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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.
MCBS Showcards
Quex Sections
ACQ
CPS
CPQ
DIQ
DVH
END
ENS
ERQ
HAQ
HFQ
Showcards
AC1
(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
HF7
HF8
HF9
Current Version
January 8, 2020
(None)
May 8, 2019
May 8, 2019
May 8, 2019
July 28, 2014
July 28, 2014
July 28, 2014
July 28, 2014
July 28, 2014
August 1, 2015
January 9, 2019
January 9, 2019
May 8, 2019
January 8, 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
August 3, 2016
July 2021
July 2021
MCBS Showcards
Quex Sections
Showcards
HF10
HHQ
HIQ
IAQ
Current Version
July 2021
HF11
HF12
HH1
HH2
HH3
HH4
HH5
HI1
July 2021
July 2021
May 2020
July 28, 2014
July 28, 2014
July 28, 2014
May 2020
HI2
HI3
HI4
HI5
HI6
HIT1
HIT2
IA1
IA2
IA3
IA4
IA5
IA6
IA7
IA8
IA9
IA10
IA11
IA12
IA13
IA14
November 5, 2019
November 5, 2019
November 5, 2019
November 5, 2019
November 5, 2019
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
August 1, 2015
August 1, 2015
August 1, 2015
August 1, 2015
February 17, 2015 & July 24, 2017
MCBS Showcards
Quex Sections
INQ
IPQ
IUQ
KNQ
Showcards
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
KN1
KN2
KN3
KN4
KN5
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
May 3, 2017
May 3, 2017
May 4, 2016
May 4, 2016
(None)
(None)
January 10, 2018
July 28, 2014
July 28, 2014
January 13, 2016
January 11, 2017
January 11, 2017
MCBS Showcards
Quex Sections
MBQ
MPQ
NAQ
NSQ
OMQ
OPQ
PMQ
PVQ
PMS and PVQ
PXQ
RXQ
Showcards
KN6
KN7
KN8
KN9
KN10
(None)
MP1
MP2
MP3
MP4
MP5
MP6
NA1
(None)
OM1
OM2
OM3
OM4
OM5
(None)
PM1
PV1
PV2
PV3
(None)
PX1
PX2
PX3
PX4
RX1
Current Version
January 11, 2017
January 11, 2017
May 8, 2019
January 11, 2017
January 8, 2020
(None)
January 9, 2019
July 28, 2014
July 28, 2014
July 28, 2014
July 28, 2014
July 24, 2017
August 3, 2016
(None)
July 28, 2014
July 28, 2014
July 28, 2014
July 28, 2014
July 28, 2014
(None)
July 24, 2017
July 2020
July 2020
July 2020
(None)
July 2020
July 2020
July 2020
May 2022
July 28, 2014
MCBS Showcards
Quex Sections
SCQ
STQ
USQ
Showcards
RX2
RX3
RX4
RX5
SC1
SC2
SC3
SC4
(None)
US1
US2
US3
US4
US5
US6
US7
US8
Current Version
July 28, 2014
July 28, 2014
July 28, 2014
May 2, 2018
July 28, 2014
July 22, 2019
July 22, 2019
July 22, 2019
(None)
January 8, 2020
January 10, 2018
January 10, 2018
January 10, 2018
January 10, 2018
January 10, 2018
January 10, 2018
January 8, 2020
AC1
• Allergy/immunology
• Anesthesiology
• Audiologist
• Cardiology (heart)
• Chiropractor
• Dentist
• Dermatology (skin)
• Endocrinology/metabolism (diabetes, thyroid)
• Family practice
• Gastroenterology
• General practice
• General surgery
• Geriatrics (elderly)
• Gynecology – obstetrics
• Hematology (blood)
• Hospital residence
(continued)
Updated January 8, 2020
AC1
• Internal medicine (internist)
• Nephrology (kidneys)
• Neurology
• Nuclear medicine
• Nurse practitioner
• Oncology (tumors, cancer)
• Ophthalmology (eyes)
• Optometrist
• Orthopedics
• Osteopathy (DO)
• Otorhinolaryngology (ear, nose, throat)
• Pain Management Specialist
• Pathology
• Phys med/rehab
• Physical Therapist
• Physician’s Assistant
(continued)
Updated January 8, 2020
AC1
• Plastic surgery
• Podiatrist
• Proctology
• Psychiatry/psychiatrist
• Psychologist
• Pulmonary (lungs)
• Radiology
• Rheumatology (arthritis)
• Thoracic surgery (chest)
• Urology
• Vascular Surgeon/Specialist
Updated January 8, 2020
CP1
● Never
● Some days
● Most days
● Every day
Updated May 8, 2019
CP2
● A little
● A lot
● Somewhere in between a little
and a lot
Updated May 8, 2019
CP3
● Not at all
● A little
● A lot
● Somewhere in between a little
and a lot
Updated May 8, 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 January 9, 2019
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 January 9, 2019
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 9, 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 May 8, 2019
DVH4
In the Canal (ITC)
In the Ear (ITE)
Behind the Ear
(BTE)
Updated January 8, 2020
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
VITAMINS AND
MINERALS
Calcium, Vitamin C, Iron, Vitamin E, Magnesium, Zinc,
Vitamin D, Vitamin A, Potassium, Vitamin B-12
MULTI-VITAMINS AND
MULTI-MINERALS
One a Day, Prenatals, B-Complex, Centrum, Theragran
HERBALS AND
BOTANICLAS
Echinacea, Garlic, Saw Palmetto, Ginkgo, Ginseng
FIBER
Metamucil, Fibercon, Benefiber
AMINO ACIDS
Lysine, Methionine, Tryptophan
OTHERS
Fish Oil, Omega-3, Chondroitin, Joint Supplements
(Glucosamine), Choline, Melatonin, Probiotics
Updated July 2021
HF9
• Calcium (with or without vitamin D)
• Choline
• Coenzyme Q
• Eye health supplement (such as Ocuvite
PreserVision or I-Caps)
• Fiber supplement (such as Metamucil or
Benefiber)
• Folate or folic acid
• Garlic supplement
• Iron
(continued)
Updated July 2021
HF9
• Joint supplement (such as glucosamine,
with or without chondroitin or other
ingredients)
• Magnesium
• Melatonin
• Niacin
• Omega-3 (ALA/DHA/EPA) or fish oil
• Potassium
• Probiotics (in pill, powder, or liquid form)
• Saw palmetto
• Vitamin A
• Vitamin B-12
(continued)
Updated July 2021
HF9
• Vitamin B-complex
• Vitamin C
• Vitamin D (NOT as part of a calcium
supplement)
• Vitamin E
• Zinc
Updated July 2021
HF10
HF9
• Not at all
• Several days
• More than half the days
• Nearly every day
Updated July 2021
HF11
HF10
HF9
HF8
• Not at all difficult
• Somewhat difficult
• Very difficult
• Extremely difficult
Updated July 2021
HF12
• 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 July 2021
HH1
Home Help by Health or Medical
Professionals
Nurse (visiting nurse, private duty nurse,
etc.)
Doctor
Social worker
Therapist
Hospice worker
Home health aides
Those who provide homemaker services
Updated May 2020
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
Friends
Neighbors
Relatives
Updated May 2020
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 11/05/2019
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
Blue Advantage (Blue Cross and Blue Shield of
Alabama)
3
Bright Advantage (Bright Health)
4
Cigna-HealthSpring (Cigna)
5
Cigna-HealthSpring True Choice (Cigna)
6
Humana Gold Choice (Humana)
7
Humana Gold Plus (Humana)
8
Humana Honor (Humana)
9
Humana Value Plus (Humana)
10
HumanaChoice (Humana)
(continued)
Created on 11/05/2019
2
HI2
MEDICARE ADVANTAGE PLANS
Alabama (AL)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
11 AARP Medicare Advantage (UnitedHealthcare)
12 AARP Medicare Advantage Plan (UnitedHealthcare)
13 VIVA Medicare (VIVA Medicare)
14 WellCare Value (WellCare)
Created on 11/05/2019
1
HI3
MEDICAID PROGRAM NAMES
Alabama (AL)
1
Medicaid
Created on 11/05/2019
1
HI4
MEDICAID HMOs
Alabama (AL)
1
Health Homes
2
Maternity Program
3
Mercy Life of Alabama
4
Patient 1st
Created on 11/05/2019
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 of Alabama,
Inc.)
