication Access)

Created on 11/05/2018

1

HI2
MEDICARE ADVANTAGE PLANS
Arkansas (AR)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
1

AR Blue Cross - Medi-Pak Advantage
(ARKANSAS BLUE CROSS AND BLUE SHIELD)

2

Allwell Medicare (Allwell)

3

Advantra Freedom (Coventry Health Care)

4

Advantra Total Care (Coventry Health Care)

5

Medi-Pak Advantage (Health Advantage)

6

Humana (Humana)

7

Humana Gold Choice (Humana)

8

Humana Value Plus (Humana)

9

HumanaChoice (Humana)

10

Lasso Healthcare (Lasso Healthcare)
(continued)

Created on 11/05/2018

2

HI2
MEDICARE ADVANTAGE PLANS
Arkansas (AR)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
11 AARP MedicareComplete Plan (UnitedHealthcare)
12 UnitedHealthcare MedicareComplete Choice
(UnitedHealthcare)
13 WellCare (WellCare)
14 WellCare Premier (WellCare)

Created on 11/05/2018

1

HI3
MEDICAID PROGRAM NAMES
Arkansas (AR)
1

Arkansas Medicaid

Created on 11/05/2018

1

HI4
MEDICAID HMOs
Arkansas (AR)
1

Multiple Primary Care Providers

2

Net Transportation

3

PACE

Created on 11/05/2018

1

HI5
HEALTHCARE MARKETPLACE PLANS
Arkansas (AR)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
1

Ambetter Balanced Care (Celtic Insurance
Company)

2

Ambetter Essential Care (Celtic Insurance
Company)

3

Ambetter Secure Care Free PCP Visits (Celtic
Insurance Company)

4

[Tier] (QCA Health Plan, Inc.)

5

[Tier] (QualChoice Life & Health Insurance
Company, Inc.)

6

[Tier] (USAble Mutual Insurance Company)

7

[Tier] AW (USAble Mutual Insurance Company)

8

[Tier] AWM (USAble Mutual Insurance Company)
(continued)

Created on 11/05/2018

2

HI5
HEALTHCARE MARKETPLACE PLANS
Arkansas (AR)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
9

[Tier] Classic (QCA Health Plan, Inc.)

10 [Tier] Classic Saver (QCA Health Plan, Inc.)
11 [Tier] M (USAble Mutual Insurance Company)
12 [Tier] Saver (QualChoice Life & Health Insurance
Company, Inc.)

Created on 11/05/2018

1

HI6
PUBLIC ASSISTANCE PLANS
Arkansas (AR)
1 AIDS Drug Assistance Program
2 Arkansas Health Care Access Foundation

Created on 11/05/2018

1

HI2
MEDICARE ADVANTAGE PLANS
Arizona (AZ)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
1

Aetna Medicare (Aetna Medicare)

2

Allwell Medicare (Allwell)

3

Allwell Medicare Premier (Allwell)

4

Amerivantage CareMore (Amerigroup)

5

Blue Medicare Advantage (Blue Cross Blue
Shield of Arizona Advantage)

6

Bright Advantage (Bright Health)

7

Cigna-HealthSpring (Cigna)

8

Clover Health Choice (Clover Health)

9

Humana Gold Choice (Humana)

10

Humana Gold Plus (Humana)
(continued)

Created on 11/05/2018

2

HI2
MEDICARE ADVANTAGE PLANS
Arizona (AZ)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
11 Humana Value Plus (Humana)
12 HumanaChoice (Humana)
13 Lasso Healthcare (Lasso Healthcare)
14 AARP MedicareComplete (UnitedHealthcare)
15 UnitedHealthcare MedicareComplete Assure
(UnitedHealthcare)
16 UnitedHealthcare MedicareDirect (UnitedHealthcare)
17 WellCare Value (WellCare)

Created on 11/05/2018

1

HI3
MEDICAID PROGRAM NAMES
Arizona (AZ)
1 Arizona Health Care Cost Containment System
(AHCCCS)

Created on 11/05/2018

1

HI4
MEDICAID HMOs
Arizona (AZ)
1

Division of Developmental Disabilities MLTSS

2

Comprehensive Medical and Dental Program

3

Bridgeway Health Solution MLTSS

4

Mercy Maricopa Integrated Care

5

Health Choice Integrated Care

6

United Healthcare Plan MLTSS

7

Cenpatico Integrated Care

8

United Healthcare Plan

9

University Family Care

10

Health Choice Arizona

11

Mercy Care Plan MLTSS

12

Care 1st Health Plan
(continued)

Created on 11/05/2018

2

HI4
MEDICAID HMOs
Arizona (AZ)
13

Maricopa Health Plan

14

Phoenix Health Plan

15

Health Net Access

16

Mercy Care Plan

Created on 11/05/2018

1

HI5
HEALTHCARE MARKETPLACE PLANS
Arizona (AZ)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
1

Ambetter Balanced Care (Health Net of Arizona,
Inc.)

2

Ambetter Essential Care (Health Net of Arizona,
Inc.)

3

Ambetter Secure Care (Health Net of Arizona,
Inc.)

4

Cigna Connect (Cigna HealthCare of Arizona,
Inc)

5

EverydayHealth Neighborhood Network (Blue
Cross and Blue Shield of Arizona, Inc.)

6

EverydayHealth PimaFocus Network (Blue Cross
and Blue Shield of Arizona, Inc.)

7

Oscar Classic [Tier] (Oscar Health Plan, Inc.)
(continued)

Created on 11/05/2018

2

HI5
HEALTHCARE MARKETPLACE PLANS
Arizona (AZ)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
8

Oscar Saver [Tier] (Oscar Health Plan, Inc.)

9

Oscar Simple Secure (Oscar Health Plan, Inc.)

10

Oscar Simple [Tier] (Oscar Health Plan, Inc.)

11

Portfolio Neighborhood Network (Blue Cross and
Blue Shield of Arizona, Inc.)

12

Portfolio PimaFocus Network (Blue Cross and
Blue Shield of Arizona, Inc.)

13

SimpleHealth Neighborhood Network (Blue Cross
and Blue Shield of Arizona, Inc.)

14

SimpleHealth PimaFocus Network (Blue Cross
and Blue Shield of Arizona, Inc.)
(continued)

Created on 11/05/2018

3

HI5
HEALTHCARE MARKETPLACE PLANS
Arizona (AZ)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
15 TrueHealth Neighborhood Network (Blue Cross and
Blue Shield of Arizona, Inc.)
16 TrueHealth PimaFocus Network (Blue Cross and
Blue Shield of Arizona, Inc.)
17 [Tier] (Bright Health Insurance Company)
18 [Tier] Perks (Bright Health Insurance Company)

Created on 11/05/2018

1

HI6
PUBLIC ASSISTANCE PLANS
Arizona (AZ)
1 Arizona AIDS Drug Assistance Program (ADAP)
2 Arizona CoppeRX

Created on 11/05/2018

1

HI2
MEDICARE ADVANTAGE PLANS
Colorado (CO)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
1

Aetna Medicare (Aetna Medicare)

2

Aetna Medicare Prime Plan (Aetna Medicare)

3

Anthem MediBlue Plus (Anthem Blue Cross and
Blue Shield)

4

Bright Advantage (Bright Health)

5

Clear Spring Health Essential (Clear Spring
Health)

6

Denver Health Medicare Select (Denver Health
Medical Plan, Inc.)

7

Friday Health Plans (Friday Health Plans of
Colorado)

8

Humana Gold Choice (Humana)
(continued)

Created on 11/05/2018

2

HI2
MEDICARE ADVANTAGE PLANS
Colorado (CO)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
9

Humana Gold Plus (Humana)

10 Humana Value Plus (Humana)
11 HumanaChoice (Humana)
12 Kaiser Permanente Senior Advantage (Kaiser
Permanente)
13 Rocky Mountain (Rocky Mountain Health Plans)
14 AARP MedicareComplete SecureHorizons
(UnitedHealthcare)
15 Erickson Advantage (UnitedHealthcare)

Created on 11/05/2018

1

HI3
MEDICAID PROGRAM NAMES
Colorado (CO)
1

Health First Colorado

Created on 11/05/2018

1

HI4
MEDICAID HMOs
Colorado (CO)
1

Accountable Care Collaborative: Rocky Mountain
Heatlh Plans Prime (ACC: RMHP Prime)

2

Total Longterm Care - Pueblo DBA Innovage
Greater Colorado PACE

3

Volunteers of America (VOANS) PACE DBA
Senior CommUnity Care

4

Total Longterm Care- InnovAge Greater
Colorado PACE

5

RCCO 4: Integrated Community Health
Partnership

6

RCCO 6: Colorado Community Health Alliance

7

Rocky Mountain Health Care Services (PACE)

8

Total Longterm Care - InnovAge Loveland

9

RCCO 7: Community Health Partnerships
(continued)

Created on 11/05/2018

2

HI4
MEDICAID HMOs
Colorado (CO)
10

Foothills Behavioral Health Partners

11

RCCO 1: Rocky Mountain Health Plans

12

Access Behavioral Care - Northeast

13

Colorado Access Kaiser Permanente

14

Access Behavioral Care - Denver

15

Denver Health Medicaid Choice

16

Colorado Health Partnerships

17

Behavioral Healthcare Inc.

18

RCCO 2: Colorado Access

19

RCCO 3: Colorado Access

20

RCCO 5: Colorado Access

Created on 11/05/2018

1

HI5
HEALTHCARE MARKETPLACE PLANS
Colorado (CO)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
1 Only state-operated exchanges serve Colorado

Created on 11/05/2018

1

HI6
PUBLIC ASSISTANCE PLANS
Colorado (CO)
1 Bridging the Gap Colorado
2 Colorado AIDS Drug Assistance Program

Created on 11/05/2018

1

HI2
MEDICARE ADVANTAGE PLANS
California (CA)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
1

Aetna Medicare (Aetna Medicare)

2

Aetna Medicare Choice Plan (Aetna Medicare)

3

Alignment Health Plan (Alignment Health Plan)

4

Anthem MediBlue Access (Anthem Blue Cross
Life and Health Insurance Co.)

5

Aspire Health (Aspire Health Plan)

6

Blue Shield (Blue Shield of California)

7

Blue Shield Promise (Blue Shield of California
Promise Health Plan)

8

Brand New Day Classic (Brand New Day)
(continued)

Created on 11/05/2018

2

HI2
MEDICARE ADVANTAGE PLANS
California (CA)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
9

Central Health (Central Health Medicare Plan)

10

CCHP Senior Program (Chinese Community
Health Plan)

11

Easy Choice (Easy Choice Health Plan)

12

Golden State (Golden State)

13

Health Net Seniority Plus Sapphire Premier
(HEALTH NET COMMUNITY SOLUTIONS, INC.)

14

Health Net (Health Net of California)

15

Humana (Humana)

16

Humana Community (Humana)

17

Ibt Voluntary Employee Benefits Trust (Employer
Pdp) (Ibt Voluntary Employee Benefits Trust)
(continued)

Created on 11/05/2018

3

HI2
MEDICARE ADVANTAGE PLANS
California (CA)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
18

Imperial Traditional (Imperial Health Plan of
California, Inc.)

19

Inter Valley Health Plan (Inter Valley Health Plan)

20

Kaiser Permanente (Kaiser Permanente)

21

SCAN (SCAN Health Plan)

22

Scripps (SCAN Health Plan)

23

Sharp Direct Advantage (Sharp Health Plan)

24

Stanford Health Care Advantage (Stanford Health
Care Advantage)

25

AARP MedicareComplete SecureHorizons
(UnitedHealthcare)
(continued)

Created on 11/05/2018

4

HI2
MEDICARE ADVANTAGE PLANS
California (CA)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
26 Sharp SecureHorizons Plan by UnitedHealthcare
(UnitedHealthcare)
27 UnitedHealthcare MedicareComplete Assure
(UnitedHealthcare)
28 Vitality (Vitality Health Plan of California)

Created on 11/05/2018

1

HI3
MEDICAID PROGRAM NAMES
California (CA)
1

Medi-Cal

Created on 11/05/2018

1

HI4
MEDICAID HMOs
California (CA)
1

Central California Alliance for Health/Santa Cruz

2

Anthem Blue Cross Partnership Plan/San
Francisco

3

Anthem Blue Cross Partnership Plan/Contra
Costa

4

Central California Alliance for Health/Monterey

5

SCAN Health Plan (Nurs hm cert)/San
Bernardino

6

Anthem Blue Cross Partnership Plan/Santa Clara

7

Anthem Blue Cross Partnership Plan/San Benito

8

Central California Alliance for Health/Merced
(continued)

Created on 11/05/2018

2

HI4
MEDICAID HMOs
California (CA)
9

Anthem Blue Cross Partnership Plan/Sacramento

10

Anthem Blue Cross Partnership Plan/Calaveras

11

Anthem Blue Cross Partnership Plan/El Dorado

12

Alta Med Health Senior Buenacare/Los Angeles

13

Brandman Centers for Senior Care/Los Angeles

14

Anthem Blue Cross Partnership Plan/Mariposa

15

Anthem Blue Cross Partnership Plan/Tuolumne

16

SCAN Health Plan (Nurs hm cert)/Los Angeles
(continued)

Created on 11/05/2018

3

HI4
MEDICAID HMOs
California (CA)
17

Center for Elders Independence/Contra Costa

18

Anthem Blue Cross Partnership Plan/Alameda

19

Anthem Blue Cross Partnership Plan/Alpine

20

Anthem Blue Cross Partnership Plan/Amador

21

Anthem Blue Cross Partnership Plan/Colusa

22

Anthem Blue Cross Partnership Plan/Nevada

23

Anthem Blue Cross Partnership Plan/Placer

24

Anthem Blue Cross Partnership Plan/Plumas
(continued)

Created on 11/05/2018

4

HI4
MEDICAID HMOs
California (CA)
25

Anthem Blue Cross Partnership Plan/Sierra

26

Anthem Blue Cross Partnership Plan/Sutter

27

Anthem Blue Cross Partnership Plan/Tehama

28

SCAN Health Plan (Nurs hm cert)/Riverside

29

Anthem Blue Cross Partnership Plan/Fresno

30

Anthem Blue Cross Partnership Plan/Madera

31

Anthem Blue Cross Partnership Plan/Tulare

32

Anthem Blue Cross Partnership Plan/Butte

33

Anthem Blue Cross Partnership Plan/Glenn
(continued)

Created on 11/05/2018

5

HI4
MEDICAID HMOs
California (CA)
34

Anthem Blue Cross Partnership Plan/Kings

35

Inland Empire Health Plan/San Bernardino

36

Anthem Blue Cross Partnership Plan/Inyo

37

Anthem Blue Cross Partnership Plan/Mono

38

Anthem Blue Cross Partnership Plan/Yuba

39

California Health & Wellness/Calaveras

40

California Health & Wellness/El Dorado

41

Health Plan of San Joaquin/San Joaquin

42

Partnership HealthPlan of CA/Mendocino

43

Partnership HealthPlan of CA/Del Norte

44

Central Valley Medical Services/Fresno

45

Center for Elders Independence/Alameda

46

California Health & Wellness/Imperial
(continued)

Created on 11/05/2018

6

HI4
MEDICAID HMOs
California (CA)
47

California Health & Wellness/Mariposa

48

California Health & Wellness/Tuolumne

49

Health Plan of San Joaquin/Stanislaus

50

Partnership HealthPlan of CA/Humboldt

51

Partnership HealthPlan of CA/Siskiyou

52

Partnership HealthPlan of CA/Trinity

53

California Health & Wellness/Alpine

54

California Health & Wellness/Amador

55

California Health & Wellness/Colusa

56

California Health & Wellness/Nevada

57

California Health & Wellness/Placer

58

California Health & Wellness/Sierra

59

California Health & Wellness/Sutter
(continued)

Created on 11/05/2018

7

HI4
MEDICAID HMOs
California (CA)
60

California Health & Wellness/Tehama

61

Inland Empire Health Plan/Riverside

62

Partnership HealthPlan of CA/Solano

63

Partnership HealthPlan of CA/Sonoma

64

Partnership HealthPlan of CA/Lassen

65

Partnership HealthPlan of CA/Shasta

66

Family Mosaic Project/San Francisco

67

California Health & Wellness/Butte

68

California Health & Wellness/Glenn

69

Partnership HealthPlan of CA/Marin

70

Partnership HealthPlan of CA/Modoc

71

Health Plan of San Mateo CCS Demo

72

California Health & Wellness/Inyo
(continued)

Created on 11/05/2018

8

HI4
MEDICAID HMOs
California (CA)
73

California Health & Wellness/Mono

74

California Health & Wellness/Yuba

75

Partnership HealthPlan of CA/Napa

76

Partnership HealthPlan of CA/Yolo

77

Partnership HealthPlan of CA/Lake

78

Sutter SeniorCare PACE/Sacramento

79

Molina Healthcare/San Bernardino

80

Community Health Group/San Diego

81

SCAN Health Plan/San Bernardino

82

Liberty Dental Plan/Los Angeles

83

Multiple Primary Care Providers

84

Santa Clara Family Health Plan

85

Access Dental Plan/Los Angeles
(continued)

Created on 11/05/2018

9

HI4
MEDICAID HMOs
California (CA)
86

Liberty Dental Plan/Sacramento

87

Care 1st Healthplan/San Diego

88

Health Net Dental/Los Angeles

89

Access Dental Plan/Sacramento

90

SCAN Health Plan/Los Angeles

91

Molina Healthcare/Sacramento

92

Health Net Dental/Sacramento

93

Innovage PACE/San Bernardino

94

ONLOK Lifeways/San Francisco

95

Molina Healthcare/Riverside

96

Alameda Alliance for Health

97

Molina Healthcare/San Diego

98

Redwood Coast PACE/Humboldt
(continued)

Created on 11/05/2018

10

HI4
MEDICAID HMOs
California (CA)
99

Molina Healthcare/Imperial

100

SCAN Health Plan/Riverside

101

ONLOK Lifeways/Santa Clara

102

San Francisco Health Plan

103

St. Paul's PACE/San Diego

104

Contra Costa Health Plan

105

Health Plan of San Mateo

106

Innovage PACE/Riverside

107

Health Net/Los Angeles

108

Health Net/San Joaquin

109

CenCal/San Luis Obispo

110

Gold Coast Health Plan

111

ONLOK Lifeways/Alameda
(continued)

Created on 11/05/2018

11

HI4
MEDICAID HMOs
California (CA)
112

CalViva Health/Madera

113

Health Net/Stanislaus

114

CalViva Health/Fresno

115

Health Net/Sacramento

116

CalOPTIMA PACE/Orange

117

CalViva Health/Kings

118

CenCal/Santa Barbara

119

Health Net/San Diego

120

Kern Health Systems

121

Health Net/Tulare

122

Kaiser/Sacramento

123

Kaiser/El Dorado

124

Kaiser/San Diego
(continued)

Created on 11/05/2018

12

HI4
MEDICAID HMOs
California (CA)
125

Health Net/Kern

126

San Diego PACE

127

Kaiser/Amador

128

Kaiser/Placer

129

CalOPTIMA

130

LA Care

Created on 11/05/2018

1

HI5
HEALTHCARE MARKETPLACE PLANS
California (CA)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
1 Only state-operated exchanges serve California

Created on 11/05/2018

1

HI6
PUBLIC ASSISTANCE PLANS
California (CA)
1

AIDS Drug Assistance Program

2

Operation Access (OA)

Created on 11/05/2018

1

HI2
MEDICARE ADVANTAGE PLANS
Connecticut (CT)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
1 Aetna Medicare (Aetna Medicare)
2 Anthem MediBlue (Anthem Blue Cross and Blue
Shield)
3 CareAdvantage (CarePartners of Connecticut)
4 ConnectiCare (ConnectiCare)
5 AARP MedicareComplete Choice (UnitedHealthcare)
6 UnitedHealthcare MedicareComplete
(UnitedHealthcare)
7 WellCare (WellCare)

Created on 11/05/2018

1

HI3
MEDICAID PROGRAM NAMES
Connecticut (CT)
1

Connecticut Medicaid

Created on 11/05/2018

1

HI5
HEALTHCARE MARKETPLACE PLANS
Connecticut (CT)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
1 Only state-operated exchanges serve Connecticut

Created on 11/05/2018

1

HI6
PUBLIC ASSISTANCE PLANS
Connecticut (CT)
1 AmeriCares Free Clinics
2 CT AIDS Drug Assistance Program (CADAP)
3 State-Administered General Assistance (SAGA)
Medical Program

Created on 11/05/2018

1

HI2
MEDICARE ADVANTAGE PLANS
District of Columbia (DC)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
1 Aetna Medicare Premier Plan (Aetna Medicare)
2 Aetna Medicare Standard Plan (Aetna Medicare)
3 Cigna-HealthSpring (Cigna-HealthSpring)
4 Kaiser Permanente Medicare Advantage (Kaiser
Permanente)

Created on 11/05/2018

1

HI3
MEDICAID PROGRAM NAMES
District of Columbia (DC)
1

DC Medicaid

Created on 11/05/2018

1

HI4
MEDICAID HMOs
District of Columbia (DC)
1 Health Services for Children with Special Needs
2 Medical Transportation Management Inc.
3 AmeriHealth District of Columbia
4 Medstar Family Choice
5 Trusted Health Plan

Created on 11/05/2018

1

HI5
HEALTHCARE MARKETPLACE PLANS
District of Columbia (DC)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
1 Only state-operated exchanges serve Washington,
D.C

Created on 11/05/2018

1

HI6
PUBLIC ASSISTANCE PLANS
District of Columbia (DC)
1

DC AIDS Drug Assistance Program

Created on 11/05/2018

1

HI2
MEDICARE ADVANTAGE PLANS
Delaware (DE)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
1 Aetna Medicare (Aetna Medicare)
2 Cigna-HealthSpring (Cigna-HealthSpring)
3 Humana Gold Plus (Humana)
4 HumanaChoice (Humana)
5 Lasso Healthcare (Lasso Healthcare)

Created on 11/05/2018

1

HI3
MEDICAID PROGRAM NAMES
Delaware (DE)
1

Medicaid

Created on 11/05/2018

1

HI4
MEDICAID HMOs
Delaware (DE)
1

UnitedHealthcare Community Plan

2

Highmark Health Options

3

Saint Francis Life

Created on 11/05/2018

1

HI5
HEALTHCARE MARKETPLACE PLANS
Delaware (DE)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
1 Health Savings Embedded Blue [Tier] (Highmark
BCBSD Inc.)
2 Major Events Blue (Highmark BCBSD Inc.)
3 Shared Cost Blue [Tier] (Highmark BCBSD Inc.)
4 Shared Cost Blue [Tier] Free PCP Visits (Highmark
BCBSD Inc.)

Created on 11/05/2018

1

HI6
PUBLIC ASSISTANCE PLANS
Delaware (DE)
1

AIDS Drug Assistance Program

2

Chronic Renal Disease Program

Created on 11/05/2018

1

HI2
MEDICARE ADVANTAGE PLANS
Florida (FL)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
1

Aetna Medicare (Aetna Medicare)

2

Aetna Medicare Premier Plan (Aetna Medicare)

3

Coventry Medicare (Aetna Medicare)

4

AvMed Medicare (AvMed Medicare)

5

Capital Health Plan (Capital Health Plan)

6

CareExtra (CarePlus Health Plans, Inc.)

7

CareFree (CarePlus Health Plans, Inc.)

8

CareOne (CarePlus Health Plans, Inc.)

9

BlueMedicare Choice (Florida Blue)

10

BlueMedicare (Florida Blue HMO)
(continued)

Created on 11/05/2018

2

HI2
MEDICARE ADVANTAGE PLANS
Florida (FL)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
11

FHCP Medicare (Florida Blue HMO)

12

Freedom (Freedom Health, Inc.)

13

Florida Hospital SunSaver Plan (Health First
Health Plans, Inc.)

14

Health First (Health First Health Plans, Inc.)

15

Cigna-HealthSpring (HealthSpring of Florida,
Inc.)

16

Leon Medical Centers Health Plans - Leon Cares
(HealthSpring of Florida, Inc.)

17

HealthSun (HealthSun Health Plans, Inc.)

18

Humana (Humana)

19

HumanaChoice (Humana)
(continued)

Created on 11/05/2018

3

HI2
MEDICARE ADVANTAGE PLANS
Florida (FL)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
20

Optimum (Optimum HealthCare, Inc.)

21

Psers Health Options Program (Employer Pdp)
(Psers Hop Program)

22

Simply (Simply Healthcare Plans, Inc.)

23

AARP MedicareComplete (UnitedHealthcare)

24

AARP MedicareComplete Choice
(UnitedHealthcare)

25

Medica HealthCare Plans MedicareMax
(UnitedHealthcare)

26

Preferred (UnitedHealthcare)

27

UnitedHealthcare Sync (UnitedHealthcare)

28

UnitedHealthcare The Villages
MedicareComplete (UnitedHealthcare)
(continued)

Created on 11/05/2018

4

HI2
MEDICARE ADVANTAGE PLANS
Florida (FL)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
29

WellCare (WellCare)

Created on 11/05/2018

1

HI3
MEDICAID PROGRAM NAMES
Florida (FL)
1

Florida Medicaid

Created on 11/05/2018

1

HI4
MEDICAID HMOs
Florida (FL)
1

AIDS Healthcare Foundation DBA Positive
Healthcare, Inc.

2

Simply Healthcare Plans DBA Clear Health
Alliance

3

Wellcare Health Plan of Florida DBA Staywell

4

South Florida Community Care Network

5

Children's Medical Services Network

6

Molina Healthcare of Florida, Inc.

7

United Healthcare of Florida, Inc.

8

Sunshine State Health Plan, Inc.

9

Sunshine State Health Plan, Inc.

10

Sunshine State Health Plan, Inc.

11

Coventry Healthcare of FL, Inc.
(continued)

Created on 11/05/2018

2

HI4
MEDICAID HMOs
Florida (FL)
12

Coventry Healthcare oF FL, Inc.

13

Suncoast Neighborly Care, Inc.

14

Simply Healthcare Plans, Inc.

15

Molina Healthcare of FL, Inc.

16

United Healthcare of FL, Inc.

17

Magellan Complete Care, LLC

18

Morselife Home Care, Inc.

19

Amerigroup Florida, Inc.

20

American Eldercare, Inc.

21

Amerigroup Florida, Inc.

22

Prestige Health Choice

23

Freedom Health, Inc.

24

Better Health, Inc.
(continued)

Created on 11/05/2018

3

HI4
MEDICAID HMOs
Florida (FL)
25

Humana Medical Plan

26

Florida Pace Center

27

Hope Select care

Created on 11/05/2018

1

HI5
HEALTHCARE MARKETPLACE PLANS
Florida (FL)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
1

Ambetter Balanced Care (Celtic Insurance
Company)

2

Ambetter Essential Care (Celtic Insurance
Company)

3

Ambetter Secure Care Free PCP Visits (Celtic
Insurance Company)

4

BlueCare [Tier] (Health Options, Inc.)

5

BlueOptions [Tier] (Blue Cross and Blue Shield of
Florida)

6

BlueSelect [Tier] (Blue Cross and Blue Shield of
Florida)

7

Florida Hospital GYM ACCESS [Tier] (Health
First Commercial Plans, Inc.)
(continued)

Created on 11/05/2018

2

HI5
HEALTHCARE MARKETPLACE PLANS
Florida (FL)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
8

Florida Hospital [Tier] (Health First Commercial
Plans, Inc.)

9

Gym Access IND Essential Plus [Tier] (Florida
Health Care Plan, Inc.)

10

Gym Access IND [Tier] (Florida Health Care
Plan, Inc.)

11

Gym Access IND [Tier] BC (Florida Health Care
Plan, Inc.)

12

Gym Access IND [Tier] Standardized (Florida
Health Care Plan, Inc.)

13

Health First GYM ACCESS [Tier] (Health First
Commercial Plans, Inc.)

14

Health First [Tier] (Health First Commercial
Plans, Inc.)
(continued)

Created on 11/05/2018

3

HI5
HEALTHCARE MARKETPLACE PLANS
Florida (FL)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
15 IND [Tier] BC (Florida Health Care Plan, Inc.)
16 Molina Marketplace [Tier] (Molina Healthcare of
Florida, Inc)
17 Oscar Classic [Tier] (Oscar Insurance Company of
Florida)
18 Oscar Saver [Tier] (Oscar Insurance Company of
Florida)
19 Oscar Simple Secure (Oscar Insurance Company of
Florida)
20 Oscar Simple [Tier] (Oscar Insurance Company of
Florida)
21 myBlue [Tier] (Health Options, Inc.)

Created on 11/05/2018

1

HI6
PUBLIC ASSISTANCE PLANS
Florida (FL)
1

AIDS Drug Assistance Program

2

Florida Discount Drug Card

Created on 11/05/2018

1

HI2
MEDICARE ADVANTAGE PLANS
Georgia (GA)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
1

Advantra Platinum (AETNA HEALTH INC. (GA))

2

Aetna Medicare (Aetna Medicare)

3

Aetna Medicare Select Plan (Aetna Medicare)

4

Allwell Medicare (Allwell)

5

Anthem MediBlue (Anthem Blue Cross and Blue
Shield)

6

Anthem MediBlue Access (Anthem Blue Cross
and Blue Shield)

7

Cigna-HealthSpring (Cigna-HealthSpring)

8

Clover Health Choice (Clover Health)
(continued)

Created on 11/05/2018

2

HI2
MEDICARE ADVANTAGE PLANS
Georgia (GA)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
9

Advantra Preferred (Coventry Health Care)

10

EON CHOICE (Eon Health)

11

EON SELECT (Eon Health)

12

Humana Gold Choice (Humana)

13

Humana Gold Plus (Humana)

14

HumanaChoice (Humana)

15

Kaiser Permanente Senior Advantage (Kaiser
Permanente)

16

AARP MedicareComplete Plan
(UnitedHealthcare)

17

AARP MedicareComplete Plus Plan
(UnitedHealthcare)
(continued)

Created on 11/05/2018

3

HI2
MEDICARE ADVANTAGE PLANS
Georgia (GA)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
18 UnitedHealthcare MedicareComplete Choice
(UnitedHealthcare)
19 UnitedHealthcare MedicareComplete Choice Plan
(UnitedHealthcare)
20 UnitedHealthcare MedicareDirect (UnitedHealthcare)
21 WellCare (WellCare)

Created on 11/05/2018

1

HI3
MEDICAID PROGRAM NAMES
Georgia (GA)
1

Georgia Medical Assistance

Created on 11/05/2018

1

HI4
MEDICAID HMOs
Georgia (GA)
1

Amerigroup Community Care

2

Amerigroup Community Care

3

Peach State Health Plan

4

Peach State Health Plan

5

WellCare of Georgia

6

WellCare of Georgia

7

Amerigroup

Created on 11/05/2018

1

HI5
HEALTHCARE MARKETPLACE PLANS
Georgia (GA)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
1

Ambetter Balanced Care (Ambetter of Peach
State Inc.)

2

Ambetter Essential Care (Ambetter of Peach
State Inc.)

3

Ambetter Secure Care Free PCP Visits (Ambetter
of Peach State Inc.)

4

Anthem [Tier] Pathway X (Blue Cross Blue Shield
Healthcare Plan of Georgia, Inc.)

5

Anthem [Tier] Pathway X Guided Access (Blue
Cross Blue Shield Healthcare Plan of Georgia,
Inc.)
(continued)

Created on 11/05/2018

2

HI5
HEALTHCARE MARKETPLACE PLANS
Georgia (GA)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
6

Anthem [Tier] Pathway X Guided Access Online
Plus (Blue Cross Blue Shield Healthcare Plan of
Georgia, Inc.)

7

Anthem [Tier] Pathway X Guided Access for
(Blue Cross Blue Shield Healthcare Plan of
Georgia, Inc.)
(continued)

Created on 11/05/2018

3

HI5
HEALTHCARE MARKETPLACE PLANS
Georgia (GA)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
8

Anthem [Tier] Pathway X Online Plus (Blue
Cross Blue Shield Healthcare Plan of Georgia,
Inc.)

9

Anthem [Tier] Pathway X for (Blue Cross Blue
Shield Healthcare Plan of Georgia, Inc.)

10

KP GA Signature [Tier] (Kaiser Foundation
Health Plan of Georgia)

11

KP GA [Tier] (Kaiser Foundation Health Plan of
Georgia)

12

SoloCare [Tier] Banks (Alliant Health Plans)

13

SoloCare [Tier] Dawson (Alliant Health Plans)

14

SoloCare [Tier] Fannin (Alliant Health Plans)
(continued)

Created on 11/05/2018

4

HI5
HEALTHCARE MARKETPLACE PLANS
Georgia (GA)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
15

SoloCare [Tier] Floyd (Alliant Health Plans)

16

SoloCare [Tier] Franklin (Alliant Health Plans)

17

SoloCare [Tier] Gilmer (Alliant Health Plans)

18

SoloCare [Tier] Gordon (Alliant Health Plans)

19

SoloCare [Tier] HDHP Banks (Alliant Health
Plans)

20

SoloCare [Tier] HDHP Dawson (Alliant Health
Plans)

21

SoloCare [Tier] HDHP Fannin (Alliant Health
Plans)
(continued)

Created on 11/05/2018

5

HI5
HEALTHCARE MARKETPLACE PLANS
Georgia (GA)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
22

SoloCare [Tier] HDHP Floyd (Alliant Health
Plans)

23

SoloCare [Tier] HDHP Franklin (Alliant Health
Plans)

24

SoloCare [Tier] HDHP Gilmer (Alliant Health
Plans)

25

SoloCare [Tier] HDHP Gordon (Alliant Health
Plans)

26

SoloCare [Tier] HDHP Habersham (Alliant Health
Plans)

27

SoloCare [Tier] HDHP HallBarrow (Alliant Health
Plans)

28

SoloCare [Tier] HDHP Hart (Alliant Health Plans)
(continued)

Created on 11/05/2018

6

HI5
HEALTHCARE MARKETPLACE PLANS
Georgia (GA)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
29

SoloCare [Tier] HDHP Lumpkin (Alliant Health
Plans)

30

SoloCare [Tier] HDHP Murray (Alliant Health
Plans)

31

SoloCare [Tier] HDHP Pickens (Alliant Health
Plans)

32

SoloCare [Tier] HDHP Polk (Alliant Health Plans)

33

SoloCare [Tier] HDHP Rabun (Alliant Health
Plans)

34

SoloCare [Tier] HDHP Stephens (Alliant Health
Plans)

35

SoloCare [Tier] HDHP Towns (Alliant Health
Plans)
(continued)

Created on 11/05/2018

7

HI5
HEALTHCARE MARKETPLACE PLANS
Georgia (GA)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
36

SoloCare [Tier] HDHP Union (Alliant Health
Plans)

37

SoloCare [Tier] HDHP White (Alliant Health
Plans)

38

SoloCare [Tier] HDHP Whitfield (Alliant Health
Plans)

39

SoloCare [Tier] Habersham (Alliant Health Plans)

40

SoloCare [Tier] HallBarrow (Alliant Health Plans)

41

SoloCare [Tier] Hart (Alliant Health Plans)

42

SoloCare [Tier] Lumpkin (Alliant Health Plans)
(continued)

Created on 11/05/2018

8

HI5
HEALTHCARE MARKETPLACE PLANS
Georgia (GA)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
43

SoloCare [Tier] Murray (Alliant Health Plans)

44

SoloCare [Tier] Pickens (Alliant Health Plans)

45

SoloCare [Tier] Polk (Alliant Health Plans)

46

SoloCare [Tier] Rabun (Alliant Health Plans)

47

SoloCare [Tier] Stephens (Alliant Health Plans)

48

SoloCare [Tier] Towns (Alliant Health Plans)

49

SoloCare [Tier] Union (Alliant Health Plans)
(continued)

Created on 11/05/2018

9

HI5
HEALTHCARE MARKETPLACE PLANS
Georgia (GA)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
50 SoloCare [Tier] White (Alliant Health Plans)
51 SoloCare [Tier] Whitfield (Alliant Health Plans)

Created on 11/05/2018

1

HI6
PUBLIC ASSISTANCE PLANS
Georgia (GA)
1 AIDS Drug Assisstance Program
2 Donated Drug Repository Program
3 Health Insurance Continuation Program (HICP)

Created on 11/05/2018

1

HI2
MEDICARE ADVANTAGE PLANS
Hawaii (HI)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
1 Essential Advantage (Essential Advantage)
2 HMSA Akamai Advantage (HMSA Akamai
Advantage)
3 Humana Gold Plus (Humana)
4 HumanaChoice (Humana)
5 Kaiser Permanente Senior Advantage (Kaiser
Permanente)
6 Lasso Healthcare (Lasso Healthcare)
7 AARP MedicareComplete Choice (UnitedHealthcare)
8 'Ohana Value (WellCare)

Created on 11/05/2018

1

HI3
MEDICAID PROGRAM NAMES
Hawaii (HI)
1

Med Quest

Created on 11/05/2018

1

HI4
MEDICAID HMOs
Hawaii (HI)
1

Hawaii Medical Service Association (HMSA) QUEST

2

UnitedHealthcare Community Plan QUEST

3

Ohana Community Care Service (BHS)

4

Kaiser Permanente QUEST

5

Ohana Health Plan QUEST

6

UnitedHealth ABD

7

AlohaCare QUEST

8

AlohaCare ABD

9

Kaiser ABD

10 Ohana ABD
11 HMSA ABD

Created on 11/05/2018

1

HI5
HEALTHCARE MARKETPLACE PLANS
Hawaii (HI)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
1

HMSA [Tier] (Hawaii Medical Service
Association)

2

KP [Tier] ChiroAcuMassage Fit (Kaiser
Foundation Health Plan, Inc.)

3

KP [Tier] Fit (Kaiser Foundation Health Plan,
Inc.)

4

KP [Tier] I ChiroAcuMassage Fit (Kaiser
Foundation Health Plan, Inc.)

5

KP [Tier] I Fit (Kaiser Foundation Health Plan,
Inc.)

6

KP [Tier] II ChiroAcuMassage Fit (Kaiser
Foundation Health Plan, Inc.)

7

KP [Tier] II Fit (Kaiser Foundation Health Plan,
Inc.)
(continued)

Created on 11/05/2018

2

HI5
HEALTHCARE MARKETPLACE PLANS
Hawaii (HI)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
8 KP [Tier] III Fit (Kaiser Foundation Health Plan, Inc.)

Created on 11/05/2018

1

HI6
PUBLIC ASSISTANCE PLANS
Hawaii (HI)
1 Community Care Program for HIV/AIDS (HCCP)
2 Developmentally Disabilities/Mental Retardation
Program (DD/MR)
3 Hawaii HIV Drug Assistance Program (HDAP)
4 Hawaii Seropositivity and Medical Management
Program (HSPAMM)

Created on 11/05/2018

1

HI2
MEDICARE ADVANTAGE PLANS
Iowa (IA)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
1

Coventry (Aetna Medicare)

2

Health Alliance Medicare Guide HMO (Health
Alliance Medicare)

3

HealthPartners UnityPoint Health (HealthPartners
UnityPoint Health)

4

Humana Gold Choice (Humana)

5

Humana Gold Plus (Humana)

6

Humana Value Plus (Humana)

7

HumanaChoice (Humana)

8

Medica Prime Solution (Medica Insurance
Company)

9

Cedar Valley Health Senior Plan (Medical
Associates Health Plan, Inc.)
(continued)

Created on 11/05/2018

2

HI2
MEDICARE ADVANTAGE PLANS
Iowa (IA)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
10

Central Iowa Health Senior Plan (Medical
Associates Health Plan, Inc.)

11

Clinton Community Health Senior Plan (Medical
Associates Health Plan, Inc.)

12

Genesis Health Network Senior Plan (Medical
Associates Health Plan, Inc.)

13

Medical Associates (Medical Associates Health
Plan, Inc.)

14

Mercy (Medical Associates Health Plan, Inc.)

15

North Iowa Health Senior Plan (Medical
Associates Health Plan, Inc.)

16

Gundersen Senior Preferred (Senior Preferred)
(continued)

Created on 11/05/2018

3

HI2
MEDICARE ADVANTAGE PLANS
Iowa (IA)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
17 AARP MedicareComplete (UnitedHealthcare)
18 AARP MedicareComplete Choice (UnitedHealthcare)
19 AARP MedicareComplete Plan (UnitedHealthcare)

Created on 11/05/2018

1

HI3
MEDICAID PROGRAM NAMES
Iowa (IA)
1

Iowa Medicaid

Created on 11/05/2018

1

HI4
MEDICAID HMOs
Iowa (IA)
1 UnitedHealthcare of the River Valley, Inc.
2 AmeriHealth Caritas of Iowa, Inc.
3 Amerigroup of Iowa, Inc.
4 Delta Dental of Iowa
5 PACE
6 TMS

Created on 11/05/2018

1

HI5
HEALTHCARE MARKETPLACE PLANS
Iowa (IA)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
1

Elevate by Medica [Tier] (Medica Insurance
Company)

2

Elevate by Medica [Tier] Plus (Medica Insurance
Company)

3

Elevate by Medica [Tier] Share (Medica
Insurance Company)

4

Inspire by Medica [Tier] (Medica Insurance
Company)

5

Inspire by Medica [Tier] Plus (Medica Insurance
Company)

6

Medica CHI Health [Tier] (Medica Insurance
Company)

7

Medica CHI Health [Tier] Plus (Medica Insurance
Company)
(continued)

Created on 11/05/2018

2

HI5
HEALTHCARE MARKETPLACE PLANS
Iowa (IA)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
8

Medica Insure [Tier] (Medica Insurance Company)

9

Medica Insure [Tier] Plus (Medica Insurance
Company)

10 Wellmark Value [Tier] (Wellmark Value Health Plan,
Inc.)
11 Wellmark Value [Tier] HDHP (Wellmark Value
Health Plan, Inc.)
12 Wellmark [Tier] (Wellmark Health Plan of Iowa)
13 Wellmark [Tier] HDHP (Wellmark Health Plan of
Iowa)

Created on 11/05/2018

1

HI6
PUBLIC ASSISTANCE PLANS
Iowa (IA)
1

AIDS Drug Assistance Program

Created on 11/05/2018

1

HI2
MEDICARE ADVANTAGE PLANS
Idaho (ID)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
1

Aetna Medicare (Aetna Medicare)

2

Secure Blue no (Blue Cross of Idaho)

3

True Blue (Blue Cross of Idaho)

4

Humana Gold Plus (Humana)

5

HumanaChoice (Humana)

6

Molina Medicare Options (Molina Healthcare of
Utah)

7

PacificSource Medicare (PacificSource Medicare)

8

PacificSource Medicare Explorer (PacificSource
Medicare)

9

Regence MedAdvantage (Regence BlueShield Of
Idaho)
(continued)

Created on 11/05/2018

2

HI2
MEDICARE ADVANTAGE PLANS
Idaho (ID)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
10 Regence Blue MedAdvantage HMO (Regence
BlueShield of Idaho)
11 SelectHealth Advantage (SelectHealth)
12 AARP MedicareComplete (UnitedHealthcare)
13 AARP MedicareComplete Choice (UnitedHealthcare)
14 UnitedHealthcare MedicareComplete Assure
(UnitedHealthcare)

Created on 11/05/2018

1

HI3
MEDICAID PROGRAM NAMES
Idaho (ID)
1

Medicaid

Created on 11/05/2018

1

HI4
MEDICAID HMOs
Idaho (ID)
1

Blue Cross of Idaho Care Plus, Inc.

2

Multiple primary care providers

3

Multiple primary care providers

4

Idaho Smiles

5

IBHP

6

NEMT

Created on 11/05/2018

1

HI5
HEALTHCARE MARKETPLACE PLANS
Idaho (ID)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
1 Only state-operated exchanges serve Idaho

Created on 11/05/2018

1

HI6
PUBLIC ASSISTANCE PLANS
Idaho (ID)
1 Access to Health Insurance (AHI)
2 Idaho AIDS Drug Assistance Program

Created on 11/05/2018

1

HI2
MEDICARE ADVANTAGE PLANS
Idaho (ID)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
1

Aetna Medicare (Aetna Medicare)

2

Secure Blue no (Blue Cross of Idaho)

3

True Blue (Blue Cross of Idaho)

4

Humana Gold Plus (Humana)

5

HumanaChoice (Humana)

6

Molina Medicare Options (Molina Healthcare of
Utah)

7

PacificSource Medicare (PacificSource Medicare)

8

PacificSource Medicare Explorer (PacificSource
Medicare)

9

Regence MedAdvantage (Regence BlueShield Of
Idaho)
(continued)

Created on 11/05/2018

2

HI2
MEDICARE ADVANTAGE PLANS
Idaho (ID)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
10 Regence Blue MedAdvantage HMO (Regence
BlueShield of Idaho)
11 SelectHealth Advantage (SelectHealth)
12 AARP MedicareComplete (UnitedHealthcare)
13 AARP MedicareComplete Choice (UnitedHealthcare)
14 UnitedHealthcare MedicareComplete Assure
(UnitedHealthcare)

Created on 11/05/2018

1

HI3
MEDICAID PROGRAM NAMES
Idaho (ID)
1

Medicaid

Created on 11/05/2018

1

HI4
MEDICAID HMOs
Idaho (ID)
1

Blue Cross of Idaho Care Plus, Inc.

2

Multiple primary care providers

3

Multiple primary care providers

4

Idaho Smiles

5

IBHP

6

NEMT

Created on 11/05/2018

1

HI5
HEALTHCARE MARKETPLACE PLANS
Idaho (ID)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
1 Only state-operated exchanges serve Idaho

Created on 11/05/2018

1

HI6
PUBLIC ASSISTANCE PLANS
Idaho (ID)
1 Access to Health Insurance (AHI)
2 Idaho AIDS Drug Assistance Program

Created on 11/05/2018

1

HI2
MEDICARE ADVANTAGE PLANS
Illinois (IL)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
1

Aetna Medicare (Aetna Medicare)

2

Aetna Medicare Value Plan (Aetna Medicare)

3

Allwell Medicare (Allwell)

4

Blue Cross Medicare Advantage (Blue Cross and
Blue Shield of IL, NM)

5

Blue Cross Medicare Advantage Choice (Blue
Cross and Blue Shield of IL, NM)

6

Cigna-HealthSpring (Cigna-HealthSpring)

7

Clear Spring Health Essential (Clear Spring
Health)

8

Community (Community Care Alliance of Illinois,
NFP)
(continued)

Created on 11/05/2018

2

HI2
MEDICARE ADVANTAGE PLANS
Illinois (IL)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
9

Advantra (Coventry Health Care)

10

Advantra Option (Coventry Health Care)

11

Coventry Total Care (Coventry Health Care)

12

Freedom Plus (Coventry Health Care)

13

Gold Advantage (Coventry Health Care)

14

Total Care (Coventry Health Care)

15

Guide HMO (Health Alliance Medicare)

16

Health Alliance Medicare (Health Alliance
Medicare)

17

Simplete (Health Alliance Medicare)
(continued)

Created on 11/05/2018

3

HI2
MEDICARE ADVANTAGE PLANS
Illinois (IL)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
18

HealthPartners UnityPoint Health (HealthPartners
UnityPoint Health)

19

Humana Gold Choice (Humana)

20

Humana Gold Plus (Humana)

21

HumanaChoice (Humana)

22

Lasso Healthcare (Lasso Healthcare)

23

Medical Associates (Medical Associates Health
Plan, Inc.)

24

MeridianCare (MeridianCare)

25

MeridianCare Essential (MeridianCare)

26

SwedishAmerican Senior Preferred (Senior
Preferred)
(continued)

Created on 11/05/2018

4

HI2
MEDICARE ADVANTAGE PLANS
Illinois (IL)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
27 Sunrise Advantage Plan (Sunrise Advantage Plan
(HMO SNP))
28 AARP MedicareComplete (UnitedHealthcare)
29 AARP MedicareComplete Choice (UnitedHealthcare)
30 AARP MedicareComplete Choice Plan
(UnitedHealthcare)
31 UnitedHealthcare MedicareComplete
(UnitedHealthcare)
32 UnitedHealthcare MedicareComplete Assure
(UnitedHealthcare)
33 WellCare (WellCare)

Created on 11/05/2018

1

HI3
MEDICAID PROGRAM NAMES
Illinois (IL)
1

Illinois Medicaid

Created on 11/05/2018

1

HI4
MEDICAID HMOs
Illinois (IL)
1

Community Care Alliance of Illinois

2

Blue Cross Blue Shield of Illinois

3

Blue Cross Blue Shield of Illinois

4

Cigna-HealthSpring of Illinois

5

Molina Healthcare of Illinois

6

Molina Healthcare of Illinois

7

NextLevel Health Partners

8

NextLevel Health Partners

9

Health Alliance Connect

10

Health Alliance Connect

11

Illinois Health Connect

12

IlliniCare Health Plan

13

IlliniCare Health Plan
(continued)

Created on 11/05/2018

2

HI4
MEDICAID HMOs
Illinois (IL)
14

Family Health Network

15

Meridian Health Plan

16

Meridian Health Plan

17

Aetna Better Health

18

Aetna Better Health

19

Harmony Health Plan

20

Humana Health Plan

21

CountyCare

22

CountyCare

Created on 11/05/2018

1

HI5
HEALTHCARE MARKETPLACE PLANS
Illinois (IL)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
1

Ambetter Balanced Care (Celtic Insurance
Company)

2

Ambetter Secure Care Free PCP Visits (Celtic
Insurance Company)

3

Blue Choice Preferred Security (Blue Cross Blue
Shield of Illinois)

4

Blue Choice Preferred [Tier] (Blue Cross Blue
Shield of Illinois)

5

Blue Choice Preferred [Tier] Two PCP Visits
(Blue Cross Blue Shield of Illinois)

6

Blue FocusCare [Tier] (Blue Cross Blue Shield of
Illinois)

7

Blue Precision [Tier] (Blue Cross Blue Shield of
Illinois)
(continued)

Created on 11/05/2018

2

HI5
HEALTHCARE MARKETPLACE PLANS
Illinois (IL)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
8

BlueCare Direct [Tier] Advocate (Blue Cross Blue
Shield of Illinois)

9

Cigna Connect (Cigna HealthCare of Illinois, Inc.)

10

Elite [Tier] (Health Alliance Medical Plans, Inc.)

11

Methodist [Tier] (Health Alliance Medical Plans,
Inc.)

12

OSF [Tier] (Health Alliance Medical Plans, Inc.)

13

Performance [Tier] (Gundersen Health Plan, Inc.)