7 [Tier] Plus (Bright Health Insurance Company of
Alabama, Inc.)
Created on 11/05/2019
1
HI6
PUBLIC ASSISTANCE PLANS
Alabama (AL)
1 Alabama AIDS Drug Assistance Program (Ryan
White Program)
2 Alabama Rx Card
3 Senior Rx
Created on 11/05/2019
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
Aetna Medicare (Aetna Medicare)
3
Aetna Medicare Premier (Aetna Medicare)
4
Allwell Medicare (Allwell)
5
Cigna-HealthSpring Preferred (Cigna)
6
Medi-Pak Advantage (Health Advantage)
7
Humana (Humana)
8
Humana Gold Choice (Humana)
9
HumanaChoice (Humana)
10
Lasso Healthcare (Lasso Healthcare)
(continued)
Created on 11/05/2019
2
HI2
MEDICARE ADVANTAGE PLANS
Arkansas (AR)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
11 AARP Medicare Advantage Plan (UnitedHealthcare)
12 UnitedHealthcare Medicare Advantage Choice Plan
(UnitedHealthcare)
13 Vantage (Vantage Health Plan of Arkansas, Inc.)
14 WellCare (WellCare)
15 WellCare Premier (WellCare)
Created on 11/05/2019
1
HI3
MEDICAID PROGRAM NAMES
Arkansas (AR)
1
Arkansas Medicaid
Created on 11/05/2019
1
HI4
MEDICAID HMOs
Arkansas (AR)
1
Multiple Primary Care Providers
2
Net Transportation
3
PACE
Created on 11/05/2019
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 Balanced Care QualChoice (QCA
Health Plan, Inc.)
3
Ambetter Balanced Care QualChoiceLife
(QualChoice Life & Health Insurance Company,
Inc.)
4
Ambetter Essential Care (Celtic Insurance
Company)
5
Ambetter Essential Care QualChoice (QCA
Health Plan, Inc.)
6
Ambetter Secure Care (Celtic Insurance
Company)
7
Ambetter Secure Care QualChoice (QCA Health
Plan, Inc.)
(continued)
Created on 11/05/2019
2
HI5
HEALTHCARE MARKETPLACE PLANS
Arkansas (AR)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
8
Ambetter Secure Care QualChoiceLife (QualChoice
Life & Health Insurance Company, Inc.)
9
[Tier] (USAble Mutual Insurance Company)
10 [Tier] AW (USAble Mutual Insurance Company)
Created on 11/05/2019
1
HI6
PUBLIC ASSISTANCE PLANS
Arkansas (AR)
1 Arkansas AIDS Drug Assistance Program (ADAP)
(Ryan White Program)
2 Arkansas Health Care Access Foundation (AHCAF)
Created on 11/05/2019
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 (Amerigroup)
5
BlueJourney (Blue Cross Blue Shield of Arizona)
6
BluePathway Plan (Blue Cross Blue Shield of
Arizona)
7
Blue Medicare Advantage (Blue Cross Blue
Shield of Arizona Advantage)
8
Bright Advantage (Bright Health)
9
Cigna-HealthSpring (Cigna)
(continued)
Created on 11/05/2019
2
HI2
MEDICARE ADVANTAGE PLANS
Arizona (AZ)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
10
Clover Health Choice (Clover Health)
11
Humana (Humana)
12
Humana Gold Plus (Humana)
13
HumanaChoice (Humana)
14
Imperial Health Insurance Traditional (Imperial
Insurance Company of Texas, Inc)
15
Lasso Healthcare (Lasso Healthcare)
16
AARP Medicare Advantage (UnitedHealthcare)
17
AARP Medicare Advantage Walgreens
(UnitedHealthcare)
18
UnitedHealthcare Medicare Advantage Assure
(UnitedHealthcare)
(continued)
Created on 11/05/2019
3
HI2
MEDICARE ADVANTAGE PLANS
Arizona (AZ)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
19 UnitedHealthcare MedicareDirect (UnitedHealthcare)
20 WellCare (WellCare)
Created on 11/05/2019
1
HI3
MEDICAID PROGRAM NAMES
Arizona (AZ)
1 Arizona Health Care Cost Containment System
(AHCCS)
Created on 11/05/2019
1
HI4
MEDICAID HMOs
Arizona (AZ)
1
Bridgeway Health Solution (MLTSS)
2
Care1st Health Plan
3
Cenpatico Integrated Care
4
DCS/CMDP
5
DES/Division of Developmental Disabilities
(MLTSS)
6
Health Choice Arizona
7
Health Choice Integrated Care
8
Health Net Access
9
Maricopa Health Plan
10
Mercy Care Plan
11
Mercy Care Plan (MLTSS)
12
Mercy Maricopa Integrated Care
(continued)
Created on 11/05/2019
2
HI4
MEDICAID HMOs
Arizona (AZ)
13
Phoenix Health Plan
14
United Healthcare Plan
15
United Healthcare Plan (MLTSS)
16
University Family Care
Created on 11/05/2019
1
HI5
HEALTHCARE MARKETPLACE PLANS
Arizona (AZ)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
1
AdvanceHealth MaricopaFocus Network (Blue
Cross and Blue Shield of Arizona, Inc.)
2
AdvanceHealth PimaFocus Network (Blue Cross
and Blue Shield of Arizona, Inc.)
3
Ambetter Balanced Care (Health Net of Arizona,
Inc.)
4
Ambetter Essential Care (Health Net of Arizona,
Inc.)
5
Ambetter Secure Care (Health Net of Arizona,
Inc.)
6
Cigna Connect (Cigna HealthCare of Arizona,
Inc)
7
EverydayHealth MaricopaFocus Network (Blue
Cross and Blue Shield of Arizona, Inc.)
(continued)
Created on 11/05/2019
2
HI5
HEALTHCARE MARKETPLACE PLANS
Arizona (AZ)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
8
EverydayHealth Neighborhood Network (Blue
Cross and Blue Shield of Arizona, Inc.)
9
EverydayHealth PimaFocus Network (Blue Cross
and Blue Shield of Arizona, Inc.)
10
Oscar Classic [Tier] (Oscar Health Plan, Inc.)
11
Oscar Classic [Tier] Next (Oscar Health Plan,
Inc.)
12
Oscar Saver [Tier] (Oscar Health Plan, Inc.)
13
Oscar Simple Secure (Oscar Health Plan, Inc.)
14
Oscar Simple [Tier] (Oscar Health Plan, Inc.)
(continued)
Created on 11/05/2019
3
HI5
HEALTHCARE MARKETPLACE PLANS
Arizona (AZ)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
15
Portfolio Neighborhood Network (Blue Cross and
Blue Shield of Arizona, Inc.)
16
Portfolio PimaFocus Network (Blue Cross and
Blue Shield of Arizona, Inc.)
17
SimpleHealth MaricopaFocus Network (Blue
Cross and Blue Shield of Arizona, Inc.)
18
SimpleHealth Neighborhood Network (Blue Cross
and Blue Shield of Arizona, Inc.)
19
SimpleHealth PimaFocus Network (Blue Cross
and Blue Shield of Arizona, Inc.)
20
TrueHealth MaricopaFocus Network (Blue Cross
and Blue Shield of Arizona, Inc.)
21
TrueHealth Neighborhood Network (Blue Cross
and Blue Shield of Arizona, Inc.)