14

Performance [Tier] Maintenance (Gundersen
Health Plan, Inc.)
(continued)

Created on 11/05/2018

3

HI5
HEALTHCARE MARKETPLACE PLANS
Illinois (IL)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
15 Riverside [Tier] (Health Alliance Medical Plans, Inc.)

Created on 11/05/2018

1

HI6
PUBLIC ASSISTANCE PLANS
Illinois (IL)
1 AIDS Drug Assistance Program
2 Access to Care
3 DuPage Physician's Medical Assistance Program
(DPMAP)

Created on 11/05/2018

1

HI2
MEDICARE ADVANTAGE PLANS
Indiana (IN)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
1

Aetna Medicare (Aetna Medicare)

2

Allwell Medicare (Allwell)

3

Anthem MediBlue Access (Anthem Blue Cross
and Blue Shield)

4

Anthem MediBlue Access Basic (Anthem Blue
Cross and Blue Shield)

5

Anthem MediBlue (Anthem HealthKeepers)

6

Health Alliance Medicare (Health Alliance
Medicare)

7

Reid (Health Alliance Medicare)

8

Simplete Riverside (Health Alliance Medicare)

9

Humana Gold Choice (Humana)
(continued)

Created on 11/05/2018

2

HI2
MEDICARE ADVANTAGE PLANS
Indiana (IN)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
10 Humana Gold Plus (Humana)
11 Humana Value Plus (Humana)
12 HumanaChoice (Humana)
13 IU Health Plans Medicare (Indiana University Health
Plans - Medicare)
14 Lasso Healthcare (Lasso Healthcare)
15 MeridianCare (MeridianCare)
16 AARP MedicareComplete (UnitedHealthcare)

Created on 11/05/2018

1

HI3
MEDICAID PROGRAM NAMES
Indiana (IN)
1

Indiana Medicaid

Created on 11/05/2018

1

HI4
MEDICAID HMOs
Indiana (IN)
1

Managed Health Services

2

Managed Health Services

3

Managed Health Services

4

MDWise

5

Anthem

6

Anthem

7

MDWise

8

MDWise

9

Anthem

Created on 11/05/2018

1

HI5
HEALTHCARE MARKETPLACE PLANS
Indiana (IN)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
1

Ambetter Balanced Care (Celtic Insurance
Company)

2

Ambetter Essential Care (Celtic Insurance
Company)

3

Ambetter Secure Care Free PCP Visits (Celtic
Insurance Company)

4

CareSource Marketplace Low Deductible [Tier]
(CareSource Indiana, Inc.)

5

CareSource Marketplace Low Deductible [Tier]
Dental and (CareSource Indiana, Inc.)

6

CareSource Marketplace Low Premium [Tier]
(CareSource Indiana, Inc.)

7

CareSource Marketplace Low Premium [Tier]
Dental and (CareSource Indiana, Inc.)
(continued)

Created on 11/05/2018

2

HI5
HEALTHCARE MARKETPLACE PLANS
Indiana (IN)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
8

CareSource Marketplace Standard [Tier]
(CareSource Indiana, Inc.)

9

CareSource Marketplace Standard [Tier] Dental and
(CareSource Indiana, Inc.)

10 CareSource Marketplace [Tier] (CareSource Indiana,
Inc.)
11 CareSource Marketplace [Tier] Dental and
(CareSource Indiana, Inc.)

Created on 11/05/2018

1

HI6
PUBLIC ASSISTANCE PLANS
Indiana (IN)
1 AIDS Drug Assistance Program
2 Healthy Indiana Plan (HIP)
3 Indiana Drug Card
4 Indiana Prescription Drug Program, Hoosier RX

Created on 11/05/2018

1

HI2
MEDICARE ADVANTAGE PLANS
Kansas (KS)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
1

Allwell Medicare (Allwell)

2

Blue Medicare Advantage (Blue Cross and Blue
Shield of Kansas City (Blue K)

3

Cigna-HealthSpring (Cigna-HealthSpring)

4

Advantra Advantage (Coventry Health Care)

5

Advantra Freedom (Coventry Health Care)

6

Freedom Plus (Coventry Health Care)

7

Medicare Advantage (Coventry Health Care)

8

Medicare Advantage Total Care (Coventry Health
Care)

9

Select Advantage (Coventry Health Care)
(continued)

Created on 11/05/2018

2

HI2
MEDICARE ADVANTAGE PLANS
Kansas (KS)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
10

Total Care (Coventry Health Care)

11

Humana (Humana)

12

Humana Community (Humana)

13

Humana Gold Choice (Humana)

14

Humana Value Plus (Humana)

15

HumanaChoice (Humana)

16

Lasso Healthcare (Lasso Healthcare)

17

AARP MedicareComplete Choice
(UnitedHealthcare)

18

AARP MedicareComplete Plan
(UnitedHealthcare)

19

Erickson Advantage (UnitedHealthcare)
(continued)

Created on 11/05/2018

3

HI2
MEDICARE ADVANTAGE PLANS
Kansas (KS)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
20 UnitedHealthcare MedicareDirect (UnitedHealthcare)

Created on 11/05/2018

1

HI3
MEDICAID PROGRAM NAMES
Kansas (KS)
1

KanCare program

Created on 11/05/2018

1

HI4
MEDICAID HMOs
Kansas (KS)
1 United HealthCare Community Plan of Kansas
2 Sunflower State Health Plan
3 Amerigroup Kansas, Inc.
4 Via Christi
5 Midland

Created on 11/05/2018

1

HI5
HEALTHCARE MARKETPLACE PLANS
Kansas (KS)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
1

Ambetter Balanced Care (Sunflower State Health
Plan, Inc)

2

Ambetter Essential Care (Sunflower State Health
Plan, Inc)

3

Ambetter Secure Care Free PCP Visits
(Sunflower State Health Plan, Inc)

4

BlueCare Simple [Tier] HDHP (Blue Cross and
Blue Shield of Kansas, Inc.)

5

BlueCare [Tier] (Blue Cross and Blue Shield of
Kansas, Inc.)

6

Medica Connect [Tier] (Medica Insurance
Company)

7

Medica Connect [Tier] H S (Medica Insurance
Company)
(continued)

Created on 11/05/2018

2

HI5
HEALTHCARE MARKETPLACE PLANS
Kansas (KS)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
8

Medica Connect [Tier] H SPlus (Medica Insurance
Company)

9

Select by Medica [Tier] (Medica Insurance
Company)

10 Select by Medica [Tier] H S (Medica Insurance
Company)
11 Select by Medica [Tier] H SPlus (Medica Insurance
Company)
12 Select by Medica [Tier] Share (Medica Insurance
Company)

Created on 11/05/2018

1

HI6
PUBLIC ASSISTANCE PLANS
Kansas (KS)
1 Kansas AIDS Drug Assistance Program

Created on 11/05/2018

1

HI2
MEDICARE ADVANTAGE PLANS
Kentucky (KY)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
1

Aetna Medicare (Aetna Medicare)

2

Aetna Medicare Value Plan (Aetna Medicare)

3

Anthem MediBlue Access (Anthem Blue Cross
and Blue Shield)

4

Anthem MediBlue Access Basic (Anthem Blue
Cross and Blue Shield)

5

Anthem MediBlue Plus (Anthem Blue Cross and
Blue Shield)

6

Humana (Humana)

7

Humana Community (Humana)

8

Humana Gold Choice (Humana)

9

Humana Gold Plus (Humana)
(continued)

Created on 11/05/2018

2

HI2
MEDICARE ADVANTAGE PLANS
Kentucky (KY)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
10 Humana Value Plus (Humana)
11 HumanaChoice (Humana)
12 Mutual of Omaha CareAdvantage (Mutual of Omaha
Medicare Advantage Company)
13 AARP MedicareComplete Plan (UnitedHealthcare)
14 UnitedHealthcare MedicareDirect (UnitedHealthcare)
15 WellCare (WellCare)

Created on 11/05/2018

1

HI3
MEDICAID PROGRAM NAMES
Kentucky (KY)
1

Kentucky Medicaid

Created on 11/05/2018

1

HI4
MEDICAID HMOs
Kentucky (KY)
1 NEMT-Human Services Transportation Delivery
2 Anthem Blue Cross Blue Shield Medicaid
3 Aetna Better Health of Kentucky
4 Passport Health Plan
5 WellCare of Kentucky
6 Humana- Caresource

Created on 11/05/2018

1

HI5
HEALTHCARE MARKETPLACE PLANS
Kentucky (KY)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
1

Anthem [Tier] Pathway (Anthem Health Plans of
KY(Anthem BCBS))

2

Anthem [Tier] Pathway Transition X (Anthem
Health Plans of KY(Anthem BCBS))

3

Anthem [Tier] Pathway Transition X for (Anthem
Health Plans of KY(Anthem BCBS))

4

Anthem [Tier] Pathway X (Anthem Health Plans
of KY(Anthem BCBS))

5

Anthem [Tier] Pathway X Transition (Anthem
Health Plans of KY(Anthem BCBS))

6

Anthem [Tier] Pathway X for (Anthem Health
Plans of KY(Anthem BCBS))

7

CareSource Marketplace Low Deductible [Tier]
(CareSource Kentucky Co.)
(continued)

Created on 11/05/2018

2

HI5
HEALTHCARE MARKETPLACE PLANS
Kentucky (KY)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
8

CareSource Marketplace Low Deductible [Tier]
Dental and (CareSource Kentucky Co.)

9

CareSource Marketplace Low Premium [Tier]
(CareSource Kentucky Co.)

10 CareSource Marketplace Low Premium [Tier] Dental
and (CareSource Kentucky Co.)
11 CareSource Marketplace Standard [Tier]
(CareSource Kentucky Co.)
12 CareSource Marketplace Standard [Tier] Dental and
(CareSource Kentucky Co.)
13 CareSource Marketplace [Tier] (CareSource
Kentucky Co.)
14 CareSource Marketplace [Tier] Dental and
(CareSource Kentucky Co.)

Created on 11/05/2018

1

HI6
PUBLIC ASSISTANCE PLANS
Kentucky (KY)
1 Kentucky AIDS Drug Assistance Program
2 Kentucky Prescription Assistance Program

Created on 11/05/2018

1

HI2
MEDICARE ADVANTAGE PLANS
Louisiana (LA)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
1

Aetna Medicare (Aetna Medicare)

2

Allwell Medicare (Allwell)

3

Blue Advantage (Blue Cross and Blue Shield of
Louisiana)

4

Advantra (Coventry Health Care)

5

Humana (Humana)

6

Humana Value Plus (Humana)

7

HumanaChoice (Humana)

8

Peoples Health Choices (Peoples Health)

9

AARP MedicareComplete Plan
(UnitedHealthcare)
(continued)

Created on 11/05/2018

2

HI2
MEDICARE ADVANTAGE PLANS
Louisiana (LA)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
10 AAA0 Vantage STANDARD (Vantage Health Plan,
Inc.)
11 AAA1 Vantage PREMIUM (Vantage Health Plan,
Inc.)
12 AAA4 Vantage TRADITIONAL PLUS (Vantage
Health Plan, Inc.)
13 AAA8 Vantage BASIC (Vantage Health Plan, Inc.)
14 AAA9 Vantage (Vantage Health Plan, Inc.)
15 WellCare (WellCare)

Created on 11/05/2018

1

HI3
MEDICAID PROGRAM NAMES
Louisiana (LA)
1

Healthy Louisiana

Created on 11/05/2018

1

HI4
MEDICAID HMOs
Louisiana (LA)
1

Louisiana Healthcare Connections

2

Aetna Better Health of Louisiana

3

Louisiana Healthcare Connections

4

UnitedHealthcare Community Plan

5

UnitedHealthcare Community Plan

6

Aetna Better Health Louisiana

7

AmeriHealth Caritas Louisiana

8

AmeriHealth Caritas Louisiana

9

PACE - Greater New Orleans

10

Amerigroup Louisiana

11

Amerigroup Louisiana

12

PACE - Baton Rouge

13

PACE - Lafayette
(continued)

Created on 11/05/2018

2

HI4
MEDICAID HMOs
Louisiana (LA)
14

MCNA

Created on 11/05/2018

1

HI5
HEALTHCARE MARKETPLACE PLANS
Louisiana (LA)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
1

Blue (HMO Louisiana, Inc.)

2

Blue Connect L (HMO Louisiana, Inc.)

3

Blue Connect N (HMO Louisiana, Inc.)

4

Blue Connect S (HMO Louisiana, Inc.)

5

Blue Max (Louisiana Health Service & Indemnity
Company)

6

Blue Saver (Louisiana Health
Service & Indemnity Company)

7

Community Blue (HMO Louisiana, Inc.)

8

Essential [Tier] IND (Vantage Health Plan, Inc.)

9

Essential [Tier] Plus IND (Vantage Health Plan,
Inc.)
(continued)

Created on 11/05/2018

2

HI5
HEALTHCARE MARKETPLACE PLANS
Louisiana (LA)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
10 Freedom [Tier] IND (Vantage Health Plan, Inc.)
11 Freedom [Tier] Plus IND (Vantage Health Plan, Inc.)
12 Savings [Tier] IND (Vantage Health Plan, Inc.)
13 Savings [Tier] Plus IND (Vantage Health Plan, Inc.)
14 Signature Blue (HMO Louisiana, Inc.)

Created on 11/05/2018

1

HI6
PUBLIC ASSISTANCE PLANS
Louisiana (LA)
1

Louisiana Health Access Program

2

Lousiana SenioRx

Created on 11/05/2018

1

HI2
MEDICARE ADVANTAGE PLANS
Massachusetts (MA)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
1

Aetna Medicare Freedom (Aetna Medicare)

2

Aetna Medicare Value Plan (Aetna Medicare)

3

Medicare HMO Blue (Blue Cross Blue Shield of
Massachusetts)

4

Medicare PPO Blue (Blue Cross Blue Shield of
Massachusetts)

5

Fallon Senior Plan (Fallon Health)

6

Harvard Pilgrim Stride (Harvard Pilgrim Health
Care of New England, Inc.)

7

Health New England Medicare (Health New
England Medicare Advantage Plans)

8

Tufts Medicare Preferred HMO (Tufts Health
Plan)
(continued)

Created on 11/05/2018

2

HI2
MEDICARE ADVANTAGE PLANS
Massachusetts (MA)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
9

AARP MedicareComplete Choice (UnitedHealthcare)

10 AARP MedicareComplete Plan (UnitedHealthcare)
11 Erickson Advantage (UnitedHealthcare)

Created on 11/05/2018

1

HI3
MEDICAID PROGRAM NAMES
Massachusetts (MA)
1

MassHealth

Created on 11/05/2018

1

HI4
MEDICAID HMOs
Massachusetts (MA)
1

Money Follows the Person - Behavioral Supports
(BFP-BH)

2

Elder Service Plan of Cambridge Health Alliance

3

Elder Service Plan of Harbor Health Services

4

Massachusetts Behavioral Health Partnership

5

Boston Medical Center Health Net Plan

6

Boston Medical Center HealthNet Plan

7

Multiple Primary Care Providers

8

Fallon Health Summit ElderCare

9

Fallon Community Health Plan

10

Upham's Elder Services Plan

11

Commonwealth Care Alliance
(continued)

Created on 11/05/2018

2

HI4
MEDICAID HMOs
Massachusetts (MA)
12

Serenity Care Pace Program

13

Neighborhood Health Plan

14

Senior Whole Health

15

Health New England

16

Element Care, Inc.

17

Tufts Health Plan

18

United HealthCare

19

Tufts Health Plan

20

Neighborhood PACE

21

Mercy Life Inc.

22

Navicare HMO

23

Celticare

Created on 11/05/2018

1

HI5
HEALTHCARE MARKETPLACE PLANS
Massachusetts (MA)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
1 Only state-operated exchanges serve Massachusetts

Created on 11/05/2018

1

HI6
PUBLIC ASSISTANCE PLANS
Massachusetts (MA)
1 CenterCare
2 Commonwealth Care
3 HIV Drug Assistance Program
4 Health Safety Net
5 Massachusetts Prescription Advantage Plan

Created on 11/05/2018

1

HI2
MEDICARE ADVANTAGE PLANS
Maryland (MD)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
1 Aetna Medicare Connect Plus (Aetna Medicare)
2 Cigna-HealthSpring (Cigna-HealthSpring)
3 HumanaChoice (Humana)
4 Johns Hopkins Advantage MD (Johns Hopkins
HealthCare)
5 Kaiser Permanente Medicare Advantage (Kaiser
Permanente)
6 Kaiser Permanente Medicare Plus (Kaiser
Permanente)
7 Lasso Healthcare (Lasso Healthcare)
8 Erickson Advantage (UnitedHealthcare)

Created on 11/05/2018

1

HI3
MEDICAID PROGRAM NAMES
Maryland (MD)
1

Maryland Medicaid

Created on 11/05/2018

1

HI4
MEDICAID HMOs
Maryland (MD)
1

Riverside Health of Maryland

2

Amerigroup Community Care

3

Maryland Physicians Care

4

MedStar Family Choice

5

Jai Medical Systems

6

Hopkins Elder Plus

7

Kaiser Permanente

8

Priority Partners

9

United HealthCare

Created on 11/05/2018

1

HI5
HEALTHCARE MARKETPLACE PLANS
Maryland (MD)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
1 Only state-operated exchanges serve Maryland

Created on 11/05/2018

1

HI6
PUBLIC ASSISTANCE PLANS
Maryland (MD)
1 Maryland AIDS Drug Assistance Program
2 Maryland Kidney Disease Program
3 Primary Adult Care Program (PAC)
4 Senior Prescription Drug Assistance Program

Created on 11/05/2018

1

HI2
MEDICARE ADVANTAGE PLANS
Maine (ME)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
1

Aetna Medicare Freedom Plan (Aetna Medicare)

2

Aetna Medicare Value Plan (Aetna Medicare)

3

Anthem MediBlue Access (Anthem Blue Cross
and Blue Shield)

4

Anthem MediBlue (Empire BlueCross BlueShield)

5

Harvard Pilgrim Stride (Harvard Pilgrim Health
Care, Inc.)

6

Humana Gold Plus (Humana)

7

HumanaChoice (Humana)

8

Martin's Point Generations Advantage (Martin's
Point Generations Advantage)
(continued)

Created on 11/05/2018

2

HI2
MEDICARE ADVANTAGE PLANS
Maine (ME)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
9

Martin's Point Generations Advantage Flex (Martin's
Point Generations Advantage)

10 Martin's Point Generations Advantage Select
(Martin's Point Generations Advantage)
11 AARP MedicareComplete Choice (UnitedHealthcare)
12 AARP MedicareComplete Choice Plan
(UnitedHealthcare)
13 WellCare Today's Options Advantage (WellCare)
14 WellCare Today's Options Premier (WellCare)
15 WellCare Value (WellCare)

Created on 11/05/2018

1

HI3
MEDICAID PROGRAM NAMES
Maine (ME)
1

MaineCare

Created on 11/05/2018

1

HI4
MEDICAID HMOs
Maine (ME)
1

Multiple Primary Care Providers

2

MidCoast Connector

3

Logisticare

4

Penquis CAP

Created on 11/05/2018

1

HI5
HEALTHCARE MARKETPLACE PLANS
Maine (ME)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
1

Anthem [Tier] X (Anthem Health Plans of
ME(Anthem BCBS))

2

Anthem [Tier] X Online Plus (Anthem Health
Plans of ME(Anthem BCBS))

3

Anthem [Tier] X for (Anthem Health Plans of
ME(Anthem BCBS))

4

Community Advance (Maine Community Health
Options)

5

Community Align (Maine Community Health
Options)

6

Community Best (Maine Community Health
Options)

7

Community Choice (Maine Community Health
Options)
(continued)

Created on 11/05/2018

2

HI5
HEALTHCARE MARKETPLACE PLANS
Maine (ME)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
8

Community Complete (Maine Community Health
Options)

9

Community Edge (Maine Community Health
Options)

10

Community Focus (Maine Community Health
Options)

11

Community Foundation (Maine Community
Health Options)

12

Community Reliant (Maine Community Health
Options)

13

Community Safe Harbor (Maine Community
Health Options)

14

Community Value (Maine Community Health
Options)
(continued)

Created on 11/05/2018

3

HI5
HEALTHCARE MARKETPLACE PLANS
Maine (ME)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
15 Community Vital (Maine Community Health Options)
16 Maines Choice [Tier] (Harvard Pilgrim Health Care
Inc.)
17 Maines Choice [Tier] Casco (Harvard Pilgrim Health
Care Inc.)
18 Maines Choice [Tier] Pemaquid (Harvard Pilgrim
Health Care Inc.)
19 [Tier] (Harvard Pilgrim Health Care Inc.)

Created on 11/05/2018

1

HI6
PUBLIC ASSISTANCE PLANS
Maine (ME)
1 AIDS Drug Assistance Program
2 DirigoChoice Health Plan
3 Maine Low Cost Drugs for the Elderly and Disabled
Program (LCD)
4 Maine Rx Plus

Created on 11/05/2018

1

HI2
MEDICARE ADVANTAGE PLANS
Michigan (MI)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
1

Aetna Medicare (Aetna Medicare)

2

BCN Advantage (Blue Care Network)

3

Medicare Plus Blue PPO (Blue Cross Blue Shield
of Michigan)

4

HAP (HAP Senior Plus)

5

HAP Senior Plus Option (HAP Senior Plus
(PPO))

6

Humana Gold Choice (Humana)

7

Humana Gold Plus (Humana)

8

Humana Value Plus (Humana)

9

HumanaChoice (Humana)

10

MeridianCare (MeridianCare)
(continued)

Created on 11/05/2018

2

HI2
MEDICARE ADVANTAGE PLANS
Michigan (MI)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
11 Paramount Elite (Paramount Elite)
12 PriorityMedicare (Priority Health Medicare)
13 Erickson Advantage (UnitedHealthcare)
14 Upper Peninsula Health Plan (Upper Peninsula
Health Plan)

Created on 11/05/2018

1

HI3
MEDICAID PROGRAM NAMES
Michigan (MI)
1 Michigan Department of Health and Human Service

Created on 11/05/2018

1

HI4
MEDICAID HMOs
Michigan (MI)
1

Meridian Health Plan of Michigan, Inc.

2

Meridian Health Plan of Michigan, Inc.

3

Macomb-Oakland Regional Center (MORC)

4

Northeast MI Community Service Agency

5

Area Agency on Aging of West Michigan

6

CMH Partnership of Southeast Michigan

7

Detroit Wayne Mental Health Authority

8

UnitedHealthcare Community Plan Inc.

9

UnitedHealthcare Community Plan Inc.

10

Southwest Michigan Behavioral Health

11

Area Agency on Aging of NW Michigan

12

Region VII (7) Area Agency on Aging

13

Region IV (4) Area Agency on Aging
(continued)

Created on 11/05/2018

2

HI4
MEDICAID HMOs
Michigan (MI)
14

Senior Resources of West Michigan

15

Northern Michigan Regional Entity

16

Reliance Community Care Partners

17

Aetna Better Health of Michigan

18

Blue Cross Complete of Michigan

19

Blue Cross Complete of Michigan

20

Northern Health Care Management

21

Region 3B Area Agency on Aging

22

Molina Healthcare of Michigan

23

Molina Healthcare of Michigan

24

Region 2 Area Agency on Aging

25

HAP Midwest Health Plan Inc.

26

Priority Health Choice, Inc.
(continued)

Created on 11/05/2018

3

HI4
MEDICAID HMOs
Michigan (MI)
27

HAP Midwest Health Plan Inc.

28

Priority Health Choice, Inc.

29

Detroit Area Agency on Aging

30

Oakland County CMH Authority

31

Upper Peninsula Health Plan

32

Upper Peninsula Health Plan

33

A & D Home Health Care Inc.

34

The Information Center Inc.

35

Valley Area Agency on Aging

36

Tri-County Office on Aging

37

Macomb County CMH Services

38

Aetna Better Health of MI

39

Lakeshore Regional Entity
(continued)

Created on 11/05/2018

4

HI4
MEDICAID HMOs
Michigan (MI)
40

Harbor Health Plan, Inc.

41

Area Agency on Aging 1-B

42

Mid-State Health Network

43

Harbor Health Plan Inc.

44

Senior Community Care

45

Senior Services Inc.

46

PACE of Southeast MI

47

PACE of Southwest MI

48

McLaren Health Plan

49

McLaren Health Plan

50

The Senior Alliance

51

UPCAP Care Services

52

Healthy Kids Dental
(continued)

Created on 11/05/2018

5

HI4
MEDICAID HMOs
Michigan (MI)
53

Total Health Care

54

Total Health Care

55

Northcare Network

56

Huron Valley PACE

57

Great Lakes PACE

58

Region 10 PIHP

59

Care Resources

60

Genesys PACE

61

Life Circles

62

CentraCare

63

Thome PACE

Created on 11/05/2018

1

HI5
HEALTHCARE MARKETPLACE PLANS
Michigan (MI)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
1

Blue Cross® Metro Detroit [Tier] (Blue Care
Network of Michigan)

2

Blue Cross® Metro Detroit [Tier] Extra (Blue Care
Network of Michigan)

3

Blue Cross® Metro Detroit [Tier] Saver (Blue
Care Network of Michigan)

4

Blue Cross® Preferred [Tier] (Blue Care Network
of Michigan)

5

Blue Cross® Preferred [Tier] Extra (Blue Care
Network of Michigan)

6

Blue Cross® Preferred [Tier] Saver (Blue Care
Network of Michigan)

7

Blue Cross® Premier Value (Blue Cross Blue
Shield of Michigan Mutual Insurance Company)
(continued)

Created on 11/05/2018

2

HI5
HEALTHCARE MARKETPLACE PLANS
Michigan (MI)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
8

Blue Cross® Premier [Tier] (Blue Cross Blue
Shield of Michigan Mutual Insurance Company)

9

Blue Cross® Premier [Tier] Extra (Blue Cross
Blue Shield of Michigan Mutual Insurance
Company)

10

Blue Cross® Premier [Tier] Saver (Blue Cross
Blue Shield of Michigan Mutual Insurance
Company)

11

Blue Cross® Select Value (Blue Care Network of
Michigan)

12

Blue Cross® Select [Tier] (Blue Care Network of
Michigan)
(continued)

Created on 11/05/2018

3

HI5
HEALTHCARE MARKETPLACE PLANS
Michigan (MI)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
13

Blue Cross® Select [Tier] Extra (Blue Care
Network of Michigan)

14

Blue Cross® Select [Tier] Saver (Blue Care
Network of Michigan)
(continued)

Created on 11/05/2018

4

HI5
HEALTHCARE MARKETPLACE PLANS
Michigan (MI)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
15

McLaren Young Adult[Tier] (McLaren Health Plan
Community)

16

McLaren [Tier] (McLaren Health Plan
Community)

17

McLaren [Tier] Exchange (McLaren Health Plan
Community)

18

Meridian Base [Tier] (Meridian Health Plan of
Michigan, Inc.)

19

Meridian Healthy Essentials (Meridian Health
Plan of Michigan, Inc.)

20

Meridian Healthy [Tier] (Meridian Health Plan of
Michigan, Inc.)

21

Meridian Savings [Tier] (Meridian Health Plan of
Michigan, Inc.)
(continued)

Created on 11/05/2018

5

HI5
HEALTHCARE MARKETPLACE PLANS
Michigan (MI)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
22

Meridian Smart [Tier] (Meridian Health Plan of
Michigan, Inc.)

23

Molina [Tier] (Molina Healthcare of Michigan,
Inc.)

24

MyPriority [Tier] (Priority Health)

25

MyPriority [Tier] Beaumont Health Network
(Priority Health)

26

MyPriority [Tier] Bronson Healthcare Partners
(Priority Health)

27

MyPriority [Tier] Spectrum Health Partners
(Priority Health)

28

MyPriority [Tier] St John Providence Network
(Priority Health)
(continued)

Created on 11/05/2018

6

HI5
HEALTHCARE MARKETPLACE PLANS
Michigan (MI)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
29

MyPriority [Tier] St Joseph Mercy Health System
Network (Priority Health)

30

Oscar Classic [Tier] (Oscar Insurance Company)

31

Oscar Saver [Tier] (Oscar Insurance Company)

32

Oscar Simple Secure (Oscar Insurance
Company)

33

Oscar Simple [Tier] (Oscar Insurance Company)

34

Sparrow PHP Healthy (Physicians Health Plan)

35

Sparrow PHP [Tier] (Physicians Health Plan)
(continued)

Created on 11/05/2018

7

HI5
HEALTHCARE MARKETPLACE PLANS
Michigan (MI)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
36

Sparrow PHP [Tier] Basic Exclusive (Physicians
Health Plan)

37

Sparrow PHP [Tier] Exclusive (Physicians Health
Plan)

38

Total Saver Complete (Total Health Care USA,
Inc.)

39

Total Saver Plus (Total Health Care USA, Inc.)

40

Total Standard (Total Health Care USA, Inc.)

41

Totally You (Total Health Care USA, Inc.)

42

Totally You Complete (Total Health Care USA,
Inc.)
(continued)

Created on 11/05/2018

8

HI5
HEALTHCARE MARKETPLACE PLANS
Michigan (MI)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
43 Totally You Simple Choice (Total Health Care USA,
Inc.)
44 Totally You Value (Total Health Care USA, Inc.)

Created on 11/05/2018

1

HI6
PUBLIC ASSISTANCE PLANS
Michigan (MI)
1 Elder Prescription Insurance Program (EPIC)
2 Michigan Drug Assistance Program (MIDAP)

Created on 11/05/2018

1

HI2
MEDICARE ADVANTAGE PLANS
Minnesota (MN)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
1

Allina Health | Aetna Medicare Discover (Allina
Health Aetna Medicare)

2

Blue Cross Medicare Advantage (Blue Cross
Blue Shield of Minnesota)

3

Blue Cross Strive Medicare Advantage (Blue
Cross and Blue Shield of Minnesota)

4

Platinum Blue Core Plan (Blue Cross and Blue
Shield of Minnesota)

5

HealthPartners Freedom (HealthPartners)

6

HealthPartners Journey (HealthPartners)

7

Humana Gold Choice (Humana)

8

Humana Value Plus (Humana)

9

HumanaChoice (Humana)
(continued)

Created on 11/05/2018

2

HI2
MEDICARE ADVANTAGE PLANS
Minnesota (MN)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
10 Medica Advantage Solution (Medica Health Plans)
11 Medica Prime Solution (Medica Insurance Company)
12 Gundersen MN Senior Preferred (Senior Preferred)
13 Care (UCare)
14 EssentiaCare (UCare)
15 UCare (UCare)
16 AARP MedicareComplete (UnitedHealthcare)
17 UnitedHealthcare Sync (UnitedHealthcare)

Created on 11/05/2018

1

HI3
MEDICAID PROGRAM NAMES
Minnesota (MN)
1

Minnesota Medical Assistance

Created on 11/05/2018

1

HI4
MEDICAID HMOs
Minnesota (MN)
1

Itasca Medical Center

2

South Country Health

3

South Country Health

4

South Country Health

5

South Country Health

6

Itasca Medical Care

7

Itasca Medical Care

8

PrimeWest Health

9

PrimeWest Health

10

PrimeWest Health

11

PrimeWest Health

12

Health Partners

13

Hennepin Health
(continued)

Created on 11/05/2018

2

HI4
MEDICAID HMOs
Minnesota (MN)
14

Health Partners

15

Health Partners

16

Health Partners

17

Blue Plus

18

Blue Plus

19

Blue Plus

20

Medica

21

Medica

22

Medica

23

Medica

24

Medica

25

Ucare

26

Ucare
(continued)

Created on 11/05/2018

3

HI4
MEDICAID HMOs
Minnesota (MN)
27

Ucare

28

Ucare

Created on 11/05/2018

1

HI5
HEALTHCARE MARKETPLACE PLANS
Minnesota (MN)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
1 Only state-operated exchanges serve Minnesota

Created on 11/05/2018

1

HI6
PUBLIC ASSISTANCE PLANS
Minnesota (MN)
1 Minnesota AIDS Drug Assistance Program (ADAP)
2 Minnesota's General Assistance Medical Care
3 MinnesotaCare

Created on 11/05/2018

1

HI2
MEDICARE ADVANTAGE PLANS
Missouri (MO)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
1

Allwell Medicare (Allwell)

2

Anthem MediBlue Access (Anthem Blue Cross
and Blue Shield)

3

Anthem MediBlue Plus (Anthem HealthKeepers)

4

Blue Medicare Advantage (Blue Cross and Blue
Shield of Kansas City (Blue K)

5

Cigna-HealthSpring (Cigna-HealthSpring)

6

Advantage (Coventry Health Care)

7

Advantra (Coventry Health Care)

8

Freedom (Coventry Health Care)

9

Gold Advantage (Coventry Health Care)
(continued)

Created on 11/05/2018

2

HI2
MEDICARE ADVANTAGE PLANS
Missouri (MO)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
10

Select Advantage (Coventry Health Care)

11

Total Care (Coventry Health Care)

12

CoxHealth MedicarePlus (Essence Healthcare)

13

Essence Advantage (Essence Healthcare)

14

Humana Community (Humana)

15

Humana Gold Choice (Humana)

16

Humana Gold Plus (Humana)

17

HumanaChoice (Humana)

18

Missouri Department Of Transportatio/ Highway
Patr (Employer Pdp) (Modot/Mshp Medical And
Life Insurance Plan)

19

AARP MedicareComplete (UnitedHealthcare)
(continued)

Created on 11/05/2018

3

HI2
MEDICARE ADVANTAGE PLANS
Missouri (MO)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
20 AARP MedicareComplete Choice (UnitedHealthcare)
21 UnitedHealthcare MedicareComplete Choice
(UnitedHealthcare)
22 UnitedHealthcare MedicareDirect (UnitedHealthcare)

Created on 11/05/2018

1

HI3
MEDICAID PROGRAM NAMES
Missouri (MO)
1

MO HealthNet

Created on 11/05/2018

1

HI4
MEDICAID HMOs
Missouri (MO)
1

Aetna Better Health of Missouri Eastern

2

Aetna Better Health of Missouri Central

3

Aetna Better Health of Missouri Western

4

Missouri Care Eastern

5

Missouri Care Central

6

Missouri Care Western

7

Logisticare Solutions

8

Home State Eastern

9

Home State Central

10

Home State Western

Created on 11/05/2018

1

HI5
HEALTHCARE MARKETPLACE PLANS
Missouri (MO)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
1

Ambetter Balanced Care (Celtic Insurance
Company)

2

Ambetter Essential Care (Celtic Insurance
Company)

3

Ambetter Secure Care Free PCP Visits (Celtic
Insurance Company)

4

Anthem [Tier] Pathway X (Healthy Alliance Life
Co(Anthem BCBS))

5

Anthem [Tier] Pathway X Online Plus (Healthy
Alliance Life Co(Anthem BCBS))

6

Anthem [Tier] Pathway X for (Healthy Alliance
Life Co(Anthem BCBS))

7

Cigna Connect (Cigna Health and Life Insurance
Company)
(continued)

Created on 11/05/2018

2

HI5
HEALTHCARE MARKETPLACE PLANS
Missouri (MO)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
8

Select by Medica [Tier] (Medica Insurance
Company)

9

Select by Medica [Tier] H S (Medica Insurance
Company)

10 Select by Medica [Tier] H SPlus (Medica Insurance
Company)
11 Select by Medica [Tier] Share (Medica Insurance
Company)
12 Select by Medica [Tier] [Tier] (Medica Insurance
Company)

Created on 11/05/2018

1

HI6
PUBLIC ASSISTANCE PLANS
Missouri (MO)
1 Missouri AIDS Drug Assistance Program
2 Missouri Rx Plan (MoRx)

Created on 11/05/2018

1

HI2
MEDICARE ADVANTAGE PLANS
Mississippi (MS)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
1 Aetna Medicare Freedom Plan (Aetna Medicare)
2 Allwell Medicare (Allwell)
3 Cigna-HealthSpring (Cigna-HealthSpring)
4 Humana Gold Choice (Humana)
5 Humana Gold Plus (Humana)
6 Humana Value Plus (Humana)
7 HumanaChoice (Humana)
8 Lasso Healthcare (Lasso Healthcare)
9 WellCare (WellCare)

Created on 11/05/2018

1

HI3
MEDICAID PROGRAM NAMES
Mississippi (MS)
1

Mississippi Medicaid

Created on 11/05/2018

1

HI4
MEDICAID HMOs
Mississippi (MS)
1 UnitedHealthcare of Mississippi Community Plan
2 Magnolia Health

Created on 11/05/2018

1

HI5
HEALTHCARE MARKETPLACE PLANS
Mississippi (MS)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
1 Ambetter Balanced Care (Ambetter of Magnolia Inc.)
2 Ambetter Essential Care (Ambetter of Magnolia Inc.)
3 Ambetter Secure Care Free PCP Visits (Ambetter of
Magnolia Inc.)

Created on 11/05/2018

1

HI6
PUBLIC ASSISTANCE PLANS
Mississippi (MS)
1

AIDS Drug Assistance Program

Created on 11/05/2018

1

HI2
MEDICARE ADVANTAGE PLANS
Montana (MT)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
1 Blue Cross Medicare Advantage (Blue Cross and Blue
Shield of Montana)
2 Humana Gold Choice (Humana)
3 Humana Gold Plus (Humana)
4 HumanaChoice (Humana)
5 Lasso Healthcare (Lasso Healthcare)
6 PacificSource Medicare MyCare (PacificSource
Medicare)
7 UnitedHealthcare MedicareDirect (UnitedHealthcare)

Created on 11/05/2018

1

HI3
MEDICAID PROGRAM NAMES
Montana (MT)
1

Montana Medicaid

Created on 11/05/2018

1

HI4
MEDICAID HMOs
Montana (MT)
1

Multiple Primary Care Providers

Created on 11/05/2018

1

HI5
HEALTHCARE MARKETPLACE PLANS
Montana (MT)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
1

Access Care Expanded [Tier] (Montana Health
Cooperative)

2

Access Care [Tier] (Montana Health Cooperative)

3

Access Care [Tier] Plus (Montana Health
Cooperative)

4

Blue Focus [Tier] (Blue Cross and Blue Shield of
Montana)

5

Blue Focus [Tier] Two PCP Visits (Blue Cross
and Blue Shield of Montana)

6

Blue Preferred Security (Blue Cross and Blue
Shield of Montana)

7

Blue Preferred [Tier] (Blue Cross and Blue Shield
of Montana)
(continued)

Created on 11/05/2018

2

HI5
HEALTHCARE MARKETPLACE PLANS
Montana (MT)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
8

Blue Preferred [Tier] Two PCP Visits (Blue Cross
and Blue Shield of Montana)

9

Connected Care Expanded [Tier] (Montana Health
Cooperative)

10 Connected Care [Tier] (Montana Health
Cooperative)
11 Connected Care [Tier] Option (Montana Health
Cooperative)
12 Connected Care [Tier] Plus (Montana Health
Cooperative)
13 PSN [Tier] (PacificSource Health Plans)
14 SmartHealth [Tier] (PacificSource Health Plans)

Created on 11/05/2018

1

HI6
PUBLIC ASSISTANCE PLANS
Montana (MT)
1

AIDS Drug Assistance Program

2

Mental Health Services Plan

3

Montana Big Sky Rx Program

Created on 11/05/2018

1

HI2
MEDICARE ADVANTAGE PLANS
North Carolina (NC)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
1

Aetna Medicare (Aetna Medicare)

2

Aetna Medicare Value Plan (Aetna Medicare)

3

Blue Medicare HMO (Blue Cross and Blue Shield
of North Carolina)

4

Blue Medicare PPO Enhanced (Blue Cross and
Blue Shield of North Carolina)

5

HealthTeam Advantage Plan (CARE N' CARE
INSURANCE COMPANY OF NORTH
CAROLINA)

6

Teal Premier Pro (CARE N' CARE INSURANCE
COMPANY OF NORTH CAROLINA)

7

Cigna-HealthSpring (Cigna-HealthSpring)

8

Clear Spring Health Essential (Clear Spring
Health)
(continued)

Created on 11/05/2018

2

HI2
MEDICARE ADVANTAGE PLANS
North Carolina (NC)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
9

FirstMedicare Direct (FirstMedicare Direct)

10

FirstMedicare Direct PPO Plus (FirstMedicare
Direct)

11

Humana Gold Choice (Humana)

12

Humana Gold Plus (Humana)

13

HumanaChoice (Humana)

14

Lasso Healthcare (Lasso Healthcare)

15

AARP MedicareComplete (UnitedHealthcare)

16

AARP MedicareComplete Choice
(UnitedHealthcare)

17

Erickson Advantage (UnitedHealthcare)
(continued)

Created on 11/05/2018

3

HI2
MEDICARE ADVANTAGE PLANS
North Carolina (NC)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
18

WellCare Value (WellCare)

Created on 11/05/2018

1

HI3
MEDICAID PROGRAM NAMES
North Carolina (NC)
1

Medicaid

Created on 11/05/2018

1

HI4
MEDICAID HMOs
North Carolina (NC)
1

North Carolina Community Care Carolina Access

2

Cardinal Innovations Healthcare Sol

3

Voans Senior Community Care Of Nort

4

Partners Behavioral Health Manag

5

Life St Joseph Of The Pines Inc

6

Alliance Behavioral Healthcare

7

Sandhills Center For Mh Dd Sa

8

Pace Of The Southern Piedmont

9

Community Carepartners, Inc.

10

Piedmont Health Services Inc

11

Senior Total Life Care, Inc.

12

Eastpointe Human Services
(continued)

Created on 11/05/2018

2

HI4
MEDICAID HMOs
North Carolina (NC)
13

Trillium Health Resources

14

Stay Well Senior Care

15

Carolina Seniorcare

16

Pace Of The Triad

17

Pace At Home Inc

18

Elderhaus Inc

19

Vaya Health

Created on 11/05/2018

1

HI5
HEALTHCARE MARKETPLACE PLANS
North Carolina (NC)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
1

Ambetter Balanced Care (Ambetter of North
Carolina Inc.)

2

Ambetter Essential Care (Ambetter of North
Carolina Inc.)

3

Ambetter Secure Care Free PCP Visits (Ambetter
of North Carolina Inc.)

4

Blue Advantage [Tier] broad network (Blue Cross
and Blue Shield of NC)

5

Blue Local [Tier] local network Atrium Health
(Blue Cross and Blue Shield of NC)

6

Blue Select [Tier] tiered network (Blue Cross and
Blue Shield of NC)

7

Blue Value [Tier] limited network (Blue Cross and
Blue Shield of NC)
(continued)

Created on 11/05/2018

2

HI5
HEALTHCARE MARKETPLACE PLANS
North Carolina (NC)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
8 Blue Value [Tier] limited network UNC Health Alliance
(Blue Cross and Blue Shield of NC)
9 Cigna Connect (Cigna HealthCare of North Carolina,
Inc.)

Created on 11/05/2018

1

HI6
PUBLIC ASSISTANCE PLANS
North Carolina (NC)
1 Med-assist
2 North Carolina AIDS Drug Assistance Program
3 Premium Assistance Program

Created on 11/05/2018

1

HI2
MEDICARE ADVANTAGE PLANS
North Dakota (ND)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
1 HealthPartners Sanford (HealthPartners)
2 Humana Gold Choice (Humana)
3 Humana Value Plus (Humana)
4 HumanaChoice (Humana)
5 Lasso Healthcare (Lasso Healthcare)
6 Medica Prime Solution (Medica Insurance Company)

Created on 11/05/2018

1

HI3
MEDICAID PROGRAM NAMES
North Dakota (ND)
1

Medicaid

Created on 11/05/2018

1

HI4
MEDICAID HMOs
North Dakota (ND)
1 ND Medicaid Expansion - Sanford Health Plan
2 Multiple Primary Care Providers
3 Health Management
4 PACE

Created on 11/05/2018

1

HI5
HEALTHCARE MARKETPLACE PLANS
North Dakota (ND)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
1

Altru Prime by Medica [Tier] (Medica Health
Plans)

2

Altru Prime by Medica [Tier] H S (Medica Health
Plans)

3

Altru Prime by Medica [Tier] H SPlus (Medica
Health Plans)

4

BlueCare [Tier] (Blue Cross Blue Shield of North
Dakota)

5

BlueDirect [Tier] (Blue Cross Blue Shield of North
Dakota)

6

BlueEssential (Blue Cross Blue Shield of North
Dakota)

7

Medica Individual Choice Catastophic (Medica
Health Plans)
(continued)

Created on 11/05/2018

2

HI5
HEALTHCARE MARKETPLACE PLANS
North Dakota (ND)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
8

Medica Individual Choice [Tier] (Medica Health
Plans)

9

Medica Individual Choice [Tier] Plus (Medica Health
Plans)

10 Sanford Simplicity (Sanford Health Plan)
11 Sanford Simplicity HDHP (Sanford Health Plan)
12 Sanford TRUE (Sanford Health Plan)
13 Sanford TRUE HDHP (Sanford Health Plan)
14 SimplyBlue (Blue Cross Blue Shield of North
Dakota)

Created on 11/05/2018

1

HI6
PUBLIC ASSISTANCE PLANS
North Dakota (ND)
1 AIDS Drug Assistance Program
2 Prescription Connection for North Dakota

Created on 11/05/2018

1

HI2
MEDICARE ADVANTAGE PLANS
Nebraska (NE)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
1

Advantra Silver (Aetna Medicare)

2

Total Care (Aetna Medicare)

3

Blue Cross Blue Shield Nebraska MA (Blue
Cross and Blue Shield of Nebraska)

4

Coventry Advantra (Coventry Health Care)

5

Humana Gold Plus (Humana)

6

Humana Value Plus (Humana)

7

HumanaChoice (Humana)

8

Medica Prime Solution (Medica Insurance
Company)

9

AARP MedicareComplete (UnitedHealthcare)
(continued)

Created on 11/05/2018

2

HI2
MEDICARE ADVANTAGE PLANS
Nebraska (NE)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
10 AARP MedicareComplete Choice (UnitedHealthcare)
11 UnitedHealthcare MedicareDirect (UnitedHealthcare)

Created on 11/05/2018

1

HI3
MEDICAID PROGRAM NAMES
Nebraska (NE)
1

Medicaid

Created on 11/05/2018

1

HI4
MEDICAID HMOs
Nebraska (NE)
1 Coventry Health Care of Nebraska (D.B.A. Aetna)
2 Amerihealth Caritas (D.B.A. Arbor Health Plan)
3 United Health Care of Nebraska
4 Immanuel Pathways
5 Magellan Health

Created on 11/05/2018

1

HI5
HEALTHCARE MARKETPLACE PLANS
Nebraska (NE)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
1 Elevate by Medica [Tier] (Medica Insurance
Company)
2 Elevate by Medica [Tier] Plus (Medica Insurance
Company)
3 Elevate by Medica [Tier] Share (Medica Insurance
Company)
4 Medica CHI Health [Tier] (Medica Insurance
Company)
5 Medica CHI Health [Tier] Plus (Medica Insurance
Company)
6 Medica Insure [Tier] (Medica Insurance Company)
7 Medica Insure [Tier] Plus (Medica Insurance
Company)

Created on 11/05/2018

1

HI6
PUBLIC ASSISTANCE PLANS
Nebraska (NE)
1

AIDS Drug Assistance Program

Created on 11/05/2018

1

HI2
MEDICARE ADVANTAGE PLANS
New Hampshire (NH)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
1

Aetna Medicare Freedom (Aetna Medicare)

2

Anthem MediBlue (Anthem Blue Cross and Blue
Shield)

3

Anthem MediBlue Access (Anthem Blue Cross
and Blue Shield)

4

Harvard Pilgrim Stride (Harvard Pilgrim Health
Care of New England, Inc.)

5

Humana (Humana)

6

HumanaChoice (Humana)

7

Martin's Point Generations Advantage (Martin's
Point Generations Advantage)

8

Martin's Point Generations Advantage Flex
(Martin's Point Generations Advantage)
(continued)

Created on 11/05/2018

2

HI2
MEDICARE ADVANTAGE PLANS
New Hampshire (NH)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
9

Martin's Point Generations Advantage Select
(Martin's Point Generations Advantage)

10 AARP MedicareComplete Choice (UnitedHealthcare)
11 AARP MedicareComplete Plan (UnitedHealthcare)
12 UnitedHealthcare MedicareComplete Assure
(UnitedHealthcare)
13 UnitedHealthcare MedicareDirect (UnitedHealthcare)

Created on 11/05/2018

1

HI3
MEDICAID PROGRAM NAMES
New Hampshire (NH)
1

New Hampshire Medicaid

Created on 11/05/2018

1

HI4
MEDICAID HMOs
New Hampshire (NH)
1

New Hampshire Healthy Families

2

New Hampshire Healthy Families

3

Well Sense

4

Well Sense

Created on 11/05/2018

1

HI5
HEALTHCARE MARKETPLACE PLANS
New Hampshire (NH)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
1 Ambetter Balanced Care (Celtic Insurance Company)
2 Ambetter Secure Care Free PCP Visits (Celtic
Insurance Company)
3 Anthem [Tier] Pathway X Enhanced (Matthew
Thornton Hlth Plan(Anthem BCBS))
4 Anthem [Tier] Pathway X Enhanced for (Matthew
Thornton Hlth Plan(Anthem BCBS))
5 ElevateHealth [Tier] (Harvard Pilgrim Health Care of
NE)

Created on 11/05/2018

1

HI6
PUBLIC ASSISTANCE PLANS
New Hampshire (NH)
1

AIDS Drug Assistance Program

2

New Hampshire Rx Card

Created on 11/05/2018

1

HI2
MEDICARE ADVANTAGE PLANS
New Jersey (NJ)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
1

Aetna Medicare (Aetna Medicare)

2

Aetna Medicare NJ Silver Plan (Aetna Medicare)

3

Amerivantage (Amerigroup Community Care)

4

Clover Health (Clover Health)

5

Clover Health Choice (Clover Health)

6

Horizon Medicare Blue (Horizon Blue Cross Blue
Shield of New Jersey)

7

Humana Value Plus (Humana)

8

HumanaChoice (Humana)

9

Psers Health Options Program (Employer Pdp)
(Psers Hop Program)
(continued)

Created on 11/05/2018

2

HI2
MEDICARE ADVANTAGE PLANS
New Jersey (NJ)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
10 AARP MedicareComplete (UnitedHealthcare)
11 Erickson Advantage (UnitedHealthcare)
12 WellCare (WellCare)

Created on 11/05/2018

1

HI3
MEDICAID PROGRAM NAMES
New Jersey (NJ)
1

New Jersey FamilyCare

Created on 11/05/2018

1

HI4
MEDICAID HMOs
New Jersey (NJ)
1

LIFE (Living Independently For Elders) St.
Francis

2

UnitedHealthcare Dual Complete ONE

3

UnitedHealthcare Community Plan

4

Amerivantage Dual Coordination

5

WellCare Liberty D-SNP

6

Aetna Better Health NJ

7

WellCare of New Jersey

8

Amerigroup New Jersey

9

Lutheran Senior LIFE

10

Horizon NJ Health

11

LIFE at Lourdes

12

Beacon of LIFE
(continued)

Created on 11/05/2018

2

HI4
MEDICAID HMOs
New Jersey (NJ)
13

Inspira LIFE

14

Logisticare

Created on 11/05/2018

1

HI5
HEALTHCARE MARKETPLACE PLANS
New Jersey (NJ)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
1

Horizon Advantage Essentials (Horizon
Healthcare Services, Inc.)