(continued)
Created on 11/05/2019
4
HI5
HEALTHCARE MARKETPLACE PLANS
Arizona (AZ)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
22 TrueHealth PimaFocus Network (Blue Cross and
Blue Shield of Arizona, Inc.)
23 [Tier] (Bright Health Company of Arizona)
24 [Tier] Plus (Bright Health Company of Arizona)
25 [Tier] Premier (Bright Health Company of Arizona)
Created on 11/05/2019
1
HI6
PUBLIC ASSISTANCE PLANS
Arizona (AZ)
1 Arizona AIDS Drug Assistance Program (ADAP)
2 Arizona Rx Card
Created on 11/05/2019
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
Aetna Medicare Plus Plan (Aetna Medicare)
4
Alignment Health Plan (Alignment Health Plan)
5
My Choice (Alignment Health Plan)
6
Sutter Advantage (Alignment Health Plan)
7
Anthem MediBlue (Anthem Blue Cross)
8
Anthem MediBlue Access (Anthem Blue Cross
Life and Health Insurance Co.)
9
Aspire Health (Aspire Health Plan)
(continued)
Created on 11/05/2019
2
HI2
MEDICARE ADVANTAGE PLANS
California (CA)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
10
Blue Shield (Blue Shield of California)
11
Blue Shield Medicare (Blue Shield of California)
12
Blue Shield Promise (Blue Shield of California
Promise Health Plan)
13
Brand New Day Classic (Brand New Day)
14
Central Health (Central Health Medicare Plan)
15
CCHP Senior Program (Chinese Community
Health Plan)
16
Connected Care (Golden State)
17
Golden State Senior Health Plan (Golden State)
(continued)
Created on 11/05/2019
3
HI2
MEDICARE ADVANTAGE PLANS
California (CA)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
18
Health Net Seniority Plus Sapphire Premier
(HEALTH NET COMMUNITY SOLUTIONS, INC.)
19
Health Net (Health Net of California)
20
Humana (Humana)
21
Humana Community (Humana)
22
Ibt Voluntary Employee Benefits Trust (Employer
Pdp) (Ibt Voluntary Employee Benefits Trust)
23
Imperial Traditional (Imperial Health Plan of
California, Inc.)
24
Inter Valley Health Plan (Inter Valley Health Plan)
25
Kaiser Permanente (Kaiser Permanente)
26
SCAN (SCAN Health Plan)
(continued)
Created on 11/05/2019
4
HI2
MEDICARE ADVANTAGE PLANS
California (CA)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
27
Scripps (SCAN Health Plan)
28
Sharp Direct Advantage (Sharp Health Plan)
29
Stanford Health Care Advantage (Stanford Health
Care Advantage)
30
AARP Medicare Advantage (UnitedHealthcare)
31
Sharp SecureHorizons Plan by UnitedHealthcare
(UnitedHealthcare)
32
UnitedHealthcare (UnitedHealthcare)
33
Choice (Vitality Health Plan of California)
34
Plus (Vitality Health Plan of California)
(continued)
Created on 11/05/2019
5
HI2
MEDICARE ADVANTAGE PLANS
California (CA)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
35
WellCare (WellCare)
Created on 11/05/2019
1
HI3
MEDICAID PROGRAM NAMES
California (CA)
1
Medi-Cal
Created on 11/05/2019
1
HI4
MEDICAID HMOs
California (CA)
1
Access Dental Plan/Los Angeles
2
Access Dental Plan/Sacramento
3
Alameda Alliance for Health
4
AltaMed Senior Buenacare/Los Angeles
5
Anthem Blue Cross Partnership Plan/Alameda
6
Anthem Blue Cross Partnership Plan/Alpine
7
Anthem Blue Cross Partnership Plan/Amador
8
Anthem Blue Cross Partnership Plan/Butte
9
Anthem Blue Cross Partnership Plan/Calaveras
10
Anthem Blue Cross Partnership Plan/Colusa
(continued)
Created on 11/05/2019
2
HI4
MEDICAID HMOs
California (CA)
11
Anthem Blue Cross Partnership Plan/Contra
Costa
12
Anthem Blue Cross Partnership Plan/El Dorado
13
Anthem Blue Cross Partnership Plan/Fresno
14
Anthem Blue Cross Partnership Plan/Glenn
15
Anthem Blue Cross Partnership Plan/Inyo
16
Anthem Blue Cross Partnership Plan/Kings
17
Anthem Blue Cross Partnership Plan/Madera
18
Anthem Blue Cross Partnership Plan/Mariposa
19
Anthem Blue Cross Partnership Plan/Mono
20
Anthem Blue Cross Partnership Plan/Nevada
(continued)
Created on 11/05/2019
3
HI4
MEDICAID HMOs
California (CA)
21
Anthem Blue Cross Partnership Plan/Placer
22
Anthem Blue Cross Partnership Plan/Plumas
23
Anthem Blue Cross Partnership Plan/Sacramento
24
Anthem Blue Cross Partnership Plan/San Benito
25
Anthem Blue Cross Partnership Plan/San
Francisco
26
Anthem Blue Cross Partnership Plan/Santa Clara
27
Anthem Blue Cross Partnership Plan/Sierra
28
Anthem Blue Cross Partnership Plan/Sutter
(continued)
Created on 11/05/2019
4
HI4
MEDICAID HMOs
California (CA)
29
Anthem Blue Cross Partnership Plan/Tehama
30
Anthem Blue Cross Partnership Plan/Tulare
31
Anthem Blue Cross Partnership Plan/Tuolumne
32
Anthem Blue Cross Partnership Plan/Yuba
33
Brandman Centers for Senior Care/Los Angeles
34
CalOptima PACE/Orange
35
CalOptima/Orange
36
CalViva Health/Fresno
37
CalViva Health/Kings
38
CalViva Health/Madera
39
California Health & Wellness/Alpine
(continued)
Created on 11/05/2019
5
HI4
MEDICAID HMOs
California (CA)
40
California Health & Wellness/Amador
41
California Health & Wellness/Butte
42
California Health & Wellness/Calaveras
43
California Health & Wellness/Colusa
44
California Health & Wellness/El Dorado
45
California Health & Wellness/Glenn
46
California Health & Wellness/Imperial
47
California Health & Wellness/Inyo
48
California Health & Wellness/Mariposa
49
California Health & Wellness/Mono
50
California Health & Wellness/Nevada
51
California Health & Wellness/Placer
52
California Health & Wellness/Plumas
(continued)
Created on 11/05/2019
6
HI4
MEDICAID HMOs
California (CA)
53
California Health & Wellness/Sierra
54
California Health & Wellness/Sutter
55
California Health & Wellness/Tehama
56
California Health & Wellness/Tuolumne
57
California Health & Wellness/Yuba
58
Care 1st Healthplan/San Diego
59
CenCal Health/San Luis Obispo
60
CenCal Health/Santa Barbara
61
Center for Elders Independence/Alameda
62
Center for Elders Independence/Contra Costa
63
Central California Alliance for Health/Merced
(continued)
Created on 11/05/2019
7
HI4
MEDICAID HMOs
California (CA)
64
Central California Alliance for Health/Monterey
65
Central California Alliance for Health/Santa Cruz
66
Community Health Group/San Diego
67
Contra Costa Health Plan
68
Family Mosaic Project/San Francisco
69
Fresno PACE
70
Gold Coast Health Plan/Ventura
71
Health Net Dental Plan/Los Angeles
72
Health Net Dental Plan/Sacramento
73
Health Net/Kern
74
Health Net/Los Angeles
75
Health Net/Sacramento
(continued)
Created on 11/05/2019
8
HI4
MEDICAID HMOs
California (CA)
76
Health Net/San Diego
77
Health Net/San Joaquin
78
Health Net/Stanislaus
79
Health Net/Tulare
80
Health Plan of San Joaquin/San Joaquin
81
Health Plan of San Joaquin/Stanislaus
82
Health Plan of San Mateo
83
Health Plan of San Mateo CCS Demo
84
Inland Empire Health Plan/Riverside
85
Inland Empire Health Plan/San Bernardino
86
InnovAge PACE/Riverside
87
InnovAge PACE/San Bernardino