2

Horizon Advantage [Tier] (Horizon Healthcare
Services, Inc.)

3

IHC Local Value Simple Saver (AmeriHealth Ins
Company of New Jersey)

4

IHC [Tier] AmeriHealth Advantage (AmeriHealth
Ins Company of New Jersey)

5

IHC [Tier] AmeriHealth Hospital Advantage
(AmeriHealth Ins Company of New Jersey)

6

IHC [Tier] Local Value (AmeriHealth HMO, Inc.)

7

IHC [Tier] Local Value (AmeriHealth Ins
Company of New Jersey)
(continued)

Created on 11/05/2018

2

HI5
HEALTHCARE MARKETPLACE PLANS
New Jersey (NJ)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
8

IHC [Tier] Regional Preferred (AmeriHealth HMO,
Inc.)

9

IHC [Tier] Regional Preferred (AmeriHealth Ins
Company of New Jersey)

10

IHC [Tier] Regional Preferred Coins (AmeriHealth
Ins Company of New Jersey)

11

OMNIA [Tier] (Horizon Healthcare Services, Inc.)

12

Oscar Classic [Tier] (Oscar Garden State
Insurance Corporation)

13

Oscar Classic [Tier] Option (Oscar Garden State
Insurance Corporation)

14

Oscar Saver [Tier] (Oscar Garden State
Insurance Corporation)
(continued)

Created on 11/05/2018

3

HI5
HEALTHCARE MARKETPLACE PLANS
New Jersey (NJ)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
15 Oscar Simple Secure (Oscar Garden State
Insurance Corporation)

Created on 11/05/2018

1

HI6
PUBLIC ASSISTANCE PLANS
New Jersey (NJ)
1 AIDS Drug Distribution Program
2 Hospital Care Payment Assistance Program
3 NJ WorkAbility
4 New Jersey Pharmaceutical Assistance for the Aged
and Disabled (PAAD)
5 New Jersey Senior Gold Prescription Discount
Program

Created on 11/05/2018

1

HI2
MEDICARE ADVANTAGE PLANS
New Mexico (NM)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
1

Aetna Medicare Choice Plan (Aetna Medicare)

2

Amerivantage Classic (Amerigroup Community
Care of New Mexico)

3

Blue Cross Medicare Advantage Basic (Blue
Cross and Blue Shield of IL, NM)

4

Blue Cross Medicare Advantage Choice Plus
(Blue Cross and Blue Shield of IL, NM)

5

Blue Cross Medicare Advantage Select (Blue
Cross and Blue Shield of New Mexico)

6

CHRISTUS Health Plan Generations (CHRISTUS
Health Plan Generations)

7

Humana Gold Choice (Humana)

8

Humana Gold Plus (Humana)
(continued)

Created on 11/05/2018

2

HI2
MEDICARE ADVANTAGE PLANS
New Mexico (NM)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
9

Humana Value Plus (Humana)

10 HumanaChoice (Humana)
11 Presbyterian Senior Care Plan (Presbyterian Health
Plan)
12 Presbyterian MediCare PPO Plan (Presbyterian
Insurance Company, Inc.)
13 AARP MedicareComplete (UnitedHealthcare)
14 AARP MedicareComplete Choice (UnitedHealthcare)
15 UnitedHealthcare MedicareComplete Assure
(UnitedHealthcare)

Created on 11/05/2018

1

HI3
MEDICAID PROGRAM NAMES
New Mexico (NM)
1

Medicaid

Created on 11/05/2018

1

HI4
MEDICAID HMOs
New Mexico (NM)
1 Innovage Greater New Mexico PACE dba Total
Community Care
2 Molina Healthcare of New Mexico Inc
3 UnitedHealthcare Community Plan
4 Blue Cross Blue Shield of NM
5 Presbyterian Health Plan

Created on 11/05/2018

1

HI5
HEALTHCARE MARKETPLACE PLANS
New Mexico (NM)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
1

Blue Community Security (Blue Cross Blue
Shield of New Mexico)

2

Blue Community [Tier] (Blue Cross Blue Shield of
New Mexico)

3

Blue Community [Tier] Three PCP Visits (Blue
Cross Blue Shield of New Mexico)

4

Blue Community [Tier] Two PCP Visits (Blue
Cross Blue Shield of New Mexico)

5

Care Connect HDHP [Tier] (New Mexico Health
Connections)

6

Care Connect [Tier] (New Mexico Health
Connections)

7

Care Connect [Tier] Essential (New Mexico
Health Connections)
(continued)

Created on 11/05/2018

2

HI5
HEALTHCARE MARKETPLACE PLANS
New Mexico (NM)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
8

Care Connect [Tier] Plus (New Mexico Health
Connections)

9

Molina [Tier] (Molina Healthcare of New Mexico,
Inc.)

10 New Mexico [Tier] (CHRISTUS Health Plan)
11 New Mexico [Tier] HD (CHRISTUS Health Plan)
12 New Mexico [Tier] LD (CHRISTUS Health Plan)
13 New Mexico [Tier] S (CHRISTUS Health Plan)
14 New Mexico [Tier] SLD (CHRISTUS Health Plan)

Created on 11/05/2018

1

HI6
PUBLIC ASSISTANCE PLANS
New Mexico (NM)
1 New Mexico Department of Health AIDS Drug
Assistance Program

Created on 11/05/2018

1

HI2
MEDICARE ADVANTAGE PLANS
Nevada (NV)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
1

Aetna Medicare (Aetna Medicare)

2

Anthem (Anthem Blue Cross and Blue Shield)

3

Humana Gold Plus (Humana)

4

HumanaChoice (Humana)

5

Prominence Plus (Prominence Health Plan)

6

SelectHealth Advantage Essential (SelectHealth)

7

Senior Care Plus: Freedom (Senior Care Plus)

8

Senior Care Plus: Value (Senior Care Plus)

9

AARP MedicareComplete (UnitedHealthcare)
(continued)

Created on 11/05/2018

2

HI2
MEDICARE ADVANTAGE PLANS
Nevada (NV)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
10 UnitedHealthcare Medicare Focus
(UnitedHealthcare)

Created on 11/05/2018

1

HI3
MEDICAID PROGRAM NAMES
Nevada (NV)
1

Medicaid

Created on 11/05/2018

1

HI4
MEDICAID HMOs
Nevada (NV)
1 Medical Transportation Management, Inc (MTM)
2 Amerigroup Community Care (AGP)
3 Health Plan of Nevada (HPN)
4 Axis Point Health

Created on 11/05/2018

1

HI5
HEALTHCARE MARKETPLACE PLANS
Nevada (NV)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
1 Ambetter Balanced Care (SilverSummit Healthplan,
Inc.)
2 Ambetter Essential Care (SilverSummit Healthplan,
Inc.)
3 Ambetter Secure Care Free PCP Visits (SilverSummit
Healthplan, Inc.)
4 MyHPN [Tier] (Health Plan of Nevada, Inc.)
5 MyHPN [Tier] Transition (Health Plan of Nevada, Inc.)

Created on 11/05/2018

1

HI6
PUBLIC ASSISTANCE PLANS
Nevada (NV)
1

Nevada Disability Rx

2

Nevada Senior Rx

3

Ryan White Part B Program

Created on 11/05/2018

1

HI2
MEDICARE ADVANTAGE PLANS
New York (NY)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
1

Aetna Medicare (Aetna Medicare)

2

Aetna Medicare Value Plan (Aetna Medicare)

3

Affinity Medicare Passport Essentials (Affinity
Health Plan)

4

BlueCross BlueShield (BlueCross BlueShield of
WNY and BlueShield of NEN)

5

BlueCross BlueShield Forever Blue (BlueCross
BlueShield of WNY and BlueShield of NEN)

6

BlueShield (BlueCross BlueShield of WNY and
BlueShield of NEN)

7

BlueShield Forever Blue (BlueCross BlueShield
of WNY and BlueShield of NEN)

8

CDPHP (CDPHP Medicare Advantage)
(continued)

Created on 11/05/2018

2

HI2
MEDICARE ADVANTAGE PLANS
New York (NY)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
9

Elderplan Extra Help (Elderplan)

10

EmblemHealth VIP (EmblemHealth Medicare
HMO)

11

Empire MediBlue (Empire BlueCross BlueShield)

12

Medicare (Excellus Health Plan, Inc)

13

Univera SeniorChoice (Excellus Health Plan, Inc)

14

Fidelis Medicare (Fidelis Legacy Plan)

15

Healthfirst (Healthfirst Medicare Plan)

16

Humana Gold Plus (Humana)

17

Independent (Independent Health)
(continued)

Created on 11/05/2018

3

HI2
MEDICARE ADVANTAGE PLANS
New York (NY)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
18 Gold PPO with Part D (MVP HEALTH CARE)
19 GoldSecure with Part D (MVP HEALTH CARE)
20 GoldValue with Part D (MVP HEALTH CARE)
21 Preferred Gold (MVP HEALTH CARE)
22 WellSelect with Part D (MVP HEALTH CARE)
23 AARP MedicareComplete (UnitedHealthcare)
24 UnitedHealthcare MedicareComplete Choice
(UnitedHealthcare)
25 WellCare Today's Options Advantage (WellCare)
26 WellCare Today's Options Premier (WellCare)

Created on 11/05/2018

1

HI3
MEDICAID PROGRAM NAMES
New York (NY)
1

New York Medicaid

Created on 11/05/2018

1

HI4
MEDICAID HMOs
New York (NY)
1

Capital District Physician's Health Plan

2

Capital District Physician's Health Plan

3

Independent Health/Hudson Valley & WNY

4

Metroplus Health Plan Special Needs

5

NYS Catholic Health Plan/Fidelis

6

NYS Catholic Health Plan/Fidelis

7

NYS Catholic Health Plan/Fidelis

8

Centers Plan for Healthy Living

9

Independent Health Association

10

Independent Living for Seniors

11

Health Advantage/Elant Choice

12

North Shore - LIJ Health Plan

13

Healthplus Advantage Plus
(continued)

Created on 11/05/2018

2

HI4
MEDICAID HMOs
New York (NY)
14

VNS Choice Special Needs

15

Liberty Health Advantage

16

NYS Catholic Health Plan

17

Independent Care Systems

18

Amidacare Special Needs

19

Crystal Run Health Plan

20

HIP of Greater New York

21

HIP of Greater New York

22

HIP of Greater New York

23

Archcare Community Life

24

HIP of Greater New York

25

Fallon Health Weinberg

26

Senior Health Partners
(continued)

Created on 11/05/2018

3

HI4
MEDICAID HMOs
New York (NY)
27

Catholic Health - Life

28

Fallon Health Weinberg

29

Metroplus Health Plan

30

Senior Network Health

31

Affinity Health Plan

32

Excellus Health Plan

33

Yourcare Health Plan

34

Affinity Health Plan

35

Excellus Health Plan

36

Yourcare Health Plan

37

Fidelis Care at Home

38

VNA Homecare Options

39

ArchCare Senior Life
(continued)

Created on 11/05/2018

4

HI4
MEDICAID HMOs
New York (NY)
40

Complete Senior Care

41

Touchstone/Prestige

42

Senior Whole Health

43

Aetna Better Health

44

Prime Health Choice

45

Senior Whole Health

46

Hudson Health Plan

47

Centerlight Select

48

United Healthcare

49

United Healthcare

50

United Healthcare

51

Kalos Health Plan

52

United Healthcare
(continued)

Created on 11/05/2018

5

HI4
MEDICAID HMOs
New York (NY)
53

Wellcare Advocate

54

Centerlight (CCM)

55

Total Senior Care

56

Agewell New York

57

Eddy Senior Care

58

MVP Health Plan

59

Today's Options

60

MVP Health Plan

61

Today's Options

62

VNS Choice Plus

63

Hamaspik Choice

64

Montefiore HMO

65

Extended MLTC
(continued)

Created on 11/05/2018

6

HI4
MEDICAID HMOs
New York (NY)
66

HIP Combined

67

Icircle Care

68

Village Care

69

Healthfirst

70

Healthfirst

71

Healthfirst

72

Healthplus

73

VNS Choice

74

Healthplus

75

Elderserve

76

Healthplus

77

VNS Choice

78

Healthnow
(continued)

Created on 11/05/2018

7

HI4
MEDICAID HMOs
New York (NY)
79

Metroplus

80

Metroplus

81

Elderplan

82

Alphacare

83

Elderplan

84

Elderwood

85

Metroplus

86

Wellcare

87

Wellcare

88

Affinity

89

Guildnet

90

Guildnet

91

PACE CNY
(continued)

Created on 11/05/2018

8

HI4
MEDICAID HMOs
New York (NY)
92

Integra

Created on 11/05/2018

1

HI5
HEALTHCARE MARKETPLACE PLANS
New York (NY)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
1 Only state-operated exchanges serve New York

Created on 11/05/2018

1

HI6
PUBLIC ASSISTANCE PLANS
New York (NY)
1 AIDS Drug Assistance Program
2 New York Elderly Pharmaceutical Insurance
Coverage (EPIC)

Created on 11/05/2018

1

HI2
MEDICARE ADVANTAGE PLANS
Ohio (OH)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
1

Aetna Medicare (Aetna Medicare)

2

Aetna Medicare OH Connect Gold (Aetna
Medicare)

3

Allwell Medicare (Allwell)

4

Anthem MediBlue (Anthem Blue Cross and Blue
Shield)

5

Anthem MediBlue Access (Anthem Blue Cross
and Blue Shield)

6

Bright Advantage (Bright Health)

7

Bright Advantage Flex (Bright Health)

8

CareSource Advantage (CareSource)

9

Advantra Silver (Coventry Health Care)
(continued)

Created on 11/05/2018

2

HI2
MEDICARE ADVANTAGE PLANS
Ohio (OH)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
10

Reid Health Alliance Medicare HMO (Health
Alliance Medicare)

11

Humana (Humana)

12

Humana Gold Choice (Humana)

13

Humana Value Plus (Humana)

14

HumanaChoice (Humana)

15

MediGold (MediGold)

16

MediGold Flexible Choice (MediGold)

17

MedMutual Advantage (Medical Mutual of Ohio)

18

MeridianCare (MeridianCare)
(continued)

Created on 11/05/2018

3

HI2
MEDICARE ADVANTAGE PLANS
Ohio (OH)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
19

Mutual of Omaha CareAdvantage (Mutual of
Omaha Medicare Advantage Company)

20

Paramount Elite (Paramount Elite)

21

PrimeTime Health Plan (PrimeTime Health Plan)

22

SummaCare Medicare (SummaCare Medicare
Advantage Plans)

23

The Health Plan SecureCare - Option (The
Health Plan)

24

The Health Plan SecureChoice - Option II (The
Health Plan)

25

UPMC for Life (UPMC Health Plan)

26

AARP MedicareComplete Choice
(UnitedHealthcare)
(continued)

Created on 11/05/2018

4

HI2
MEDICARE ADVANTAGE PLANS
Ohio (OH)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
27 AARP MedicareComplete Plan (UnitedHealthcare)

Created on 11/05/2018

1

HI3
MEDICAID PROGRAM NAMES
Ohio (OH)
1

Ohio Medicaid

Created on 11/05/2018

1

HI4
MEDICAID HMOs
Ohio (OH)
1 United Healthcare Community Plan of Ohio
2 Molina Healthcare of Ohio
3 Buckeye Health Plan
4 Paramount Advantage
5 McGregor PACE
6 CareSource

Created on 11/05/2018

1

HI5
HEALTHCARE MARKETPLACE PLANS
Ohio (OH)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
1

Ambetter Balanced Care (Buckeye Community
Health Plan)

2

Ambetter Secure Care Free PCP Visits (Buckeye
Community Health Plan)

3

Anthem [Tier] Pathway X (Community Insurance
Company(Anthem BCBS))

4

Anthem [Tier] Pathway X Online Plus
(Community Insurance Company(Anthem
BCBS))

5

Anthem [Tier] Pathway X for (Community
Insurance Company(Anthem BCBS))

6

AultCare [Tier] (AultCare Insurance Company)

7

AultCare [Tier] Select (AultCare Insurance
Company)
(continued)

Created on 11/05/2018

2

HI5
HEALTHCARE MARKETPLACE PLANS
Ohio (OH)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
8

AultCare [Tier] Standard Select (AultCare
Insurance Company)

9

CareSource Marketplace Low Deductible [Tier]
(CareSource)

10

CareSource Marketplace Low Deductible [Tier]
Dental and (CareSource)

11

CareSource Marketplace Low Premium [Tier]
(CareSource)

12

CareSource Marketplace Low Premium [Tier]
Dental and (CareSource)

13

CareSource Marketplace Standard [Tier]
(CareSource)

14

CareSource Marketplace Standard [Tier] Dental
and (CareSource)
(continued)

Created on 11/05/2018

3

HI5
HEALTHCARE MARKETPLACE PLANS
Ohio (OH)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
15

CareSource Marketplace [Tier] (CareSource)

16

CareSource Marketplace [Tier] Dental and
(CareSource)

17

Classic [Tier] (Oscar Buckeye State Insurance
Corp.)

18

Classic [Tier] (Oscar Insurance Corporation of
Ohio)

19

Market Dayton (Medical Health Insuring Corp. of
Ohio)

20

Market Mercy (Medical Health Insuring Corp. of
Ohio)

21

Market NE Ohio (Medical Health Insuring Corp. of
Ohio)
(continued)

Created on 11/05/2018

4

HI5
HEALTHCARE MARKETPLACE PLANS
Ohio (OH)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
22

Market OhioHealth (Medical Health Insuring
Corp. of Ohio)

23

Market ProMedica (Medical Health Insuring Corp.
of Ohio)

24

Market Young Adult Essentials Dayton (Medical
Health Insuring Corp. of Ohio)

25

Market Young Adult Essentials Mercy (Medical
Health Insuring Corp. of Ohio)

26

Market Young Adult Essentials NE Ohio (Medical
Health Insuring Corp. of Ohio)

27

Market Young Adult Essentials OhioHealth
(Medical Health Insuring Corp. of Ohio)

28

Market Young Adult Essentials ProMedica
(Medical Health Insuring Corp. of Ohio)
(continued)

Created on 11/05/2018

5

HI5
HEALTHCARE MARKETPLACE PLANS
Ohio (OH)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
29

Molina [Tier] (Molina Healthcare of Ohio, Inc.)

30

Paramount [Tier] (Paramount Insurance
Company)

31

Saver [Tier] (Oscar Buckeye State Insurance
Corp.)

32

Saver [Tier] (Oscar Insurance Corporation of
Ohio)

33

Simple Secure (Oscar Buckeye State Insurance
Corp.)

34

Simple Secure (Oscar Insurance Corporation of
Ohio)

35

Simple [Tier] (Oscar Buckeye State Insurance
Corp.)
(continued)

Created on 11/05/2018

6

HI5
HEALTHCARE MARKETPLACE PLANS
Ohio (OH)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
36 Simple [Tier] (Oscar Insurance Corporation of Ohio)
37 SummaCare Value SCConnect Network and Free
PCP Visits (Summa Insurance Company, Inc.)
38 SummaCare [Tier] SCConnect Network (Summa
Insurance Company, Inc.)
39 SummaCare [Tier] SCConnect Network and Free
PCP Visits (Summa Insurance Company, Inc.)
40 SummaCare [Tier] SCConnect and Free PCP Visits
(Summa Insurance Company, Inc.)

Created on 11/05/2018

1

HI6
PUBLIC ASSISTANCE PLANS
Ohio (OH)
1 Ohio HIV Drug Assistance Program (OHDAP)
2 Ohio Healthy Families
3 Ohio's Best Rx

Created on 11/05/2018

1

HI2
MEDICARE ADVANTAGE PLANS
Oklahoma (OK)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
1

Blue Cross Medicare Advantage Basic (Blue
Cross and Blue Shield of OK)

2

Advantage (CommunityCare Advantage
Medicare Plan (HMO))

3

Senior Health Plan (CommunityCare Senior
Health Plan (HMO))

4

Advantra Freedom (Coventry Health Care)

5

Select Advantage (Coventry Health Care)

6

Total Care (Coventry Health Care)

7

Generations (GlobalHealth)

8

Humana (Humana)

9

Humana Gold Choice (Humana)
(continued)

Created on 11/05/2018

2

HI2
MEDICARE ADVANTAGE PLANS
Oklahoma (OK)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
10 Humana Value Plus (Humana)
11 HumanaChoice (Humana)
12 AARP MedicareComplete Choice (UnitedHealthcare)
13 AARP MedicareComplete SecureHorizons Plan
(UnitedHealthcare)
14 UnitedHealthcare MedicareDirect (UnitedHealthcare)

Created on 11/05/2018

1

HI3
MEDICAID PROGRAM NAMES
Oklahoma (OK)
1

SoonerCare

Created on 11/05/2018

1

HI4
MEDICAID HMOs
Oklahoma (OK)
1

Multiple Primary Care Providers

2

Cherokee Elder Care (CEC)

3

SoonerRide

4

Valir PACE

5

Life PACE

Created on 11/05/2018

1

HI5
HEALTHCARE MARKETPLACE PLANS
Oklahoma (OK)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
1

Blue Advantage [Tier] (Blue Cross Blue Shield of
Oklahoma)

2

Blue Preferred Security (Blue Cross Blue Shield
of Oklahoma)

3

Blue Preferred [Tier] (Blue Cross Blue Shield of
Oklahoma)

4

Harmony by Medica [Tier] (Medica Insurance
Company)

5

Harmony by Medica [Tier] H S (Medica Insurance
Company)

6

Harmony by Medica [Tier] H SPlus (Medica
Insurance Company)

7

Harmony by Medica [Tier] Share (Medica
Insurance Company)
(continued)

Created on 11/05/2018

2

HI5
HEALTHCARE MARKETPLACE PLANS
Oklahoma (OK)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
8

Medica Quest [Tier] (Medica Insurance Company)

9

Medica Quest [Tier] H S (Medica Insurance
Company)

10 Medica Quest [Tier] H SPlus (Medica Insurance
Company)
11 Medica Quest [Tier] Share (Medica Insurance
Company)

Created on 11/05/2018

1

HI6
PUBLIC ASSISTANCE PLANS
Oklahoma (OK)
1

HIV Drug Assistance Program

2

Insure Oklahoma

3

Rx for Oklahoma

Created on 11/05/2018

1

HI2
MEDICARE ADVANTAGE PLANS
Oregon (OR)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
1

ATRIO (ATRIO Health Plans)

2

Aetna Medicare (Aetna Medicare)

3

AllCare Advantage (AllCare Advantage)

4

Health Net Ruby (Health Net Health Plan of
Oregon, Inc.)

5

Health Net (Health Net Life Insurance Company)

6

Humana Gold Plus (Humana)

7

HumanaChoice (Humana)

8

Kaiser Permanente Senior Advantage (Kaiser
Permanente)

9

Moda Health (Moda Health Plan, Inc.)
(continued)

Created on 11/05/2018

2

HI2
MEDICARE ADVANTAGE PLANS
Oregon (OR)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
10

Moda Health HMO (Moda Health Plan, Inc.)

11

PacificSource Medicare (PacificSource Medicare)

12

PacificSource Medicare Explorer (PacificSource
Medicare)

13

Providence Medicare (Providence Health
Assurance)

14

Regence BlueAdvantage HMO (Regence
BlueCross BlueShield of Oregon)

15

Regence MedAdvantage (Regence BlueCross
BlueShield of Oregon)

16

Samaritan Advantage (Samaritan Advantage
Health Plan)
(continued)

Created on 11/05/2018

3

HI2
MEDICARE ADVANTAGE PLANS
Oregon (OR)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
17 AARP MedicareComplete Choice (UnitedHealthcare)
18 AARP MedicareComplete Plan (UnitedHealthcare)

Created on 11/05/2018

1

HI3
MEDICAID PROGRAM NAMES
Oregon (OR)
1

Oregon HealthCare

Created on 11/05/2018

1

HI4
MEDICAID HMOs
Oregon (OR)
1

PacificSource Community Solutions - Central
Oregon

2

PacificSource Community Solutions - Columbia
Gorge

3

Greater Oregon Behavioral Health, Inc.

4

Willamette Valley Community Health

5

PrimaryHealth of Josephine County

6

Trillium Community Health Plan

7

Western Oregon Advanced Health

8

Managed Dental Care of Oregon

9

InterCommunity Health Network

10

Advantage Dental Services

11

Capitol Dental Care, Inc.

12

ODS Community Health Inc.
(continued)

Created on 11/05/2018

2

HI4
MEDICAID HMOs
Oregon (OR)
13

Access Dental Plan, LLC

14

Cascade Health Alliance

15

Umpqua Health Alliance

16

Yamhill Community Care

17

Providence Elder Place

18

HealthShare of Oregon

19

Jackson Care Connect

20

AllCare Health Plan

21

Family Dental Care

22

Eastern Oregon CCO

23

CareOregon Dental

24

Columbia Pacific

25

FamilyCare

Created on 11/05/2018

1

HI5
HEALTHCARE MARKETPLACE PLANS
Oregon (OR)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
1

BridgeSpan Standard [Tier] OHSU Plus
(BridgeSpan Health Company)

2

Connect [Tier] (Providence Health Plan)

3

KP OR [Tier] (Kaiser Foundation Healthplan of
the NW)

4

KP Oregon Standard [Tier] (Kaiser Foundation
Healthplan of the NW)

5

Legacy [Tier] (PacificSource Health Plans)

6

Moda Health Beacon [Tier] (Moda Health Plan,
Inc.)

7

Moda Health Cornerstone [Tier] (Moda Health
Plan, Inc.)
(continued)

Created on 11/05/2018

2

HI5
HEALTHCARE MARKETPLACE PLANS
Oregon (OR)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
8

Moda Health Oregon Standard [Tier] Affinity
(Moda Health Plan, Inc.)

9

Moda Health Oregon Standard [Tier] Beacon
(Moda Health Plan, Inc.)

10

PacificSource Oregon Standard [Tier] LHN
(PacificSource Health Plans)

11

PacificSource Oregon Standard [Tier] SCN
(PacificSource Health Plans)

12

Providence Oregon Standard [Tier] Choice
Network (Providence Health Plan)

13

Providence Oregon Standard [Tier] Signature
Network (Providence Health Plan)

14

Qualified [Tier] Choice Network (Providence
Health Plan)
(continued)

Created on 11/05/2018

3

HI5
HEALTHCARE MARKETPLACE PLANS
Oregon (OR)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
15 Qualified [Tier] Signature Network (Providence
Health Plan)
16 SmartChoice [Tier] (PacificSource Health Plans)
17 [Tier] Essential OHSU Plus (BridgeSpan Health
Company)
18 [Tier] HDHP OHSU Plus (BridgeSpan Health
Company)

Created on 11/05/2018

1

HI6
PUBLIC ASSISTANCE PLANS
Oregon (OR)
1 CAREAssist
2 Oregon Prescription Drug Program (OPDP)
3 Oregon Senior Prescription Drug Assistance Program
(SPDAP)

Created on 11/05/2018

1

HI2
MEDICARE ADVANTAGE PLANS
Pennsylvania (PA)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
1

Aetna Medicare (Aetna Medicare)

2

Allwell Medicare (Allwell)

3

BlueJourney (Capital Advantage Insurance
Company)

4

Cigna-HealthSpring (Cigna-HealthSpring)

5

Clover Health Choice (Clover Health)

6

Advantra (Coventry Health Care)

7

AdvantraOne (Coventry Health Care)

8

Geisinger Gold Classic (Geisinger Gold)

9

Geisinger Gold Preferred (Geisinger Gold)
(continued)

Created on 11/05/2018

2

HI2
MEDICARE ADVANTAGE PLANS
Pennsylvania (PA)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
10

Health Partners Medicare Prime (Health Partners
Medicare)

11

Community Blue Medicare HMO (Highmark
Choice Company)

12

Security Blue HMO-POS (Highmark Choice
Company)

13

Community Blue Medicare (Highmark Senior
Health Company)

14

Freedom Blue PPO (Highmark Senior Health
Company)

15

Humana Gold Choice (Humana)

16

Humana Gold Plus (Humana)

17

Humana Value Plus (Humana)
(continued)

Created on 11/05/2018

3

HI2
MEDICARE ADVANTAGE PLANS
Pennsylvania (PA)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
18

HumanaChoice (Humana)

19

Keystone 65 (Keystone 65 HMO)

20

Lasso Healthcare (Lasso Healthcare)

21

Personal Choice 65 (Personal Choice 65 PPO)

22

Psers Health Options Program (Employer Pdp)
(Psers Hop Program)

23

Sunrise Advantage Plan (Sunrise Advantage Plan
(HMO SNP))

24

UPMC for Life (UPMC Health Plan)

25

UPMC for Life PPO (UPMC Health Plan)

26

AARP MedicareComplete (UnitedHealthcare)
(continued)

Created on 11/05/2018

4

HI2
MEDICARE ADVANTAGE PLANS
Pennsylvania (PA)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
27 AARP MedicareComplete Choice (UnitedHealthcare)
28 Erickson Advantage (UnitedHealthcare)
29 Vibra Health Plan (Vibra Health Plan)

Created on 11/05/2018

1

HI3
MEDICAID PROGRAM NAMES
Pennsylvania (PA)
1 Pennsylvania Medical Assistance (MA) (Medicaid)

Created on 11/05/2018

1

HI4
MEDICAID HMOs
Pennsylvania (PA)
1

Northeast Behavioral Health Care
Consortium - Community Care Behavioral Health
Organization

2

Northwest Behavioral Health Partnership - Value
Behavioral Health of Pennsylvania

3

Carbon-Monroe-Pike Joinder Board - Community
Care Behavioral Health Organization

4

Southwest Behavioral Health
Management - Value Behavioral Health of
Pennsylvnia

5

Allegheny County HealthChoices - Community
Care Behavioral Health Organization

6

Lycoming-Clinton Joinder Board - Community
Care Behavioral Health Organization
(continued)

Created on 11/05/2018

2

HI4
MEDICAID HMOs
Pennsylvania (PA)
7

Northampton County HealthChoices - Magellan
Behavioral Health of Pennsylvania

8

Chester County HealthCHoices - Community
Care Behavioral Health Organization
(continued)

Created on 11/05/2018

3

HI4
MEDICAID HMOs
Pennsylvania (PA)
9

Montgomery County HealthChoices - Magellan
Behavioral Health of Pennsylvania

10

Adams County HealthChoices - Community Care
Behavioral Health Organization

11

Berks County HealthChoices - Community Care
Behavioral Health Organization

12

Blair County HealthChoices - Community Care
Behavioral Health Organization

13

Delaware County HealthChoices - Magellan
Behavioral Health of Pennsylvania

14

North Central State Option - Community Care
Behavioral Health Organization

15

Erie County HealthChoices - Community Care
Behavioral Health Organization

16

York County HealthChoices - Community Care
Behavioral Health Organization
(continued)

Created on 11/05/2018

4

HI4
MEDICAID HMOs
Pennsylvania (PA)
17

Lehigh County HealthChoices - Magellan
Behavioral Health of Pennsylvania

18

Bucks County HealthChoices - Magellan
Behavioral Health of Pennsylvania

19

Cambria County HealthChoices - Value
Behavioral Health of Pennsylvania

20

Fayette County HealthChoices - Value Behavioral
Health of Pennsylvania

21

Greene County (Commonwealth) - Value
Behavioral Health of Pennsylvania

22

Beaver County HealthChoices - Value Behavioral
Health of Pennsylvania

23

Behavioral Health Services of Bedford and
Somerset - Performcare

24

Philadelphia County HealthChoices - Community
Behavioral Health
(continued)

Created on 11/05/2018

5

HI4
MEDICAID HMOs
Pennsylvania (PA)
25

United Healthcare Community Plan of
Pennsylvania

26

Cumberland County
HealthChoices - PerformCare

27

Lancaster County HealthChoices - PerformCare

28

Tuscarora Managed Care Alliance - PeformCare

29

Dauphin County HealthChoices - PerformCare

30

Lebanon County HealthChoices - PerformCare

31

Perry County HealthChoices - PerformCare

32

Health Partners of Philadelphia, Inc.

33

Mercy LIFE West Philadelphia H-3908

34

Adult Community Autism Program
(continued)

Created on 11/05/2018

6

HI4
MEDICAID HMOs
Pennsylvania (PA)
35

Senior LIFE Greensburg H-2937

36

Senior LIFE Washington H-2992

37

Senior LIFE Johnstown H-3925

38

Senior LIFE Altoona H-5902

39

Senior LIFE Lehigh H-5978

40

New Courtland LIFE H-9830

41

VieCare Armstrong H-6188

42

Senior LIFE York H-0819

43

SpiriTrust LIFE H-2537

44

LIFE-Pittsburgh H-3918

45

Geisinger Health Plan

46

LIFE Geisinger H-2064

47

Community LIFE H-3917
(continued)

Created on 11/05/2018

7

HI4
MEDICAID HMOs
Pennsylvania (PA)
48

VieCare Butler H-3060

49

VieCare Beaver H-7660

50

LIFE St. Mary H-6551

51

Albright LIFE H-9068

52

Aetna Better Health

53

Gateway Health Plan

54

UPMC for You Inc.

55

Mercy LIFE H-3919

56

LIFE NWPA H-4999

57

Logisticare

58

Vista

Created on 11/05/2018

1

HI5
HEALTHCARE MARKETPLACE PLANS
Pennsylvania (PA)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
1

Ambetter Balanced Care (Pennsylvania
Health & Wellness, Inc.)

2

Ambetter Essential Care (Pennsylvania
Health & Wellness, Inc.)

3

Ambetter Secure Care Free PCP Visits
(Pennsylvania Health & Wellness, Inc.)

4

Geisinger Marketplace (Geisinger Health Plan)

5

Geisinger Marketplace (Geisinger Quality
Options)

6

Geisinger Marketplace Extra (Geisinger Health
Plan)

7

Geisinger Marketplace Value (Geisinger Health
Plan)
(continued)

Created on 11/05/2018

2

HI5
HEALTHCARE MARKETPLACE PLANS
Pennsylvania (PA)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
8

Keystone [Tier] (Keystone Health Plan East, Inc)

9

Keystone [Tier] Proactive (Keystone Health Plan
East, Inc)

10

Major Events Blue Community Blue (Highmark
Inc.)

11

Personal Choice [Tier] (Independence Blue Cross
(QCC Ins. Co.))

12

Personal Choice [Tier] Reserve (Independence
Blue Cross (QCC Ins. Co.))

13

Tower UPMC Advantage [Tier] Premium Network
(UPMC Health Options, Inc.)

14

Tower UPMC Advantage [Tier] Tower Network
(UPMC Health Options, Inc.)
(continued)

Created on 11/05/2018

3

HI5
HEALTHCARE MARKETPLACE PLANS
Pennsylvania (PA)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
15

UPMC Advantage [Tier] Partner Network (UPMC
Health Options, Inc.)

16

UPMC Advantage [Tier] Premium Network
(UPMC Health Options, Inc.)

17

UPMC Advantage [Tier] Select Network (UPMC
Health Options, Inc.)

18

[Tier] (Capital Advantage Assurance Company)

19

my Direct Blue Conemaugh [Tier] (Highmark
Inc.)

20

my Direct Blue Conemaugh [Tier] Free PCP
Visits (Highmark Inc.)

21

my Direct Blue Erie [Tier] (Highmark Choice
Company)
(continued)

Created on 11/05/2018

4

HI5
HEALTHCARE MARKETPLACE PLANS
Pennsylvania (PA)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
22

my Direct Blue Erie [Tier] Free PCP Visits
(Highmark Choice Company)

23

my Direct Blue Lehigh Valley Major Events
(Highmark Health Insurance Company)

24

my Direct Blue Lehigh Valley [Tier] (Highmark
Health Insurance Company)

25

my Direct Blue Lehigh Valley [Tier] Free PCP
Visits (Highmark Health Insurance Company)

26

my Direct Blue Major Events (Highmark Health
Insurance Company)

27

my Direct Blue [Tier] (Highmark Choice
Company)

28

my Direct Blue [Tier] (Highmark Health Insurance
Company)
(continued)

Created on 11/05/2018

5

HI5
HEALTHCARE MARKETPLACE PLANS
Pennsylvania (PA)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
29

my Direct Blue [Tier] (Highmark Inc.)

30

my Direct Blue [Tier] Free PCP Visits (Highmark
Choice Company)

31

my Direct Blue [Tier] Free PCP Visits (Highmark
Health Insurance Company)

32

my Direct Blue [Tier] Free PCP Visits (Highmark
Inc.)

33

my Lehigh Valley Flex Blue [Tier] Free PCP Visit
(First Priority Health)

34

my Lehigh Valley Flex Blue [Tier] Free PCP Visits
(First Priority Health)

35

my Priority Blue Flex [Tier] (First Priority Health)
(continued)

Created on 11/05/2018

6

HI5
HEALTHCARE MARKETPLACE PLANS
Pennsylvania (PA)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
36 my Priority Blue Flex [Tier] Free PCP Visits (First
Priority Health)
37 my Priority Blue Major Events (First Priority Health)

Created on 11/05/2018

1

HI6
PUBLIC ASSISTANCE PLANS
Pennsylvania (PA)
1 AIDS Drug Assistance Program
2 Pennsylvania PACE Needs Enhancement Tier
(PACENET)
3 Pennsylvania Pharmaceutical Assistance Contract for
the Elderly (PACE)
4 Special Pharmaceutical Benefits Program

Created on 11/05/2018

1

HI2
MEDICARE ADVANTAGE PLANS
Puerto Rico (PR)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
1

Apollo (Constellation Health)

2

Olympus (Constellation Health)

3

Orion Constellation Health (Constellation Health)

4

Humana Gold Plus (Humana)

5

HumanaChoice Value (Humana)

6

MCS Classicare (MCS Classicare)

7

MMM (Medicare y Mucho Más)

8

MMM Advantage (Medicare y Mucho Más)

9

PMC Max (PMC Medicare Choice)

10

Basic (Triple S Advantage)
(continued)

Created on 11/05/2018

2

HI2
MEDICARE ADVANTAGE PLANS
Puerto Rico (PR)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
11

Magno (Triple S Advantage)

12

Royal (Triple S Advantage)

13

Titán (Triple S Advantage)

14

Titán+ (Triple S Advantage)

15

Óptimo (Triple-S Advantage)

Created on 11/05/2018

1

HI3
MEDICAID PROGRAM NAMES
Puerto Rico (PR)
1

Medicaid

Created on 11/05/2018

1

HI4
MEDICAID HMOs
Puerto Rico (PR)
1

Preferred Medicare Choice Inc.

2

Humana Health Plan of PR Inc.

3

MMM MULTI HEALTH, Inc. - PMC

4

Molina Health Care PR, Inc.

5

Constellation Health, LLC.

6

First Medical Plan Inc.

7

MMM MULTI HEALTH, Inc.

8

MMM Health Care Inc.

9

Triple-S Salud Inc.

10

MCS Advantage Inc.

11

Triple S

Created on 11/05/2018

1

HI6
PUBLIC ASSISTANCE PLANS
Puerto Rico (PR)
1

AIDS Drug Assistance Program

Created on 11/05/2018

1

HI2
MEDICARE ADVANTAGE PLANS
Rhode Island (RI)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
1 Aetna Medicare Freedom (Aetna Medicare)
2 BlueCHiP for Medicare (Blue Cross & Blue Shield of
Rhode Island)
3 AARP MedicareComplete (UnitedHealthcare)
4 AARP MedicareComplete Choice (UnitedHealthcare)

Created on 11/05/2018

1

HI3
MEDICAID PROGRAM NAMES
Rhode Island (RI)
1

Rhode Island Medical Assistance

Created on 11/05/2018

1

HI4
MEDICAID HMOs
Rhode Island (RI)
1

Multiple Primary Care providers

2

Neighborhood Health Plan of RI

3

Neighborhood Health Plan of R

4

Neighborhood Health Plan

5

Neighborhood Health Plan

6

United Healthcare Dental

7

United Healthcare

8

United Healthcare

9

United Healthcare

10

CareLink

11

PACE

Created on 11/05/2018

1

HI5
HEALTHCARE MARKETPLACE PLANS
Rhode Island (RI)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
1 Only state-operated exchanges serve Rhode Island

Created on 11/05/2018

1

HI6
PUBLIC ASSISTANCE PLANS
Rhode Island (RI)
1 RI AIDS Drug Assistance Program
2 RIRx Prescription Drug Assistance
3 RIte Share
4 Rhode Island Pharmacy Assistance for Elderly
(RIPAE)
5 Rhody Health Partners

Created on 11/05/2018

1

HI2
MEDICARE ADVANTAGE PLANS
South Carolina (SC)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
1

Aetna Medicare (Aetna Medicare)

2

Allwell Medicare (Allwell)

3

AFC Care (America's 1st Choice of South
Carolina)

4

BlueCross Secure (Blue Cross Blue Shield of
South Carolina)

5

BlueCross Total (Blue Cross Blue Shield of South
Carolina)

6

Cigna-HealthSpring (Cigna-HealthSpring)

7

Clover Health Choice (Clover Health)

8

EON CHOICE (Eon Health)

9

EON SELECT (Eon Health)
(continued)

Created on 11/05/2018

2

HI2
MEDICARE ADVANTAGE PLANS
South Carolina (SC)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
10 Humana Gold Choice (Humana)
11 Humana Gold Plus (Humana)
12 HumanaChoice (Humana)
13 AARP MedicareComplete (UnitedHealthcare)
14 UnitedHealthcare MedicareComplete Choice
(UnitedHealthcare)
15 WellCare Elite (WELLCARE)
16 WellCare (WellCare)

Created on 11/05/2018

1

HI3
MEDICAID PROGRAM NAMES
South Carolina (SC)
1

Healthy Connections

Created on 11/05/2018

1

HI4
MEDICAID HMOs
South Carolina (SC)
1

Select Health of South Carolina

2

BlueChoice Healthplan Medicaid

3

WellCare of South Carolina

4

South Carolina Solutions

5

Palmetto Senior Care

6

Absolute Total Care

7

Molina HealthCare

8

Logisticare

9

The Oaks

Created on 11/05/2018

1

HI5
HEALTHCARE MARKETPLACE PLANS
South Carolina (SC)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
1 Ambetter Balanced Care (Absolute Total Care, Inc)
2 Ambetter Essential Care (Absolute Total Care, Inc)
3 Ambetter Secure Care Free PCP Visits (Absolute
Total Care, Inc)
4 BlueEssentials HD [Tier] (Blue Cross and Blue Shield
of South Carolina)
5 BlueEssentials [Tier] (Blue Cross and Blue Shield of
South Carolina)

Created on 11/05/2018

1

HI6
PUBLIC ASSISTANCE PLANS
South Carolina (SC)
1 AIDS Drug Assistance Plan
2 Gap Assistance Pharmacy Program for Seniors
(GAPS)

Created on 11/05/2018

1

HI2
MEDICARE ADVANTAGE PLANS
South Dakota (SD)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
1 Coventry (Coventry Health Care)
2 HealthPartners Sanford (HealthPartners)
3 Humana Gold Choice (Humana)
4 Humana Gold Plus (Humana)
5 Humana Value Plus (Humana)
6 HumanaChoice (Humana)
7 Lasso Healthcare (Lasso Healthcare)
8 Medica Prime Solution (Medica Insurance Company)

Created on 11/05/2018

1

HI3
MEDICAID PROGRAM NAMES
South Dakota (SD)
1

Medicaid

Created on 11/05/2018

1

HI4
MEDICAID HMOs
South Dakota (SD)
1

Multiple Primary Care Providers

Created on 11/05/2018

1

HI5
HEALTHCARE MARKETPLACE PLANS
South Dakota (SD)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
1 Avera (Avera Health Plans, Inc.)
2 Avera Preferred (Avera Health Plans, Inc.)
3 Sanford Simplicity (Sanford Health Plan)
4 Sanford Simplicity HDHP (Sanford Health Plan)
5 Sanford TRUE (Sanford Health Plan)
6 Sanford TRUE HDHP (Sanford Health Plan)

Created on 11/05/2018

1

HI6
PUBLIC ASSISTANCE PLANS
South Dakota (SD)
1 AIDS Drug Reimbursement Program

Created on 11/05/2018

1

HI2
MEDICARE ADVANTAGE PLANS
Tennessee (TN)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
1

Aetna Medicare Premier Plan (Aetna Medicare)

2

Amerivantage (Amerigroup)

3

BlueAdvantage (BlueCross BlueShield of
Tennessee)

4

Bright Advantage (Bright Health)

5

Bright Advantage Flex (Bright Health)

6

Clover Health Choice (Clover Health)

7

Humana Gold Plus (Humana)

8

Humana Value Plus (Humana)

9

HumanaChoice (Humana)

10

AARP MedicareComplete (UnitedHealthcare)
(continued)

Created on 11/05/2018

2

HI2
MEDICARE ADVANTAGE PLANS
Tennessee (TN)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
11

WellCare (WellCare)

Created on 11/05/2018

1

HI3
MEDICAID PROGRAM NAMES
Tennessee (TN)
1

TennCare

Created on 11/05/2018

1

HI4
MEDICAID HMOs
Tennessee (TN)
1 Volunteer State Health Plan (TennCare Select)
2 Volunteer State Health Plan (BlueCare)
3 Alexian Brothers Community Services
4 DentaQuest USA Insurance Company
5 UnitedHealthcare Community Plan
6 Magellan Health Services
7 Amerigroup

Created on 11/05/2018

1

HI5
HEALTHCARE MARKETPLACE PLANS
Tennessee (TN)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
1

Ambetter Balanced Care (Celtic Insurance
Company)

2

Ambetter Essential Care (Celtic Insurance
Company)

3

Ambetter Secure Care Free PCP Visits (Celtic
Insurance Company)

4

Cigna Connect (Cigna Health and Life Insurance
Company)

5

Oscar Classic [Tier] (Oscar Insurance Company)

6

Oscar Saver [Tier] (Oscar Insurance Company)

7

Oscar Simple Secure (Oscar Insurance
Company)
(continued)

Created on 11/05/2018

2

HI5
HEALTHCARE MARKETPLACE PLANS
Tennessee (TN)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
8

Oscar Simple [Tier] (Oscar Insurance Company)

9

[Tier] (Bright Health Insurance Company of
Tennessee)

10 [Tier] G Network S (BlueCross BlueShield of
Tennessee)
11 [Tier] Perks (Bright Health Insurance Company of
Tennessee)
12 [Tier] S Network S (BlueCross BlueShield of
Tennessee)
13 [Tier]Network S (BlueCross BlueShield of
Tennessee)

Created on 11/05/2018

1

HI6
PUBLIC ASSISTANCE PLANS
Tennessee (TN)
1 CoverRX
2 Project Access Nashville
3 Tennessee HIV Drug Assistance Program

Created on 11/05/2018

1

HI2
MEDICARE ADVANTAGE PLANS
Texas (TX)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
1

Aetna Medicare (Aetna Medicare)

2

Allwell Medicare (Allwell)

3

Amerivantage (Amerigroup)

4

Blue Cross Medicare Advantage Basic (Blue
Cross and Blue Shield of Texas)

5

Blue Cross Medicare Advantage Choice (Blue
Cross and Blue Shield of Texas)

6

Blue Cross Medicare Advantage Value (Blue
Cross and Blue Shield of Texas)

7

CHRISTUS Health Plan Generations (CHRISTUS
Health Plan Generations)

8

Care N' Care Classic (Care N' Care Insurance
Company)
(continued)

Created on 11/05/2018

2

HI2
MEDICARE ADVANTAGE PLANS
Texas (TX)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
9

Care N' Care Choice (Care N’ Care Insurance
Company)

10

Cigna-HealthSpring (Cigna-HealthSpring)

11

Clover Health Choice (Clover Health)

12

Clover Health Classic (Clover Health)

13

Humana Gold Choice (Humana)

14

Humana Gold Plus (Humana)

15

HumanaChoice (Humana)

16

Imperial Insurance Company of Texas
Traditional (Imperial Insurance Company of
Texas, Inc)

17

KelseyCare Advantage (KelseyCare Advantage)
(continued)

Created on 11/05/2018

3

HI2
MEDICARE ADVANTAGE PLANS
Texas (TX)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
18

Lasso Healthcare (Lasso Healthcare)

19

Memorial Hermann Advantage (Memorial
Hermann Health Plan)

20

Mutual of Omaha CareAdvantage Complete
(Mutual of Omaha Medicare Advantage
Company)

21

Prominence Plus (Prominence Health Plan)

22

SeniorCare Advantage (Scott and White Health
Plan)

23

AARP MedicareComplete (UnitedHealthcare)

24

AARP MedicareComplete Choice
(UnitedHealthcare)

25

AARP MedicareComplete Plan
(UnitedHealthcare)
(continued)

Created on 11/05/2018

4

HI2
MEDICARE ADVANTAGE PLANS
Texas (TX)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
26 Erickson Advantage (UnitedHealthcare)
27 UnitedHealthcare MedicareComplete Choice
(UnitedHealthcare)
28 UnitedHealthcare MedicareDirect (UnitedHealthcare)
29 WellCare (WellCare)
30 WellCare TexanPlus (WellCare)
31 WellCare TexanPlus Classic (WellCare)

Created on 11/05/2018

1

HI3
MEDICAID PROGRAM NAMES
Texas (TX)
1

Medicaid

Created on 11/05/2018

1

HI4
MEDICAID HMOs
Texas (TX)
1

Bienvivir Senior Health Services (El Paso)

2

Silver Star Health Network (Lubbock)

3

The Basics at Jan Werner (Amarillo)

4

Driscoll Children's Health Plan

5

Driscoll Children's Health Plan

6

Texas Children's Health Plan

7

Texas Children's Health Plan

8

Community First Health Plan

9

Cook Children's Health Plan

10

Community First Health Plan

11

Cook Children's Health Plan

12

Molina Healthcare of Texas
(continued)

Created on 11/05/2018

2

HI4
MEDICAID HMOs
Texas (TX)
13

Children's Medical Center

14

Community Health Choice

15

United Healthcare Texas

16

United Healthcare Texas

17

United Healthcare Texas

18

Blue Cross Blue Shield

19

Amerigroup Texas, Inc.