88
Kaiser/Amador
(continued)
Created on 11/05/2019
9
HI4
MEDICAID HMOs
California (CA)
89
Kaiser/El Dorado
90
Kaiser/Placer
91
Kaiser/Sacramento
92
Kaiser/San Diego
93
Kern Family Health Care
94
L.A. Care Health Plan
95
LIBERTY Dental Plan/Los Angeles
96
LIBERTY Dental Plan/Sacramento
97
Molina Healthcare/Imperial
98
Molina Healthcare/Riverside
99
Molina Healthcare/Sacramento
100
Molina Healthcare/San Bernardino
101
Molina Healthcare/San Diego
(continued)
Created on 11/05/2019
10
HI4
MEDICAID HMOs
California (CA)
102
On Lok Lifeways/Alameda
103
On Lok Lifeways/San Francisco
104
On Lok Lifeways/Santa Clara
105
Partnership HealthPlan of CA/Del Norte
106
Partnership HealthPlan of CA/Humboldt
107
Partnership HealthPlan of CA/Lake
108
Partnership HealthPlan of CA/Lassen
109
Partnership HealthPlan of CA/Marin
110
Partnership HealthPlan of CA/Mendocino
111
Partnership HealthPlan of CA/Modoc
112
Partnership HealthPlan of CA/Napa
113
Partnership HealthPlan of CA/Shasta
114
Partnership HealthPlan of CA/Siskiyou
(continued)
Created on 11/05/2019
11
HI4
MEDICAID HMOs
California (CA)
115
Partnership HealthPlan of CA/Solano
116
Partnership HealthPlan of CA/Sonoma
117
Partnership HealthPlan of CA/Trinity
118
Partnership HealthPlan of CA/Yolo
119
Positive Healthcare/Los Angeles
120
Redwood Coast PACE/Humboldt
121
SCAN Health Plan (Nurs hm cert)/Los Angeles
122
SCAN Health Plan (Nurs hm cert)/Riverside
123
SCAN Health Plan (Nurs hm cert)/San
Bernardino
124
SCAN Health Plan/Los Angeles
125
SCAN Health Plan/Riverside
(continued)
Created on 11/05/2019
12
HI4
MEDICAID HMOs
California (CA)
126
SCAN Health Plan/San Bernardino
127
San Diego PACE
128
San Francisco Health Plan
129
Santa Clara Family Health Plan
130
St. Paul's PACE/San Diego
131
Sutter SeniorCare PACE/Sacramento
Created on 11/05/2019
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 11/05/2019
1
HI6
PUBLIC ASSISTANCE PLANS
California (CA)
1
AIDS Drug Assistance Program
2
Operation Access (OA)
Created on 11/05/2019
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 Elite Prime (Aetna Medicare)
3
Aetna Medicare Prime (Aetna Medicare)
4
Anthem MediBlue Plus (Anthem Blue Cross and
Blue Shield)
5
Bright Advantage (Bright Health)
6
Cigna-HealthSpring Preferred (Cigna)
7
Cigna-HealthSpring True Choice (Cigna)
8
Clear Spring Health Essential (Clear Spring
Health)
9
Denver Health Medicare Select (Denver Health
Medical Plan, Inc.)
(continued)
Created on 11/05/2019
2
HI2
MEDICARE ADVANTAGE PLANS
Colorado (CO)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
10
Friday Health Plans (Friday Health Plans of
Colorado)
11
Humana (Humana)
12
Humana Gold Choice (Humana)
13
Humana Gold Plus (Humana)
14
HumanaChoice (Humana)
15
Kaiser Permanente Senior Advantage (Kaiser
Permanente)
16
Mutual of Omaha CareAdvantage (Mutual of
Omaha Medicare Advantage)
17
Rocky Mountain (Rocky Mountain Health Plans)
(continued)
Created on 11/05/2019
3
HI2
MEDICARE ADVANTAGE PLANS
Colorado (CO)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
18 AARP Medicare Advantage SecureHorizons
(UnitedHealthcare)
19 AARP Medicare Advantage Walgreens
(UnitedHealthcare)
20 Erickson Advantage (UnitedHealthcare)
Created on 11/05/2019
1
HI3
MEDICAID PROGRAM NAMES
Colorado (CO)
1
Health First Colorado
Created on 11/05/2019
1
HI4
MEDICAID HMOs
Colorado (CO)
1
Access Behavioral Care - Denver
2
Access Behavioral Care - Northeast
3
Accountable Care Collaborative: Rocky Mountain
Health Plans Prime (ACC: RMHP)
4
Behavioral Healthcare Inc.
5
Colorado Access Kaiser Permanente
6
Colorado Health Partnerships
7
Denver Health Medicaid Choice (PIHP)
8
Foothills Behavioral Health Partners
9
RCCO 1: Rocky Mountain Health Plans
10
RCCO 2: Colorado Access
11
RCCO 3: Colorado Access
12
RCCO 4: Integrated Community Health
Partnership
(continued)
Created on 11/05/2019
2
HI4
MEDICAID HMOs
Colorado (CO)
13 RCCO 5: Colorado Access
14 RCCO 6: Colorado Community Health Alliance
15 RCCO 7: Community Health Partnerships
16 Rocky Mountain Health Care Services (PACE)
17 TRU Community Care
18 Total Longterm Care - Innovage Greater Colorado
PACE
19 Total Longterm Care - Innovage Loveland
20 Total Longterm Care - Pueblo DBA Innovage
Greater Colorado PACE
21 Volunteers of America (VOANS) PACE DBA Senior
Community Care
Created on 11/05/2019
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 11/05/2019
1
HI6
PUBLIC ASSISTANCE PLANS
Colorado (CO)
1 Public Health Intervention Program (PHIP)
2 Ryan White State Drug Assistance Program
Created on 11/05/2019
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
CarePartners of CT CareAdvantage
(CarePartners of Connecticut)
4
ConnectiCare (ConnectiCare)
5
AARP Medicare Advantage Choice
(UnitedHealthcare)
6
AARP Medicare Advantage Walgreens
(UnitedHealthcare)
7
UnitedHealthcare Medicare Advantage
(UnitedHealthcare)
8
WellCare (WellCare)
(continued)
Created on 11/05/2019
2
HI2
MEDICARE ADVANTAGE PLANS
Connecticut (CT)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
9
WellCare Premier (WellCare)
Created on 11/05/2019
1
HI3
MEDICAID PROGRAM NAMES
Connecticut (CT)
1
Connecticut Medicaid
Created on 11/05/2019
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 11/05/2019
1
HI6
PUBLIC ASSISTANCE PLANS
Connecticut (CT)
1 AmeriCares Free Clinics
2 Connecticut AIDS Drug Assistance Program
3 State-Administered General Assistance (SAGA)
Medical Program
Created on 11/05/2019
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 Preferred (Cigna)
4 Kaiser Permanente Medicare Advantage (Kaiser
Permanente)
5 Lasso Healthcare (Lasso Healthcare)
Created on 11/05/2019
1
HI3
MEDICAID PROGRAM NAMES
District of Columbia (DC)
1
DC Medicaid
Created on 11/05/2019
1
HI4
MEDICAID HMOs
District of Columbia (DC)
1 AmeriHealth District of Columbia
2 Health Services for Children with Special Needs
3 MedStar Family Choice
4 Medical Transportation Management, Inc.
5 Trusted Health Plan
Created on 11/05/2019
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 11/05/2019
1
HI6
PUBLIC ASSISTANCE PLANS
District of Columbia (DC)
1 AIDS Drug Assistance Program (ADAP)
Created on 11/05/2019
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 Preferred (Cigna)
3 Cigna-HealthSpring True Choice (Cigna)
4 Humana Gold Plus (Humana)
5 Humana Honor (Humana)
6 HumanaChoice (Humana)
7 Lasso Healthcare (Lasso Healthcare)
Created on 11/05/2019
1
HI3
MEDICAID PROGRAM NAMES
Delaware (DE)
1
Medicaid
Created on 11/05/2019
1
HI4
MEDICAID HMOs
Delaware (DE)
1 Highmark Health Options of Delaware
2 Saint Francis Life
3 UnitedHealthcare Community Plan
Created on 11/05/2019
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 Free PCP Visits (Highmark
BCBSD Inc.)
3 Shared Cost Blue [Tier] (Highmark BCBSD Inc.)
4 Shared Cost Blue [Tier] Free PCP Visit (Highmark
BCBSD Inc.)
5 Shared Cost Blue [Tier] Free PCP Visits (Highmark
BCBSD Inc.)
Created on 11/05/2019
1
HI6
PUBLIC ASSISTANCE PLANS
Delaware (DE)
1 Delaware AIDS Drug Assistance Program
2 Delaware Prescription Assistance Program
Created on 11/05/2019
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 (Aetna Medicare)
3
AvMed Medicare (AvMed Medicare)
4
Capital Health Plan (Capital Health Plan)
5
CareExtra (CarePlus Health Plans, Inc.)
6
CareFree (CarePlus Health Plans, Inc.)
7
CareOne (CarePlus Health Plans, Inc.)
8
BlueMedicare Choice (Florida Blue)
9
BlueMedicare (Florida Blue HMO)
10
FHCP Medicare (Florida Blue HMO)
(continued)
Created on 11/05/2019
2
HI2
MEDICARE ADVANTAGE PLANS
Florida (FL)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
11
Freedom (Freedom Health, Inc.)
12
AdventHealth SunSaver Plan (Health First Health
Plans, Inc.)
13
Health First (Health First Health Plans, Inc.)
14
Cigna-HealthSpring (HealthSpring of Florida,
Inc.)
15
Leon Medical Centers Health Plans - Leon Cares
(HealthSpring of Florida, Inc.)
16
HealthSun (HealthSun Health Plans, Inc.)
17
Humana (Humana)
18
HumanaChoice (Humana)
19
Optimum (Optimum HealthCare, Inc.)
(continued)
Created on 11/05/2019
3
HI2
MEDICARE ADVANTAGE PLANS
Florida (FL)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
20
Psers Health Options Program (Employer Pdp)
(Psers Hop Program)
21
Simply (Simply Healthcare Plans, Inc.)
22
AARP Medicare Advantage (UnitedHealthcare)
23
AARP Medicare Advantage Choice
(UnitedHealthcare)
24
Medica HealthCare Plans MedicareMax
(UnitedHealthcare)
25
Preferred (UnitedHealthcare)
26
UnitedHealthcare Sync (UnitedHealthcare)
27
UnitedHealthcare The Villages Medicare
Advantage (UnitedHealthcare)
(continued)
Created on 11/05/2019
4
HI2
MEDICARE ADVANTAGE PLANS
Florida (FL)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
28
WellCare (WellCare)
Created on 11/05/2019
1
HI3
MEDICAID PROGRAM NAMES
Florida (FL)
1
Florida Medicaid
Created on 11/05/2019
1
HI4
MEDICAID HMOs
Florida (FL)
1
Amerigroup Florida, Inc.
2
Better Health, Inc.
3
Children's Medical Services Network
4
Clear Health Alliance
5
Community Care Plan
6
Coventry Healthcare of FL, Inc.
7
Florida PACE Center
8
Freedom Health, Inc.
9
Hope Select Care
10
Humana Medical Plan
11
Humana Medical Plan, Inc.
12
Magellan Complete Care, LLC.
13
Molina Healthcare of Florida, Inc.
(continued)
Created on 11/05/2019
2
HI4
MEDICAID HMOs
Florida (FL)
14
Morselife Home Care, Inc.
15
Positive Healthcare, Inc.
16
Prestige Health Choice
17
Simply Healthcare Plans, Inc.
18
Staywell
19
Suncoast Neighborly Care, Inc.
20
Sunshine State Health Plan, Inc.
21
United Healthcare of FL, Inc.
22
United Healthcare of Florida, Inc.
Created on 11/05/2019
1
HI5
HEALTHCARE MARKETPLACE PLANS
Florida (FL)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
1
AdventHealth GYM ACCESS [Tier] (Health First
Commercial Plans, Inc.)
2
AdventHealth [Tier] (Health First Commercial
Plans, Inc.)
3
AdventHealthGYM ACCESS [Tier] (Health First
Commercial Plans, Inc.)
4
Ambetter Balanced Care (Celtic Insurance
Company)
5
Ambetter Essential Care (Celtic Insurance
Company)
6
Ambetter Secure Care (Celtic Insurance
Company)
7
BlueCare [Tier] (Health Options, Inc.)
(continued)
Created on 11/05/2019
2
HI5
HEALTHCARE MARKETPLACE PLANS
Florida (FL)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
8
BlueOptions [Tier] (Blue Cross and Blue Shield of
Florida)
9
BlueSelect [Tier] (Blue Cross and Blue Shield of
Florida)
10
Cigna Connect (Cigna Health and Life Insurance
Company)
11
Confident Care [Tier] (Molina Healthcare of
Florida, Inc)
12
Constant Care [Tier] (Molina Healthcare of
Florida, Inc)
13
Core Care [Tier] (Molina Healthcare of Florida,
Inc)
14
Gym Access IND Essential Plus [Tier] (Florida
Health Care Plan, Inc.)
(continued)
Created on 11/05/2019
3
HI5
HEALTHCARE MARKETPLACE PLANS
Florida (FL)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
15
Gym Access IND [Tier] (Florida Health Care
Plan, Inc.)
16
Gym Access IND [Tier] BC (Florida Health Care
Plan, Inc.)
17
Gym Access IND [Tier] Standardized (Florida
Health Care Plan, Inc.)
18
Health First GYM ACCESS [Tier] (Health First
Commercial Plans, Inc.)
19
Health First [Tier] (Health First Commercial
Plans, Inc.)
20
IND [Tier] BC (Florida Health Care Plan, Inc.)
21
Oscar Classic [Tier] (Oscar Insurance Company
of Florida)
(continued)
Created on 11/05/2019
4
HI5
HEALTHCARE MARKETPLACE PLANS
Florida (FL)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
22 Oscar Classic [Tier] Next (Oscar Insurance
Company of Florida)
23 Oscar Saver [Tier] (Oscar Insurance Company of
Florida)
24 Oscar Simple Secure (Oscar Insurance Company of
Florida)
25 Oscar Simple [Tier] (Oscar Insurance Company of
Florida)
26 [Tier] (Bright Health Insurance Company of Florida)
27 [Tier] Premier (Bright Health Insurance Company of
Florida)
28 myBlue [Tier] (Health Options, Inc.)