20

Amerigroup Texas, Inc.

21

Blue Cross Blue Shield

22

Parkland HEALTH First

23

Superior Health Plan

24

Superior Health Plan

25

Superior Health Plan
(continued)

Created on 11/05/2018

3

HI4
MEDICAID HMOs
Texas (TX)
26

Superior Health Plan

27

Cigna-HealthSpring

28

AxisPoint Health

29

Project Amistad

30

Scott & White

31

El Paso First

32

ValueOptions

33

MCNA Dental

34

Logisticare

35

Amerigroup

36

DentaQuest

37

FirstCare

38

Christus
(continued)

Created on 11/05/2018

4

HI4
MEDICAID HMOs
Texas (TX)
39

Sendero

40

LeFleur

41

Molina

42

Seton

43

Aetna

44

Aetna

45

MTM

46

AMR

Created on 11/05/2018

1

HI5
HEALTHCARE MARKETPLACE PLANS
Texas (TX)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
1

Ambetter Balanced Care (Celtic Insurance
Company)

2

Ambetter Essential Care (Celtic Insurance
Company)

3

Ambetter Secure Care Free PCP Visits (Celtic
Insurance Company)

4

Blue Advantage Plus [Tier] (Blue Cross Blue
Shield of Texas)

5

Blue Advantage Security (Blue Cross Blue Shield
of Texas)

6

Blue Advantage [Tier] (Blue Cross Blue Shield of
Texas)

7

Blue Advantage [Tier] Three PCP Visits (Blue
Cross Blue Shield of Texas)
(continued)

Created on 11/05/2018

2

HI5
HEALTHCARE MARKETPLACE PLANS
Texas (TX)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
8

Blue Advantage [Tier] Two PCP Visits (Blue
Cross Blue Shield of Texas)

9

CHP TX [Tier] (CHRISTUS Health Plan)

10

CHP TX [Tier] HD (CHRISTUS Health Plan)

11

CHP TX [Tier] LD (CHRISTUS Health Plan)

12

Community Health Choice [Tier] (Community
Health Choice, Inc.)

13

Community Health Choice [Tier] High Deductible
Health Compatible (Community Health Choice,
Inc.)

14

Community Health Choice [Tier] Limited Network
(Community Health Choice, Inc.)

15

IdealCare (Sendero Health Plans, inc.)
(continued)

Created on 11/05/2018

3

HI5
HEALTHCARE MARKETPLACE PLANS
Texas (TX)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
16

IdealCare Complete (Sendero Health Plans, inc.)

17

IdealCare Essential (Sendero Health Plans, inc.)

18

IdealCare [Tier] (Sendero Health Plans, inc.)

19

IdealCare [Tier] High Deductible (Sendero Health
Plans, inc.)

20

Molina Choice [Tier] (Molina Healthcare of Texas,
Inc.)

21

Molina [Tier] (Molina Healthcare of Texas, Inc.)

22

Oscar Classic [Tier] (Oscar Insurance Company)
(continued)

Created on 11/05/2018

4

HI5
HEALTHCARE MARKETPLACE PLANS
Texas (TX)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
23 Oscar Saver [Tier] (Oscar Insurance Company)
24 Oscar Simple Secure (Oscar Insurance Company)
25 Oscar Simple [Tier] (Oscar Insurance Company)
26 [Tier] (SHA, LLC DBA FirstCare Health Plans)
27 [Tier] H S (SHA, LLC DBA FirstCare Health Plans)

Created on 11/05/2018

1

HI6
PUBLIC ASSISTANCE PLANS
Texas (TX)
1 Texas HIV State Pharmacy Assistance Program
(SPAP)
2 Texas Kidney Health Care Program

Created on 11/05/2018

1

HI2
MEDICARE ADVANTAGE PLANS
Utah (UT)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
1

Aetna Advantra (Aetna Medicare)

2

Aetna Medicare (Aetna Medicare)

3

Humana Gold Plus (Humana)

4

HumanaChoice (Humana)

5

Lasso Healthcare (Lasso Healthcare)

6

Healthy Advantage Plus (Molina Healthcare of
Utah)

7

Regence MedAdvantage (Regence BlueCross
BlueShield of Utah)

8

SelectHealth Advantage (SelectHealth)

9

AARP MedicareComplete (UnitedHealthcare)
(continued)

Created on 11/05/2018

2

HI2
MEDICARE ADVANTAGE PLANS
Utah (UT)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
10 UnitedHealthcare MedicareComplete Assure
(UnitedHealthcare)
11 UnitedHealthcare MedicareComplete Choice
(UnitedHealthcare)

Created on 11/05/2018

1

HI3
MEDICAID PROGRAM NAMES
Utah (UT)
1

Medicaid

Created on 11/05/2018

1

HI4
MEDICAID HMOs
Utah (UT)
1

Four Corners Community Behavioral Health

2

Southwest Behavioral Health

3

Central Utah Mental Health

4

Bear River Mental Health

5

Valley Behavioral Health

6

Davis Behavioral Health

7

Northeastern Counseling

8

Wasatch Mental Health

9

Logisticare Solutions

10

Weber Mental Health

11

Premier Access

12

Health Choice

13

SelectHealth
(continued)

Created on 11/05/2018

2

HI4
MEDICAID HMOs
Utah (UT)
14

Optum Health

15

Delta Dental

16

Molina Plus

17

Healthy U

18

Molina

19

HOME

Created on 11/05/2018

1

HI5
HEALTHCARE MARKETPLACE PLANS
Utah (UT)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
1

Healthy Preferred Expanded [Tier] (University of
Utah Health Insurance Plans)

2

Healthy Preferred [Tier] (University of Utah
Health Insurance Plans)

3

Healthy Preferred [Tier]s before Deductible
(University of Utah Health Insurance Plans)

4

Healthy Premier Expanded [Tier] (University of
Utah Health Insurance Plans)

5

Healthy Premier [Tier] (University of Utah Health
Insurance Plans)

6

Healthy Premier [Tier]s before Deductible
(University of Utah Health Insurance Plans)

7

Molina [Tier] (Molina Healthcare of Utah)
(continued)

Created on 11/05/2018

2

HI5
HEALTHCARE MARKETPLACE PLANS
Utah (UT)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
8

Select Med Benchmark Expanded [Tier]
(SelectHealth)

9

Select Med Benchmark [Tier] (SelectHealth)

10

Select Med Expanded [Tier] deductible for office
visits (SelectHealth)

11

Select Med Expanded [Tier] deductible for one
urgentand all (SelectHealth)

12

Select Med Healtve Expanded [Tier] Qualified
(SelectHealth)

13

Select Med Healtve [Tier] Qualified (SelectHealth)

14

Select Med [Tier] (SelectHealth)
(continued)

Created on 11/05/2018

3

HI5
HEALTHCARE MARKETPLACE PLANS
Utah (UT)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
15

Select Med [Tier] deductible for office visits
(SelectHealth)

16

Select Med [Tier] deductible for one urgentand all
PCP visits (SelectHealth)

17

Select Value Benchmark Expanded [Tier]
(SelectHealth)

18

Select Value Benchmark [Tier] (SelectHealth)

19

Select Value Expanded [Tier] deductible for office
visits (SelectHealth)

20

Select Value Expanded [Tier] deductible for one
urgentand al (SelectHealth)

21

Select Value Healtve Expanded [Tier] Qualified
(SelectHealth)
(continued)

Created on 11/05/2018

4

HI5
HEALTHCARE MARKETPLACE PLANS
Utah (UT)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
22 Select Value Healtve [Tier] Qualified (SelectHealth)
23 Select Value Healtve [Tier] qualified (SelectHealth)
24 Select Value [Tier] (SelectHealth)
25 Select Value [Tier] deductible for office visits
(SelectHealth)
26 Select Value [Tier] deductible for one urgentand all
PCP visits (SelectHealth)

Created on 11/05/2018

1

HI6
PUBLIC ASSISTANCE PLANS
Utah (UT)
1 Utah AIDS Drug Assistance Program

Created on 11/05/2018

1

HI2
MEDICARE ADVANTAGE PLANS
Virginia (VA)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
1

Aetna Medicare (Aetna Medicare)

2

Anthem MediBlue Access (Anthem Blue Cross
and Blue Shield)

3

Anthem MediBlue (Anthem HealthKeepers)

4

Clear Spring Health Essential (Clear Spring
Health)

5

Humana (Humana)

6

Humana Gold Choice (Humana)

7

Humana Gold Plus (Humana)

8

Humana Value Plus (Humana)

9

HumanaChoice (Humana)
(continued)

Created on 11/05/2018

2

HI2
MEDICARE ADVANTAGE PLANS
Virginia (VA)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
10

Innovation Health Medicare Connection Plan
(Innovation Health Medicare)

11

Innovation Health Medicare Voyager Plan
(Innovation Health Medicare)

12

Kaiser Permanente Medicare Plus (Kaiser
Permanente)

13

Optima Medicare (Optima Medicare)

14

Piedmont Select Medicare Option (Piedmont
Medicare Advantage)

15

Sunrise Advantage Plan (Sunrise Advantage
Plan (HMO SNP))

16

AARP MedicareComplete (UnitedHealthcare)

17

Erickson Advantage (UnitedHealthcare)
(continued)

Created on 11/05/2018

3

HI2
MEDICARE ADVANTAGE PLANS
Virginia (VA)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
18 UnitedHealthcare MedicareDirect (UnitedHealthcare)
19 Virginia Premier Advantage (Virginia Premier)

Created on 11/05/2018

1

HI3
MEDICAID PROGRAM NAMES
Virginia (VA)
1

Medicaid

Created on 11/05/2018

1

HI4
MEDICAID HMOs
Virginia (VA)
1

Kaiser Foundation Health Plan of the Mid-Atlantic
States, INC (KFHPMA)

2

HEALTHKEEPERS INC (Anthem Healthkeepers
Plus)

3

Mountain Empire Older Citizen PACE (MEOC)

4

Sentara Life Care PACE - Virginia Beach

5

Sentara Life Care PACE - Churchland

6

Aetna Better Health of Virginia

7

Riverside PACE - Newport News

8

INOVA Cares for Seniors PACE

9

Riverside PACE - MacTavish

10

Riverside PACE - Hampton

11

Centra PACE - Lynchburg
(continued)

Created on 11/05/2018

2

HI4
MEDICAID HMOs
Virginia (VA)
12

Centra PACE- Farmville

13

Centra PACE - Gretna

14

Optima Family Care

15

Virginia Premier

16

Blue Ridge PACE

17

INTotal Health

18

AllCare Pace

19

Kissito PACE

Created on 11/05/2018

1

HI5
HEALTHCARE MARKETPLACE PLANS
Virginia (VA)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
1

Anthem HealthKeepers [Tier] X (HealthKeepers,
Inc.)

2

Anthem HealthKeepers [Tier] X Online Plus
(HealthKeepers, Inc.)

3

Anthem HealthKeepers [Tier] X for
(HealthKeepers, Inc.)

4

BlueChoice Young Adult (CareFirst BlueChoice,
Inc.)

5

BlueChoice [Tier] (CareFirst BlueChoice, Inc.)

6

BluePreferred [Tier] (Group Hospitalization and
Medical Services Inc.)

7

Cigna Connect (Cigna Health and Life Insurance
Company)
(continued)

Created on 11/05/2018

2

HI5
HEALTHCARE MARKETPLACE PLANS
Virginia (VA)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
8

HealthyBlue [Tier] (CareFirst BlueChoice, Inc.)

9

HealthyBlue [Tier] (Group Hospitalization and
Medical Services Inc.)

10

KP VA [Tier] (Kaiser Foundation Health Plan of
the Mid-Atlantic States, Inc.)

11

OptimaFit [Tier] CH M (Optima Health Plan)

12

OptimaFit [Tier] Direct CH M (Optima Health
Plan)

13

OptimaFit [Tier] Direct M (Optima Health Plan)

14

OptimaFit [Tier] Direct RK M (Optima Health
Plan)
(continued)

Created on 11/05/2018

3

HI5
HEALTHCARE MARKETPLACE PLANS
Virginia (VA)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
15

OptimaFit [Tier] M (Optima Health Plan)

16

OptimaFit [Tier] RK M (Optima Health Plan)

17

OptimaFit [Tier] Select CH M (Optima Health
Plan)

18

OptimaFit [Tier] Select RK M (Optima Health
Plan)

19

Piedmont Choice AH [Tier] (Piedmont
Community HealthCare HMO, Inc.)

20

Piedmont Choice AH [Tier] Standard (Piedmont
Community HealthCare HMO, Inc.)

21

Piedmont Choice [Tier] (Piedmont Community
HealthCare HMO, Inc.)
(continued)

Created on 11/05/2018

4

HI5
HEALTHCARE MARKETPLACE PLANS
Virginia (VA)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
22 Piedmont Choice [Tier] Standard (Piedmont
Community HealthCare HMO, Inc.)
23 Virginia Premier Preferred [Tier] (Virginia Premier
Health Plan, Inc.)

Created on 11/05/2018

1

HI6
PUBLIC ASSISTANCE PLANS
Virginia (VA)
1 Virginia AIDS Drug Assistance Program
2 Virginia HIV SPAP

Created on 11/05/2018

1

HI2
MEDICARE ADVANTAGE PLANS
Vermont (VT)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
1 Gold PPO with Part D (MVP HEALTH CARE)
2 GoldValue with Part D (MVP HEALTH CARE)
3 WellSelect with Part D (MVP HEALTH CARE)
4 AARP MedicareComplete Choice (UnitedHealthcare)
5 AARP MedicareComplete Plan (UnitedHealthcare)
6 UnitedHealthcare MedicareComplete Assure
(UnitedHealthcare)
7 UnitedHealthcare MedicareDirect (UnitedHealthcare)

Created on 11/05/2018

1

HI3
MEDICAID PROGRAM NAMES
Vermont (VT)
1

Vermont Medicaid

Created on 11/05/2018

1

HI4
MEDICAID HMOs
Vermont (VT)
1 Department of Vermont Health Access

Created on 11/05/2018

1

HI5
HEALTHCARE MARKETPLACE PLANS
Vermont (VT)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
1 Only state-operated exchanges serve Vermont

Created on 11/05/2018

1

HI6
PUBLIC ASSISTANCE PLANS
Vermont (VT)
1 Catamount Health
2 Vermont Medication Assistance Program
3 Vermont VPharm

Created on 11/05/2018

1

HI2
MEDICARE ADVANTAGE PLANS
Washington (WA)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
1

Amerivantage Classic (AMERIGROUP)

2

Aetna Medicare (Aetna Medicare)

3

Asuris TruAdvantage (Asuris Northwest Health)

4

Community HealthFirst MA (Community
HealthFirst Medicare Advantage Plan)

5

Health Alliance NW (Health Alliance Northwest)

6

Health Net (Health Net Life Insurance Company)

7

Humana Gold Plus (Humana)

8

HumanaChoice (Humana)
(continued)

Created on 11/05/2018

2

HI2
MEDICARE ADVANTAGE PLANS
Washington (WA)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
9

Kaiser Permanente Medicare Advantage (Kaiser
Foundation Health Plan of Washington)

10

Kaiser Permanente Senior Advantage (Kaiser
Permanente)

11

PacificSource Medicare MyCare (PacificSource
Medicare)

12

Premera Blue Cross Medicare Advantage
(Premera Blue Cross Medicare Advantage)

13

Providence Medicare (Providence Health
Assurance)

14

Regence BlueAdvantage HMO (Regence
BlueCross BlueShield of Oregon)

15

Regence MedAdvantage (Regence BlueShield Of
Idaho)
(continued)

Created on 11/05/2018

3

HI2
MEDICARE ADVANTAGE PLANS
Washington (WA)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
16 Soundpath Health (Soundpath Health)
17 AARP MedicareComplete (UnitedHealthcare)

Created on 11/05/2018

1

HI3
MEDICAID PROGRAM NAMES
Washington (WA)
1

Apple Health (Medicaid)

Created on 11/05/2018

1

HI4
MEDICAID HMOs
Washington (WA)
1

Community Health Plan of Washington

2

Community Health Plan of Washington

3

Multiple Regional Support Networks

4

Multiple Primary Care Providers

5

Multiple Transportation Brokers

6

Coordinated Care of Washington

7

Coordinated Care of Washington

8

Community Health Plan of WA

9

Providence Elder Place

10

Molina Health Care

11

United Health Care

12

United Health Care

13

Multiple Sites
(continued)

Created on 11/05/2018

2

HI4
MEDICAID HMOs
Washington (WA)
14

Amerigroup

15

Amerigroup

16

Molina

17

Molina

Created on 11/05/2018

1

HI6
PUBLIC ASSISTANCE PLANS
Washington (WA)
1 Early Intervention Program
2 Washington State Health Insurance Pool

Created on 11/05/2018

1

HI2
MEDICARE ADVANTAGE PLANS
Wisconsin (WI)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
1

Aetna Medicare (Aetna Medicare)

2

Anthem MediBlue Access (Anthem Blue Cross
and Blue Shield)

3

Anthem MediBlue Plus (Anthem Blue Cross and
Blue Shield)

4

Dean Advantage (Dean Advantage, Prevea360
Medicare Advantage)

5

Prevea360 Medicare Advantage (Dean
Advantage, Prevea360 Medicare Advantage)

6

DeanCare Gold (Dean Health Plan, Inc.)

7

HealthPartners Freedom (HealthPartners)

8

HealthPartners Robin (HealthPartners)

9

Humana Gold Choice (Humana)
(continued)

Created on 11/05/2018

2

HI2
MEDICARE ADVANTAGE PLANS
Wisconsin (WI)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
10

Humana Gold Plus (Humana)

11

Humana Value Plus (Humana)

12

HumanaChoice (Humana)

13

Medica Prime Solution (Medica Insurance
Company)

14

Medical Associates (Medical Associates Clinic
Health Plan of Wisconsi)

15

Network (Network Health Medicare Advantage
Plans)

16

Network Health Medicare Explore (Network
Health Medicare Advantage Plans)

17

NetworkPrime (Network Health Medicare
Advantage Plans)
(continued)

Created on 11/05/2018

3

HI2
MEDICARE ADVANTAGE PLANS
Wisconsin (WI)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
18

Assurance (Security Health Plan of Wisconsin,
Inc.)

19

Essence (Security Health Plan of Wisconsin, Inc.)

20

Esteem (Security Health Plan of Wisconsin, Inc.)

21

Promise (Security Health Plan of Wisconsin, Inc.)

22

Secure Saver (Security Health Plan of Wisconsin,
Inc.)

23

Spirit (Security Health Plan of Wisconsin, Inc.)

24

Surety (Security Health Plan of Wisconsin, Inc.)
(continued)

Created on 11/05/2018

4

HI2
MEDICARE ADVANTAGE PLANS
Wisconsin (WI)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
25 Gundersen Senior Preferred (Senior Preferred)
26 ProHealth Senior Preferred (Senior Preferred)
27 UW Health Senior Preferred (Senior Preferred)
28 EssentiaCare (UCare)
29 AARP MedicareComplete (UnitedHealthcare)
30 UnitedHealthcare MedicareComplete Open
(UnitedHealthcare)

Created on 11/05/2018

1

HI3
MEDICAID PROGRAM NAMES
Wisconsin (WI)
1

BadgerCare Plus

Created on 11/05/2018

1

HI4
MEDICAID HMOs
Wisconsin (WI)
1

Community Care Health Plan, Inc. – Community
Care, Inc.

2

Care Wisconsin Health Plan, Inc. – Care
Wisconsin

3

Group Health Cooperative Of South Central WI

4

Community Care Connections of Wisconsin (FC)

5

Group Health Cooperative Of Eau Claire

6

Group Health Cooperative Of Eau Claire

7

Independent Care Health Plan – iCare

8

Children’s Community Health Plan

9

Children’s Hospital of Wisconsin

10

UnitedHealthcare Community Plan

11

UnitedHealthcare Community Plan
(continued)

Created on 11/05/2018

2

HI4
MEDICAID HMOs
Wisconsin (WI)
12

Anthem Blue Cross Blue Shield

13

Anthem Blue Cross Blue Shield

14

Health Tradition Health Plan

15

MercyCare Insurance Company

16

Physicians Plus Health Plan

17

Community Care, Inc. (FC)

18

Independent Care (iCare)

19

Trilogy Health Insurance

20

Independent Care (iCare)

21

Trilogy Health Insurance

22

Western Wisconsin Cares

23

Lakeland Care District

24

Gundersen Health Plan
(continued)

Created on 11/05/2018

3

HI4
MEDICAID HMOs
Wisconsin (WI)
25

My Choice Family Care

26

Security Health Plan

27

WrapAround Milwaukee

28

Community Care, Inc.

29

Children Come First

30

Network Health Plan

31

Network Health Plan

32

Care Wisconsin (FC)

33

Molina Health Plan

34

Molina Health Plan

35

Unity Health Plan

36

Dean Health Plan

37

MHS of Wisconsin
(continued)

Created on 11/05/2018

4

HI4
MEDICAID HMOs
Wisconsin (WI)
38

MHS of Wisconsin

39

Care Wisconsin

40

ContinuUs

41

Compcare

42

Compcare

Created on 11/05/2018

1

HI5
HEALTHCARE MARKETPLACE PLANS
Wisconsin (WI)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
1

Atlas Individual Plus [Tier] (HealthPartners
Insurance Company)

2

Atlas Individual [Tier] (HealthPartners Insurance
Company)

3

Beloit One [Tier] (Unity Health Plans Insurance
Corporation)

4

Beloit One [Tier] Dental (Unity Health Plans
Insurance Corporation)

5

Beloit One [Tier] Maintenance (Unity Health
Plans Insurance Corporation)

6

Beloit One [Tier] Maintenance Dental (Unity
Health Plans Insurance Corporation)

7

Dean Focus Network [Tier] E (Dean Health Plan)
(continued)

Created on 11/05/2018

2

HI5
HEALTHCARE MARKETPLACE PLANS
Wisconsin (WI)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
8

Dean Focus Network [Tier] Value (Dean Health
Plan)

9

Dean [Tier] Classic (Dean Health Plan)

10

Dean [Tier] E (Dean Health Plan)

11

Dean [Tier] Plus (Dean Health Plan)

12

Dean [Tier] Safety Net (Dean Health Plan)

13

Dean [Tier] Value (Dean Health Plan)

14

Elite [Tier] (Unity Health Plans Insurance
Corporation)

15

Elite [Tier] Dental (Unity Health Plans Insurance
Corporation)
(continued)

Created on 11/05/2018

3

HI5
HEALTHCARE MARKETPLACE PLANS
Wisconsin (WI)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
16

Elite [Tier] Maintenance (Unity Health Plans
Insurance Corporation)

17

Elite [Tier] Maintenance Dental (Unity Health
Plans Insurance Corporation)

18

En Aurora Bellin ThedaCare CHHS [Tier]
(Common Ground Healthcare Cooperative)

19

Engage by Medica [Tier] (Medica Health Plans of
Wisconsin)

20

Engage by Medica [Tier] Plus (Medica Health
Plans of Wisconsin)

21

Gundersen Health System R [Tier] (Unity Health
Plans Insurance Corporation)

22

Gundersen Health System R [Tier] Dental (Unity
Health Plans Insurance Corporation)
(continued)

Created on 11/05/2018

4

HI5
HEALTHCARE MARKETPLACE PLANS
Wisconsin (WI)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
23

Gundersen Health System R [Tier] Maintenance
(Unity Health Plans Insurance Corporation)

24

Gundersen Health System R [Tier] Maintenance
Dental (Unity Health Plans Insurance
Corporation)

25

HDHP [Tier] (Aspirus Arise Health Plan of
Wisconsin, Inc.)

26

Medica Individual Choice [Tier] (Medica Health
Plans of Wisconsin)

27

Medica Individual Choice [Tier] H S (Medica
Health Plans of Wisconsin)

28

Medica Individual Choice [Tier] H SPlus (Medica
Health Plans of Wisconsin)

29

MercyCare [Tier] Option (MercyCare HMO, Inc.)
(continued)

Created on 11/05/2018

5

HI5
HEALTHCARE MARKETPLACE PLANS
Wisconsin (WI)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
30

Molina [Tier] (Molina Healthcare of Wisconsin,
Inc.)

31

Pioneer One [Tier] (Unity Health Plans Insurance
Corporation)

32

Pioneer One [Tier] Dental (Unity Health Plans
Insurance Corporation)

33

Pioneer One [Tier] Maintenance (Unity Health
Plans Insurance Corporation)

34

Pioneer One [Tier] Maintenance Dental (Unity
Health Plans Insurance Corporation)

35

Prestige [Tier] (Network Health Plan)

36

Prestige [Tier] Essential (Network Health Plan)
(continued)

Created on 11/05/2018

6

HI5
HEALTHCARE MARKETPLACE PLANS
Wisconsin (WI)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
37

Prestige [Tier] HDHP (Network Health Plan)

38

Prime [Tier] (Unity Health Plans Insurance
Corporation)

39

Prime [Tier] Dental (Unity Health Plans Insurance
Corporation)

40

Prime [Tier] Maintenance (Unity Health Plans
Insurance Corporation)

41

Prime [Tier] Maintenance Dental (Unity Health
Plans Insurance Corporation)

42

ProHealth [Tier] (Unity Health Plans Insurance
Corporation)

43

ProHealth [Tier] Dental (Unity Health Plans
Insurance Corporation)
(continued)

Created on 11/05/2018

7

HI5
HEALTHCARE MARKETPLACE PLANS
Wisconsin (WI)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
44

ProHealth [Tier] Maintenance (Unity Health Plans
Insurance Corporation)

45

ProHealth [Tier] Maintenance Dental (Unity
Health Plans Insurance Corporation)

46

Select (Security Health Plan of Wisconsin, Inc.)

47

Select HDHP (Security Health Plan of Wisconsin,
Inc.)

48

Select Protection (Security Health Plan of
Wisconsin, Inc.)

49

Select [Tier] Ded MOOP (Group Health
Cooperative of South Central Wisconsin)

50

Select [Tier] Simple Choice Ded MOOP (Group
Health Cooperative of South Central Wisconsin)
(continued)

Created on 11/05/2018

8

HI5
HEALTHCARE MARKETPLACE PLANS
Wisconsin (WI)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
51

Select [Tier]Ded MOOP (Group Health
Cooperative of South Central Wisconsin)

52

Together Standard [Tier] (Children's Community
Health Plan)

53

Together [Tier] (Children's Community Health
Plan)

54

Together [Tier] HDHP (Children's Community
Health Plan)

55

Together [Tier] Select (Children's Community
Health Plan)

56

[Tier] (Aspirus Arise Health Plan of Wisconsin,
Inc.)

57

[Tier] Ded MOOP (Group Health Cooperative of
South Central Wisconsin)
(continued)

Created on 11/05/2018

9

HI5
HEALTHCARE MARKETPLACE PLANS
Wisconsin (WI)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
58 [Tier] Simple Choice Ded MOOP (Group Health
Cooperative of South Central Wisconsin)
59 [Tier]Ded MOOP (Group Health Cooperative of
South Central Wisconsin)

Created on 11/05/2018

1

HI6
PUBLIC ASSISTANCE PLANS
Wisconsin (WI)
1 BadgerCare Plus
2 Wisconsin AIDS/HIV Drug Assistance Program
3 Wisconsin Chronic Disease Program
4 Wisconsin SeniorCare

Created on 11/05/2018

1

HI2
MEDICARE ADVANTAGE PLANS
West Virginia (WV)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
1

Advantra (Coventry Health Care)

2

AdvantraOne (Coventry Health Care)

3

Freedom Blue PPO Standard (Highmark Senior
Solutions Company)

4

Humana Gold Choice (Humana)

5

Humana Gold Plus (Humana)

6

Humana Value Plus (Humana)

7

HumanaChoice (Humana)

8

The Health Plan SecureCare (The Health Plan)

9

The Health Plan SecureChoice (The Health Plan)
(continued)

Created on 11/05/2018

2

HI2
MEDICARE ADVANTAGE PLANS
West Virginia (WV)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
10 United Mine Workers Of America Hlth & Retirement
(United Mine Workers Of America
Hlth & Retirement)
11 AARP MedicareComplete Choice Plan
(UnitedHealthcare)

Created on 11/05/2018

1

HI3
MEDICAID PROGRAM NAMES
West Virginia (WV)
1

West Virginia Medicaid

Created on 11/05/2018

1

HI4
MEDICAID HMOs
West Virginia (WV)
1

CoventryCares of WV

2

WV Family Health

3

The Health Plan

4

UniCare

Created on 11/05/2018

1

HI5
HEALTHCARE MARKETPLACE PLANS
West Virginia (WV)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
1

CareSource Marketplace Low Deductible [Tier]
(CareSource West Virginia Co.)

2

CareSource Marketplace Low Deductible [Tier]
Dental and (CareSource West Virginia Co.)

3

CareSource Marketplace Low Premium [Tier]
(CareSource West Virginia Co.)

4

CareSource Marketplace Low Premium [Tier]
Dental and (CareSource West Virginia Co.)

5

CareSource Marketplace Standard [Tier]
(CareSource West Virginia Co.)

6

CareSource Marketplace Standard [Tier] Dental
and (CareSource West Virginia Co.)

7

CareSource Marketplace [Tier] (CareSource
West Virginia Co.)
(continued)

Created on 11/05/2018

2

HI5
HEALTHCARE MARKETPLACE PLANS
West Virginia (WV)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
8

CareSource Marketplace [Tier] Dental and
(CareSource West Virginia Co.)

9

my Blue Access WV Major Events (Highmark Blue
Cross Blue Shield West Virginia)

10 my Blue Access WV [Tier] (Highmark Blue Cross
Blue Shield West Virginia)
11 my Blue Access WV [Tier] Free PCP Visits
(Highmark Blue Cross Blue Shield West Virginia)

Created on 11/05/2018

1

HI6
PUBLIC ASSISTANCE PLANS
West Virginia (WV)
1 West Virginia AIDS Drug Assistance Program

Created on 11/05/2018

1

HI2
MEDICARE ADVANTAGE PLANS
Wyoming (WY)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
1 Aetna Advantra Select (Aetna Medicare)
2 Aetna Medicare Select Plan (Aetna Medicare)
3 Lasso Healthcare (Lasso Healthcare)
4 UnitedHealthcare MedicareDirect (UnitedHealthcare)

Created on 11/05/2018

1

HI3
MEDICAID PROGRAM NAMES
Wyoming (WY)
1

Medicaid

Created on 11/05/2018

1

HI4
MEDICAID HMOs
Wyoming (WY)
1 Cheyenne Regional Medical Center PACE
2 CME Statewide

Created on 11/05/2018

1

HI5
HEALTHCARE MARKETPLACE PLANS
Wyoming (WY)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
1 BlueSelect [Tier] Balance (Blue Cross Blue Shield of
Wyoming)
2 BlueSelect [Tier] Classic (Blue Cross Blue Shield of
Wyoming)
3 BlueSelect [Tier] Core (Blue Cross Blue Shield of
Wyoming)
4 BlueSelect [Tier] HealthPlus (Blue Cross Blue Shield
of Wyoming)
5 BlueSelect [Tier] Value (Blue Cross Blue Shield of
Wyoming)

Created on 11/05/2018

1

HI6
PUBLIC ASSISTANCE PLANS
Wyoming (WY)
1 AIDS Drug Assistance Program
2 Wyoming Prescription Drug Assistance Program
(PDAP)

HIT1
TRICARE Plan Names
A. TRICARE for Life
B. TRICARE Plus
C. TRICARE Prime
D. TRICARE Extra
E. TRICARE Standard
F. TRICARE Pharmacy / TRICARE Senior
Pharmacy
G. TRICARE Dental Program
H. TRICARE Retiree Dental Program
I. TRICARE Reserve Select (TRS)
J. TRICARE US Family Health Plan
(continued)
Updated July 28, 2014

HIT1
Beneficiary Information Card
for TRICARE For Life
FRONT OF CARD

TRICARE For Life
To Provider: File claims in the usual manner to Medicare.
To Patient : Services that are a benefit of both Medicare and
TRICARE :No deductible or cost share is required.
Medicare only benefit :Medicare deductible and
cost share required.
TRICARE only benefit:TRICARE deductible and
cost share required.
For benefit questions call 1-888-DoD-LIFE

(1-888-363-5433)

www.tricare.osd.mil

For more information call 1-800-977-6753

www.hnfs.net

BACK OF CARD
TRICARE Senior Pharmacy
Military Treatment Facility: No Co-pay
National Mail Order Pharmacy: $3 generic;$9 brand name
(90 day supply)

TRICARE Network Pharmacy: $3 generic;$9 brand name
(30 day supply)

TRICARE Non-network Pharmacy: $9 or 20%of cost (30 day supply)
$150/person or $300/family
annual deductible applies.
For pharmacy questions call 1-877-DoD-MEDS

(1-877-363-6337)

(Co-pays subject to change)
5007334 (9/01 T85)

Updated July 28, 2014

HIT2
Places to Obtain Medicines in Tricare
Plan
• TRICARE Mail Order Pharmacy (TMOP)
• TRICARE Retail Pharmacy Network
Pharmacy (TRRx)
• Military Treatment Facility Pharmacy
(MTF)
• Non-network retail pharmacy

Updated July 28, 2014

IA1
Monthly Mortgage Payments
A. Less than $250
B. $250 – less than $500
C. $500 – less than $1,000
D. $1,000 – less than $3,000
E. $3,000 – less than $5,000
F. $5,000 or more

Updated August 1, 2015

IA2
Present Value of
Home/Apartment/Condo
A. Less than $50,000
B. $50,000 – less than $75,000
C. $75,000 – less than $100,000
D. $100,000 – less than $200,000
E. $200,000 – less than $300,000
F. $300,000 – less than $500,000
G. $500,000 – less than $750,000

H. $750,000 or more

Updated August 1, 2015

IA3
Monthly Rent
A. Less than $250
B. $250 – less than $500
C. $500 – less than $1,000
D. $1,000 – less than $3,000
E. $3,000 – less than $5,000
F. $5,000 or more

Updated August 1, 2015

IA4
Retirement Plans
• 401(k)
• 403(b)
• IRA
• Keogh

Updated August 1, 2015

IA5

Combined Monthly Social
Security or Railroad Retirement
Amount
A. Less than $1,300
B. $1,300 – less than $1,700
C. $1,700 – less than $2,200
D. $2,200 – less than $2,600
E. $2,600 or more

Updated August 1, 2015

IA6

Individual Monthly Social
Security or Railroad
Retirement Amount
A. Less than $700
B. $700 – less than $1,000
C. $1,000 – less than $1,300
D. $1,300 – less than $1,600
E. $1,600 or more

Updated August 1, 2015

IA7

Combined Monthly
Supplemental Security
Income Amount
A. Less than $300
B. $300 – less than $700
C. $700 – less than $1,000
D. $1,000 or more

Updated August 1, 2015

IA8

Individual Monthly
Supplemental Security
Income Amount
A. Less than $100
B. $100 – less than $200
C. $200 – less than $400
D. $400 – less than $700
E. $700 or more

Updated August 1, 2015

IA9

Combined Monthly Veterans
Administration Income
Amount
A. Less than $1,000
B. $1,000 – less than $1,400
C. $1,400 – less than $1,800
D. $1,800 – less than $2,200
E. $2,200 or more

Updated August 1, 2015

IA10

Individual Monthly Veterans
Administration Income
Amount
A. Less than $500
B. $500 – less than $700
C. $700 – less than $900
D. $900 – less than $1,100
E. $1,100 or more

Updated August 1, 2015

IA11
Combined Monthly Pension
Payment
A. Less than $600
B. $600 – less than $1,300
C. $1,300 – less than $2,100
D. $2,100 – less than $5,900
E. $5,900 or more

Updated August 1, 2015

IA12
Individual Monthly Pension
Payment
A. Less than $400
B. $400 – less than $900
C. $900 – less than $1,600
D. $1,600 – less than $3,800
E. $3,800 or more

Updated August 1, 2015

IA13
Combined Total Retirement
Accounts
A. Less than $34,000
B. $34,000 – less than $82,000
C. $82,000 – less than $175,000
D. $175,000 – less than $413,000
E. $413,000 or more

Updated August 1, 2015

IA14
Individual Total Retirement
Accounts
A. Less than $20,000
B. $20,000 – less than $47,000
C. $47,000 – less than $92,000
D. $92,000 – less than $218,000
E. $218,000 or more

Updated August 1, 2015

IA15

Combined Monthly Amount
Received from Retirement
Account
A. Less than $200
B. $200 – less than $500
C. $500 – less than $1,000
D. $1,000 – less than $2,500
E. $2,500 or more

Updated August 1, 2015

IA16

Individual Monthly Amount
Received from Retirement
Account
A. Less than $100
B. $100 – less than $300
C. $300 – less than $700
D. $700 – less than $1,700
E. $1,700 or more

Updated August 1, 2015

IA17

Combined Amount Received
from Retirement Account Last
Year
A. Less than $2,400
B. $2,400 – less than $6,000
C. $6,000 – less than $12,000
D. $12,000 – less than $30,000
E. $30,000 or more

Updated August 1, 2015

IA18

Individual Amount Received
from Retirement Account Last
Year
A. Less than $1,200
B. $1,200 – less than $3,600
C. $3,600 – less than $8,400
D. $8,400 – less than $20,400
E. $20,400 or more

Updated August 1, 2015

IA19

Combined Mutual
Funds/Stocks/Bonds Not Part
of Retirement Account
A. Less than $9,000
B. $9,000 – less than $18,000
C. $18,000 – less than $93,000
D. $93,000 – less than $350,000
E. $350,000 or more

Updated August 1, 2015

IA20

IAQ35C- Mutual
Funds/Stocks/Bonds Not Part
of Retirement Account
A. Less than $600
B. $600 – less than $5,000
C. $5,000 – less than $16,000
D. $16,000 – less than $62,000
E. $62,000 or more

Updated August 1, 2015

IA21

IAC26A- Mutual
Funds/Stocks/Bonds Not Part
of Retirement Account
A. Less than $8,000
B. $8,000 – less than $62,000
C. $62,000 – less than $192,000
D. $192,000 – less than $213,000
E. $213,000 or more

Updated August 1, 2015

IA22

IAQ36C- Mutual
Funds/Stocks/Bonds Not Part
of Retirement Account
A. Less than $300
B. $300 – less than $2,500
C. $2,500 – less than $8,000
D. $8,000 – less than $37,000
E. $37,000 or more

Updated August 1, 2015

IA23
IAQ38B – All Accounts Last
Month
A. Less than $11,000
B. $11,000 – less than $25,000
C. $25,000 – less than $50,000
D. $50,000 – less than $108,000
E. $108,000 or more

Updated August 1, 2015

IA24
IAQ38C – All Accounts Last
Month
A. Less than $2,000
B. $2,000 – less than $7,000
C. $7,000 – less than $17,000
D. $17,000 – less than $57,000
E. $57,000 or more

Updated August 1, 2015

IA25
IAQ39B/IAQ40B – All Accounts
Last Month
A. Less than $8,000
B. $8,000 – less than $13,000
C. $13,000 – less than $28,000
D. $28,000 – less than $54,000
E. $54,000 or more

Updated August 1, 2015

IA26
IAQ39C/IAQ40C – All Accounts
Last Month
A. Less than $500
B. $500 – less than $1,900
C. $1,900 – less than $5,000
D. $5,000 – less than $20,000
E. $20,000 or more

Updated August 1, 2015

IA27
IAQ41 – Combined Interest and
Dividends Last Year
A. Less than $200
B. $200 – less than $1,000
C. $1,000 – less than $4,000
D. $4,000 – less than $16,000
E. $16,000 or more

Updated August 1, 2015

IA28
IAQ42B/IAQ43B – Individual
Interest and Dividend Income
A. Less than $400
B. $400 – less than $1,000
C. $1,000 – less than $2,000
D. $2,000 – less than $11,000
E. $11,000 or more

Updated August 1, 2015

IA29
IAQ44A – Value of Business,
Farm, or Real Estate
A. Less than $30,000
B. $30,000 – less than $101,000
C. $101,000 – less than $247,000
D. $247,000 – less than $703,000
E. $703,000 or more

Updated August 1, 2015

IA30
IAQ45B/IAQ46A – Value of
Business, Farm, or Real Estate
A. Less than $18,000
B. $18,000 – less than $68,000
C. $68,000 – less than $122,000
D. $122,000 – less than $293,000
E. $293,000 or more

Updated August 1, 2015

IA31
IAQ47B – Income from
Businesses or Property
A. Less than $3,600
B. $3,600 – less than $12,000
C. $12,000 – less than $25,000
D. $25,000 – less than $64,000
E. $64,000 or more

Updated August 1, 2015

IA32
IAQ48B/IAQ49B – Income from
Businesses or Property
A. Less than $3,600
B. $3,600 – less than $7,200
C. $7,200 – less than $14,000
D. $14,000 – less than $38,000
E. $38,000 or more

Updated August 1, 2015

IA33
IAQ51A – Total Combined
Income
A. Less than $5,000
B. $5,000 - less than $10,000
C. $10,000 - less than $15,000
D. $15,000 - less than $20,000
E. $20,000 - less than $25,000
F. $25,000 - less than $30,000
G. $30,000 - less than $40,000
H. $40,000 - less than $50,000
I.

$50,000 - less than $66,000

J. $66,000 - less than $109,000
K. $109,000 or more

Updated May 3, 2017

IA34
IAQ51B – Total Income
A. Less than $5,000
B. $5,000 - less than $10,000
C. $10,000 - less than $15,000
D. $15,000 - less than $20,000
E. $20,000 - less than $25,000
F. $25,000 - less than $30,000
G. $30,000 - less than $40,000
H. $40,000 - less than $50,000
I. $50,000 - less than $66,000
J. $66,000 - less than $109,000
K. $109,000 or more

Updated May 3, 2017

IA35
Lump Sum Payments
A. Insurance Settlement
B. Pension Settlement
C. Inheritance (or Trust)
D. Gift
E. Lawsuit

Updated May 4, 2016

IA36
Present Value of Vehicles
A. Less than $2,500
B. $2,500 – less than $5,000
C. $5,000 – less than $7,500
D. $7,500 – less than $10,000
E. $10,000 – less than $20,000
F. $20,000 or more

Updated May 4, 2016

IU1
Long Term Care Places
●

Skilled nursing homes

●

Intermediate care facilities

●

Board and care homes

●

Nursing home units in hospitals

●

Facilities for the intellectually disabled

●

Psychiatric facilities

●

Group homes

Updated January 10, 2018

KN1
• Very easy
• Somewhat easy
• Somewhat difficult
• Very difficult

Updated July 28, 2014

KN2
• Just about everything you need to know
• Most of what you need to know
• Some of what you need to know
• A little of what you need to know
• Almost none of what you need to know

Updated July 28, 2014

KN3
• Very interested
• Somewhat interested
• Not very interested
• Not at all interested

Updated January 13, 2016

KN4
• Very easy
• Somewhat easy
• Somewhat difficult
• Very difficult

Updated January 11, 2017

KN5
• At least once every year
• Once every few years
• Rarely
• Never
• Only once when first signed up for drug
plan
• Only once when first signed up for
Medicare
• Just signed up for Medicare

Updated January 11, 2017

KN6
• Completely agree
• Somewhat agree
• Somewhat disagree
• Completely disagree

Updated January 11, 2017

KN7
• Very satisfied
• Satisfied
• Dissatisfied
• Very Dissatisfied

Updated January 11, 2017

KN8

Updated January 10, 2018

KN9
• Very easy
• Somewhat easy
• Somewhat difficult
• Very difficult

Updated January 11, 2017

KN10
KN1
KN2
• Medicare Parts A and B (Original
Medicare)
• Medicare Part C, Medicare Advantage
(MA) Plans
• Medicare Part D, Medicare Prescription
Drug Plans (MPDPs)
• Medigap Plans

Updated January, 2020

MP1
Health Practitioners Who Are Not
Medical Doctors
● Acupuncturist
● Chiropractor
● Podiatrist (foot doctor)
● Homeopath
● Naturopath
● Any other kind of health provider who is
not a medical doctor

Updated January 2019

MP2
Mental Health Professionals
• Psychiatrist
• Psychologist
• Clinical social worker
• Licensed professional counselor

Updated July 28, 2014

MP3
Therapists
• Physical therapist
• Speech therapist
• (Intravenous) I.V. therapist
• Massage therapist
• Occupational therapist
• Respiratory therapist

Updated July 28, 2014

MP4
Other Medical Persons
• Nurse
• Nurse practitioner
• Paramedic (not including ambulance
services)
• Physician's assistant

Updated July 28, 2014

MP5
Other Types of Medical Places
• Health clinic
• Neighborhood health center
• Rural health clinic
• Infirmary
• Mental health clinic
• Urgent care center
• Any other place

Updated July 28, 2014

MP6
• Didn't think the problem was serious
• Thought it would cost too much
• Trouble finding or getting to the doctor
• Time, schedule, or personal conflicts
• Thought doctor couldn’t do much about
the problem
• Was afraid of finding out what was wrong
• Doctor would not accept my insurance

Updated July 24, 2017

NA1
• 12 oz. beer
• 5 oz. glass of wine
• One and a half ounces of liquor

Updated August 3, 2016

OM1
Orthopedic Items
• Crutches
• Canes
• Wheelchairs
• Walkers
• Corrective shoes or inserts
• Support stockings
• Braces or supports

Updated July 28, 2014

OM2
Diabetic Equipment or Supplies
• Syringes
• Test paper
• Test strips
• Blood monitoring kits

Updated July 28, 2014

OM3
Prostheses
• Artificial leg or arm
• Mastectomy prosthesis
• Artificial or glass eye

Updated July 28, 2014

OM4
Other Medical Equipment and Supplies
• Portable commode or raised toilet seat
• Portable tub seat
• Special chair or cushion
• Hospital bed
• Ostomy supplies
• Incontinence supplies (such as depends,
serenity or other brands of disposable
undergarments, pads, or briefs)
• Bandages, dressings, tape supplies
• Pulmonary equipment (nebulizer, CPAP, etc.)

• Blood pressure equipment (such as cuffs or
monitors)

Updated July 28, 2014

OM5
Alterations Inside or Outside Home or
Car
• Ramps
• Handrails (other than tub handrails)
• Elevator or incline chair
• Tub seats
• Tub handrails
• Any car alteration

Updated July 28, 2014

PM1
• Thought it would cost too much
• Didn’t think medicine would help
condition
• Was afraid of medicine
reactions/contraindications
• Don’t like to take medicine
• Didn’t think medicine was necessary
• Not covered by insurance/not on plan
formulary
• Trouble obtaining medicine
• Obtained/used samples
• Used another medicine as a substitution

Updated July 24, 2017

KN2
PV1
• It’s unlikely you’ve been exposed to HIV
• You were afraid to find out if you were
HIV positive (that you had HIV)
• Dr. did not prescribe or recommend it
• You didn’t want to think about HIV or
about being HIV positive
• You were worried your name would be
reported to the government if you tested
positive
• You didn’t know where to get tested
• You don’t like needles
• You were afraid of losing job, insurance,
housing, friends, family, if people knew
you were positive for AIDS infection
• Some other reason
• No particular reason

Updated July, 2019

RX1
• Very easy
• Somewhat easy
• Somewhat difficult
• Very difficult

Updated July 28, 2014

RX2
• Just about everything you need to know
• Most of what you need to know
• Some of what you need to know
• A little of what you need to know
• Almost none of what you need to know

Updated July 28, 2014

RX3
• Very satisfied
• Satisfied
• Dissatisfied
• Very dissatisfied

Updated July 28, 2014

RX4
• Extremely confident
• Very confident
• Moderately confident
• Slightly confident
• Not confident

Updated July 28, 2014

RX5

● Often
● Sometimes
● Never

Updated May 2 2018

SC1
• Very satisfied
• Satisfied
• Dissatisfied
• Very dissatisfied

Updated July 28, 2014

SC2
• Very Confident
• Confident
• Somewhat Confident
• Not at all Confident

Updated July, 2019

SC3
• Very Likely
• Likely
• Unlikely
• Very Unlikely

Updated July 2019

SC4
• Always
• Usually
• Sometimes
• Never

Updated July, 2019

US1
• Allergy/Immunology
• Anesthesiology
• Cardiology (Heart)
• Dermatology (Skin)
• Endocrinology/ Metabolism (Diabetes, Thyroid)
• Family Practice
• Gastroenterology
• General Practice
• General Surgery
• Geriatrics (Elderly)
• Gynecology - Obstetrics
• Hematology (Blood)
• Hospital Residence
• Internal Medicine (Internist)
• Nephrology (Kidneys)
• Neurology
(continued)
Updated January 10, 2018

US1
• Nuclear Medicine
• Oncology (Tumors, Cancer)
• Ophthalmology (Eyes)
• Orthopedics
• Osteopathy (DO)
• Otorhinolaryngology (Ear, Nose, Throat)
• Pathology
• Phys Med/Rehab
• Physician’s Assistant
• Plastic Surgery
• Proctology
• Psychiatry/Psychiatrist
• Pulmonary (Lungs)
• Radiology
• Rheumatology (Arthritis)
• Thoracic Surgery (Chest)
• Urology

Updated January 10, 2018

US2
• Very Well
• Well
• Not Well
• Not at All

Updated January 10, 2018

US3
US3
• Professional Interpreter
• Staff Person At Medical Provider’s
Office
• Family Member
• Friend
• Someone Else
• Does Best That Can In English

Updated January 10, 2018

US4
• Never
• Sometimes
• Usually
• Always

Updated January 10, 2018

US5
• Yes, Definitely
• Yes, Somewhat
• No

Updated January 10, 2018

US6
• Strongly Agree
• Agree
• Disagree
• Strongly Disagree

Updated January 10, 2018

US7
0 Hard to Manage
1
2
3
4
5
6
7
8
9
10 Easy to Manage

Updated January 10, 2018

US8
KN1
KN2
• Much more than it should be
• Somewhat more than it should be
• About what it should be
• Somewhat less than it should be
• Much less than it should be
• No opinion

Updated January, 2020