Created on 11/05/2019
1
HI6
PUBLIC ASSISTANCE PLANS
Florida (FL)
1 AIDS Drug Assistance Program (ADAP)
2 Florida Rx Card
3 Medically Needy Program
Created on 11/05/2019
1
HI2
MEDICARE ADVANTAGE PLANS
Georgia (GA)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
1
Aetna Medicare (Aetna Medicare)
2
Aetna Medicare Advantra Platinum Plan (Aetna
Medicare)
3
Aetna Medicare Advantra Preferred Plan (Aetna
Medicare)
4
Aetna Medicare Select Plan (Aetna Medicare)
5
Allwell Medicare (Allwell)
6
Anthem MediBlue (Anthem Blue Cross and Blue
Shield)
7
Anthem MediBlue Access (Anthem Blue Cross
and Blue Shield)
8
Cigna-HealthSpring (Cigna)
(continued)
Created on 11/05/2019
2
HI2
MEDICARE ADVANTAGE PLANS
Georgia (GA)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
9
Cigna-HealthSpring Preferred (Cigna)
10
Cigna-HealthSpring True Choice (Cigna)
11
EON CHOICE (Clear Spring Health)
12
EON SELECT (Clear Spring Health)
13
Clover Health Choice (Clover Health)
14
Humana Gold Choice (Humana)
15
Humana Gold Plus (Humana)
16
Humana Honor (Humana)
17
HumanaChoice (Humana)
18
Kaiser Permanente Senior Advantage (Kaiser
Permanente)
(continued)
Created on 11/05/2019
3
HI2
MEDICARE ADVANTAGE PLANS
Georgia (GA)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
19 Lasso Healthcare (Lasso Healthcare)
20 AARP Medicare Advantage Plus Plan
(UnitedHealthcare)
21 AARP Medicare Advantage Walgreens Plan
(UnitedHealthcare)
22 UnitedHealthcare Medicare Advantage
(UnitedHealthcare)
23 UnitedHealthcare Medicare Advantage Choice Plan
(UnitedHealthcare)
24 UnitedHealthcare MedicareDirect (UnitedHealthcare)
25 WellCare (WellCare)
Created on 11/05/2019
1
HI3
MEDICAID PROGRAM NAMES
Georgia (GA)
1
Georgia Medical Assistance
Created on 11/05/2019
1
HI4
MEDICAID HMOs
Georgia (GA)
1
Amerigroup Community Care
2
Amerigroup Community Plan
3
CareSource Georgia
4
Peach State Health Plan
5
WellCare of Georgia
Created on 11/05/2019
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 (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 11/05/2019
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 for
(Blue Cross Blue Shield Healthcare Plan of
Georgia, Inc.)
7
Anthem [Tier] Pathway X for (Blue Cross Blue
Shield Healthcare Plan of Georgia, Inc.)
(continued)
Created on 11/05/2019
3
HI5
HEALTHCARE MARKETPLACE PLANS
Georgia (GA)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
8
CareSource Marketplace Low Deductible [Tier]
(CareSource Georgia Co.)
9
CareSource Marketplace Low Deductible [Tier]
Dental & Fitness (CareSource Georgia Co.)
10
CareSource Marketplace Low Premium [Tier]
(CareSource Georgia Co.)
11
CareSource Marketplace Low Premium [Tier]
Dental & Fitness (CareSource Georgia Co.)
12
CareSource Marketplace Standard [Tier]
(CareSource Georgia Co.)
13
CareSource Marketplace Standard [Tier]
Dental & Fitness (CareSource Georgia Co.)
14
CareSource Marketplace [Tier] (CareSource
Georgia Co.)
(continued)
Created on 11/05/2019
4
HI5
HEALTHCARE MARKETPLACE PLANS
Georgia (GA)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
15
CareSource Marketplace [Tier] Dental & Fitness
(CareSource Georgia Co.)
16
KP GA Signature [Tier] (Kaiser Foundation
Health Plan of Georgia)
17
KP GA [Tier] (Kaiser Foundation Health Plan of
Georgia)
18
Oscar Classic [Tier] (Oscar Health Plan of
Georgia)
19
Oscar Classic [Tier] Next (Oscar Health Plan of
Georgia)
20
Oscar Saver [Tier] (Oscar Health Plan of
Georgia)
21
Oscar Simple Secure (Oscar Health Plan of
Georgia)
(continued)
Created on 11/05/2019
5
HI5
HEALTHCARE MARKETPLACE PLANS
Georgia (GA)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
22
Oscar Simple [Tier] (Oscar Health Plan of
Georgia)
23
SoloCare [Tier] Banks (Alliant Health Plans)
24
SoloCare [Tier] BarrowJacksonMacon (Alliant
Health Plans)
25
SoloCare [Tier] Chattooga (Alliant Health Plans)
26
SoloCare [Tier] Dawson (Alliant Health Plans)
27
SoloCare [Tier] Fannin (Alliant Health Plans)
28
SoloCare [Tier] Floyd (Alliant Health Plans)
(continued)
Created on 11/05/2019
6
HI5
HEALTHCARE MARKETPLACE PLANS
Georgia (GA)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
29
SoloCare [Tier] Franklin (Alliant Health Plans)
30
SoloCare [Tier] Gilmer (Alliant Health Plans)
31
SoloCare [Tier] Gordon (Alliant Health Plans)
32
SoloCare [Tier] HDHP Banks (Alliant Health
Plans)
33
SoloCare [Tier] HDHP BarrowJacksonMacon
(Alliant Health Plans)
34
SoloCare [Tier] HDHP Chattooga (Alliant Health
Plans)
35
SoloCare [Tier] HDHP Dawson (Alliant Health
Plans)
(continued)
Created on 11/05/2019
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 Fannin (Alliant Health
Plans)
37
SoloCare [Tier] HDHP Floyd (Alliant Health
Plans)
38
SoloCare [Tier] HDHP Franklin (Alliant Health
Plans)
39
SoloCare [Tier] HDHP Gilmer (Alliant Health
Plans)
40
SoloCare [Tier] HDHP Gordon (Alliant Health
Plans)
41
SoloCare [Tier] HDHP Habersham (Alliant Health
Plans)
42
SoloCare [Tier] HDHP Hall (Alliant Health Plans)
(continued)
Created on 11/05/2019
8
HI5
HEALTHCARE MARKETPLACE PLANS
Georgia (GA)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
43
SoloCare [Tier] HDHP Hart (Alliant Health Plans)
44
SoloCare [Tier] HDHP Lumpkin (Alliant Health
Plans)
45
SoloCare [Tier] HDHP Murray (Alliant Health
Plans)
46
SoloCare [Tier] HDHP Pickens (Alliant Health
Plans)
47
SoloCare [Tier] HDHP Polk (Alliant Health Plans)
48
SoloCare [Tier] HDHP Rabun (Alliant Health
Plans)
49
SoloCare [Tier] HDHP Stephens (Alliant Health
Plans)
(continued)
Created on 11/05/2019
9
HI5
HEALTHCARE MARKETPLACE PLANS
Georgia (GA)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
50
SoloCare [Tier] HDHP Towns (Alliant Health
Plans)
51
SoloCare [Tier] HDHP Union (Alliant Health
Plans)
52
SoloCare [Tier] HDHP White (Alliant Health
Plans)
53
SoloCare [Tier] HDHP Whitfield (Alliant Health
Plans)
54
SoloCare [Tier] Habersham (Alliant Health Plans)
55
SoloCare [Tier] Hall (Alliant Health Plans)
56
SoloCare [Tier] Hart (Alliant Health Plans)
(continued)
Created on 11/05/2019
10
HI5
HEALTHCARE MARKETPLACE PLANS
Georgia (GA)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
57
SoloCare [Tier] Lumpkin (Alliant Health Plans)
58
SoloCare [Tier] Murray (Alliant Health Plans)
59
SoloCare [Tier] Pickens (Alliant Health Plans)
60
SoloCare [Tier] Polk (Alliant Health Plans)
61
SoloCare [Tier] Rabun (Alliant Health Plans)
62
SoloCare [Tier] Stephens (Alliant Health Plans)
63
SoloCare [Tier] Towns (Alliant Health Plans)
(continued)
Created on 11/05/2019
11
HI5
HEALTHCARE MARKETPLACE PLANS
Georgia (GA)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
64 SoloCare [Tier] Union (Alliant Health Plans)
65 SoloCare [Tier] White (Alliant Health Plans)
66 SoloCare [Tier] Whitfield (Alliant Health Plans)
Created on 11/05/2019
1
HI6
PUBLIC ASSISTANCE PLANS
Georgia (GA)
1 Donated Drug Repository Program
2 Georgia AIDS Drug Assistance Program (ADAP)
3 Georgia Drug Card
4 Health Insurance Continuation Program (HICP)
Created on 11/05/2019
1
HI2
MEDICARE ADVANTAGE PLANS
Hawaii (HI)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
1 HMSA Akamai Advantage (HMSA Akamai
Advantage)
2 HMSA Essential Advantage (HMSA Essential
Advantage)
3 Humana Gold Plus (Humana)
4 HumanaChoice (Humana)
5 Kaiser Permanente Senior Advantage (Kaiser
Permanente)
6 Lasso Healthcare (Lasso Healthcare)
7 AARP Medicare Advantage Choice
(UnitedHealthcare)
8 'Ohana (WellCare)
Created on 11/05/2019
1
HI3
MEDICAID PROGRAM NAMES
Hawaii (HI)
1
Med Quest
Created on 11/05/2019
1
HI4
MEDICAID HMOs
Hawaii (HI)
1
AlohaCare ABD
2
AlohaCare QUEST
3
HMSA ABD
4
Hawaii Medical Service Association (HMSA) QUEST
5
Kaiser ABD
6
Kaiser Permanente QUEST
7
Ohana ABD
8
Ohana Community Care Service (BHS)
9
Ohana Health Plan QUEST
10 UnitedHealth ABD
11 UnitedHealthcare Community Plan QUEST
Created on 11/05/2019
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 HI [Tier] (Kaiser Foundation Health Plan, Inc.)
3 KP HI [Tier] Plus CAM (Kaiser Foundation Health
Plan, Inc.)
Created on 11/05/2019
1
HI6
PUBLIC ASSISTANCE PLANS
Hawaii (HI)
1 Hawaii HIV Drug Assistance Program (HDAP)
2 Hawai‘i Insurance Continuation Program (H-COBRA)
3 Hawai‘i Seropositivity & Medical Management
Program (HSPAMM)
Created on 11/05/2019
1
HI2
MEDICARE ADVANTAGE PLANS
Iowa (IA)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
1
Aetna (Aetna Medicare)
2
Aetna Medicare (Aetna Medicare)
3
Health Alliance Medicare Guide HMO (Health
Alliance Medicare)
4
HealthPartners UnityPoint Health (HealthPartners
UnityPoint Health)
5
Humana Gold Choice (Humana)
6
Humana Gold Plus (Humana)
7
Humana Value Plus (Humana)
8
HumanaChoice (Humana)
9
Medica Advantage Solution with CHI Health
(Medica)
(continued)
Created on 11/05/2019
2
HI2
MEDICARE ADVANTAGE PLANS
Iowa (IA)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
10
Medica Prime Solution (Medica)
11
Central Iowa Health Senior Plan (Medical
Associates Health Plan, Inc.)
12
Medical Associates (Medical Associates Health
Plan, Inc.)
13
Mercy (Medical Associates Health Plan, Inc.)
14
MercyOne (Medical Associates Health Plan, Inc.)
15
Omaha Community Senior Plan (Medical
Associates Health Plan, Inc.)
16
Quad Cities Community Health Senior Plan
(Medical Associates Health Plan, Inc.)
(continued)
Created on 11/05/2019
3
HI2
MEDICARE ADVANTAGE PLANS
Iowa (IA)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
17 Gundersen Senior Preferred (Senior Preferred)
18 AARP Medicare Advantage (UnitedHealthcare)
19 AARP Medicare Advantage Choice
(UnitedHealthcare)
20 AARP Medicare Advantage Plan (UnitedHealthcare)
Created on 11/05/2019
1
HI3
MEDICAID PROGRAM NAMES
Iowa (IA)
1
Iowa Medicaid
Created on 11/05/2019
1
HI4
MEDICAID HMOs
Iowa (IA)
1 Access2Care
2 AmeriHealth Caritas of Iowa, Inc.
3 Amerigroup of Iowa, Inc.
4 Delta Dental of Iowa
5 MCNA Dental
6 PACE
7 UnitedHealthcare of the River Valley, Inc.
Created on 11/05/2019
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
Elevate by Medica [Tier] Share Plus (Medica
Insurance Company)
5
Inspire by Medica [Tier] (Medica Insurance
Company)
6
Inspire by Medica [Tier] Plus (Medica Insurance
Company)
7
Inspire by Medica [Tier] Share Plus (Medica
Insurance Company)
(continued)
Created on 11/05/2019
2
HI5
HEALTHCARE MARKETPLACE PLANS
Iowa (IA)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
8
Medica CHI Health [Tier] (Medica Insurance
Company)
9
Medica CHI Health [Tier] Plus (Medica Insurance
Company)
10
Medica CHI [Tier] Share Plus (Medica Insurance
Company)
11
Medica Insure [Tier] (Medica Insurance
Company)
12
Medica Insure [Tier] Plus (Medica Insurance
Company)
13
Medica Insure [Tier] Share Plus (Medica
Insurance Company)
14
Wellmark Value [Tier] (Wellmark Value Health
Plan, Inc.)
(continued)
Created on 11/05/2019
3
HI5
HEALTHCARE MARKETPLACE PLANS
Iowa (IA)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
15 Wellmark Value [Tier] HDHP (Wellmark Value
Health Plan, Inc.)
16 Wellmark [Tier] (Wellmark Health Plan of Iowa, Inc.)
17 Wellmark [Tier] HDHP (Wellmark Health Plan of
Iowa, Inc.)
Created on 11/05/2019
1
HI6
PUBLIC ASSISTANCE PLANS
Iowa (IA)
1 AIDS/HIV Health Insurance Premium Payment
Program
2 Iowa Drug Card
Created on 11/05/2019
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
Humana Honor (Humana)
6
HumanaChoice (Humana)
7
MediGold (MediGold)
8
Molina Medicare Choice Care (Molina Healthcare
of Utah & Idaho)
9
PacificSource Medicare (PacificSource Medicare)
(continued)
Created on 11/05/2019
2
HI2
MEDICARE ADVANTAGE PLANS
Idaho (ID)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
10 PacificSource Medicare Explorer (PacificSource
Medicare)
11 Regence MedAdvantage (Regence BlueShield Of
Idaho)
12 Regence (Regence BlueShield of Idaho)
13 SelectHealth Advantage (SelectHealth)
14 AARP Medicare Advantage (UnitedHealthcare)
15 UnitedHealthcare Medicare Advantage Assure
(UnitedHealthcare)
Created on 11/05/2019
1
HI3
MEDICAID PROGRAM NAMES
Idaho (ID)
1
Medicaid
Created on 11/05/2019
1
HI4
MEDICAID HMOs
Idaho (ID)
1 MCNA Dental
2 Medicare-Medicaid Coordinated Plan
3 Multiple Primary Care Providers
4 Non-Emergent Medical Transportation
5 Optum Idaho
Created on 11/05/2019
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 11/05/2019
1
HI6
PUBLIC ASSISTANCE PLANS
Idaho (ID)
1 Idaho AIDS Drug Assistance Program
2 Idaho Rx Card
Created on 11/05/2019
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 Prime (Aetna Medicare)
3
Aetna Medicare Value (Aetna Medicare)
4
Allwell Medicare (Allwell)
5
Ascension Complete Illinois (Ascension
Complete)
6
Blue Cross Medicare Advantage (Blue Cross and
Blue Shield of IL, NM)
7
Blue Cross Medicare Advantage Choice (Blue
Cross and Blue Shield of IL, NM)
8
Bright Advantage Assist (Bright Health)
9
Bright Advantage Flex Plus (Bright Health)
(continued)
Created on 11/05/2019
2
HI2
MEDICARE ADVANTAGE PLANS
Illinois (IL)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
10
Cigna-HealthSpring (Cigna)
11
Cigna-HealthSpring True Choice (Cigna)
12
Clear Spring Health Essential (Clear Spring
Health)
13
Community (Community Care Alliance of Illinois)
14
Essence Advantage (Essence Healthcare)
15
Health Alliance Medicare (Health Alliance
Medicare)
16
OSF MedAdvantage (Health Alliance Medicare)
17
Simplete (Health Alliance Medicare)
(continued)
Created on 11/05/2019
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 (Humana)
20
Humana Gold Choice (Humana)
21
Humana Gold Plus (Humana)
22
Humana Honor (Humana)
23
HumanaChoice (Humana)
24
Lasso Healthcare (Lasso Healthcare)
25
Medical Associates (Medical Associates Health
Plan, Inc.)
26
Quad Cities Community Health Senior Plan
(Medical Associates Health Plan, Inc.)
(continued)
Created on 11/05/2019
4
HI2
MEDICARE ADVANTAGE PLANS
Illinois (IL)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
27
MoreCare For You (MoreCare)
28
SwedishAmerican Senior Preferred (Senior
Preferred)
29
Sunrise Advantage Community Plan (Sunrise
Advantage Plan)
30
AARP Medicare Advantage (UnitedHealthcare)
31
UnitedHealthcare Medicare Advantage
(UnitedHealthcare)
32
UnitedHealthcare Medicare Advantage Assure
(UnitedHealthcare)
33
WellCare (WellCare)
34
Zing Choice IL (Zing Health)
(continued)
Created on 11/05/2019
5
HI2
MEDICARE ADVANTAGE PLANS
Illinois (IL)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
35
iCare Medicare Advantage Plan (iCare)
Created on 11/05/2019
1
HI3
MEDICAID PROGRAM NAMES
Illinois (IL)
1
Illinois Medicaid
Created on 11/05/2019
1
HI4
MEDICAID HMOs
Illinois (IL)
1
Aetna Better Health
2
Blue Cross Blue Shield of Illinois
3
Cigna-HealthSpring
4
Community Care Alliance of Illinois
5
CountyCare
6
Family Health Network
7
Harmony Health Plan
8
Humana Health Plan
9
IlliniCare Health Plan
10
Illinois Health Connect
11
Meridian Health Plan
12
Molina Healthcare of Illinois
13
NextLevel Health Partners
Created on 11/05/2019
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 Essential Care (Celtic Insurance
Company)
3
Ambetter Secure Care (Celtic Insurance
Company)
4
Blue Choice Preferred Security (Blue Cross Blue
Shield of Illinois)
5
Blue Choice Preferred [Tier] (Blue Cross Blue
Shield of Illinois)
6
Blue Choice Preferred [Tier] Two PCP Visits
(Blue Cross Blue Shield of Illinois)
7
Blue FocusCare [Tier] (Blue Cross Blue Shield of
Illinois)
(continued)
Created on 11/05/2019
2
HI5
HEALTHCARE MARKETPLACE PLANS
Illinois (IL)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
8
Blue Precision [Tier] (Blue Cross Blue Shield of
Illinois)
9
BlueCare Direct [Tier] Advocate (Blue Cross Blue
Shield of Illinois)
10
C Elite [Tier] (Health Alliance Medical Plans, Inc.)
11
Cigna Connect (Cigna HealthCare of Illinois, Inc.)
12
Elite [Tier] (Health Alliance Medical Plans, Inc.)
13
Performance [Tier] I (Quartz Health Benefit Plans
Corporation)
14
Performance [Tier] I Maintenance (Quartz Health
Benefit Plans Corporation)
(continued)
Created on 11/05/2019
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 11/05/2019
1
HI6
PUBLIC ASSISTANCE PLANS
Illinois (IL)
1 AIDS Drug Assistance Program
2 Access to Care
3 DuPage Physician's Medical Assistance Program
(DPMAP)
4 Illinois Rx Card
Created on 11/05/2019
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 (Health Alliance
Medicare)
8
Simplete (Health Alliance Medicare)
9
Humana (Humana)
(continued)
Created on 11/05/2019
2
HI2
MEDICARE ADVANTAGE PLANS
Indiana (IN)
(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 IU Health Plans Medicare (Indiana University Health
Plans - Medicare)
14 Lasso Healthcare (Lasso Healthcare)
15 AARP Medicare Advantage (UnitedHealthcare)
16 WellCare (WellCare)
Created on 11/05/2019
1
HI3
MEDICAID PROGRAM NAMES
Indiana (IN)
1
Indiana Medicaid
Created on 11/05/2019
1
HI4
MEDICAID HMOs
Indiana (IN)
1
Anthem
2
Caresource Indiana, Inc
3 MDWise
4 Managed Health Services of Indiana
Created on 11/05/2019
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 (Celtic Insurance
Company)
4
CareSource Marketplace Low Deductible [Tier]
(CareSource Indiana, Inc.)
5
CareSource Marketplace Low Deductible [Tier]
Dental & Fitness (CareSource Indiana, Inc.)
6
CareSource Marketplace Low Premium [Tier]
(CareSource Indiana, Inc.)
7
CareSource Marketplace Low Premium [Tier]
Dental & Fitness (CareSource Indiana, Inc.)
(continued)
Created on 11/05/2019
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 & Fitness (CareSource Indiana, Inc.)
10 CareSource Marketplace [Tier] (CareSource Indiana,
Inc.)
11 CareSource Marketplace [Tier] Dental & Fitness
(CareSource Indiana, Inc.)
Created on 11/05/2019
1
HI6
PUBLIC ASSISTANCE PLANS
Indiana (IN)
1 AIDS Drug Assistance Program
2 HoosierRx
3 Indiana Drug Card
4 Indiana State Health Insurance Assistance Program
Created on 11/05/2019
1
HI2
MEDICARE ADVANTAGE PLANS
Kansas (KS)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
1
Aetna Medicare (Aetna Medicare)
2
Allwell Medicare (Allwell)
3
Ascension Complete Via Christi (Ascension
Complete)
4
Blue Medicare Advantage (Blue Cross and Blue
Shield of Kansas)
5
Cigna-HealthSpring (Cigna)
6
Humana (Humana)
7
Humana Community (Humana)
8
Humana Gold Choice (Humana)
9
HumanaChoice (Humana)
10
Lasso Healthcare (Lasso Healthcare)
(continued)
Created on 11/05/2019
2
HI2
MEDICARE ADVANTAGE PLANS
Kansas (KS)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
11 AARP Medicare Advantage Choice
(UnitedHealthcare)
12 AARP Medicare Advantage Plan (UnitedHealthcare)
13 Erickson Advantage (UnitedHealthcare)
14 UnitedHealthcare MedicareDirect (UnitedHealthcare)
Created on 11/05/2019
1
HI3
MEDICAID PROGRAM NAMES
Kansas (KS)
1
KanCare program
Created on 11/05/2019
1
HI4
MEDICAID HMOs
Kansas (KS)
1 Amerigroup Kansas, Inc.
2 Bluestem PACE
3 Midland Care
4 Sunflower State Health Plan
5 United Healthcare Community Plan of Kansas
6 Via Christi
Created on 11/05/2019
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 (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
Cigna Connect (Cigna Health and Life Insurance
Company)
7
Medica Connect [Tier] (Medica Insurance
Company)
(continued)
Created on 11/05/2019
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 S (Medica Insurance
Company)
9
Medica Connect [Tier] H SPlus (Medica
Insurance Company)
10
Medica Connect [Tier] Share Plus (Medica
Insurance Company)
11
Medica Healthier You [Tier] (Medica Insurance
Company)
12
Medica Healthier You [Tier] H S (Medica
Insurance Company)
13
Medica Healthier You [Tier] H SPlus (Medica
Insurance Company)
14
Medica Healthier You [Tier] Share (Medica
Insurance Company)
(continued)
Created on 11/05/2019
3
HI5
HEALTHCARE MARKETPLACE PLANS
Kansas (KS)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
15
Medica Healthier You [Tier] Share Plus (Medica
Insurance Company)
16
Oscar Classic [Tier] (Oscar Insurance Company)
17
Oscar Classic [Tier] Next (Oscar Insurance
Company)
18
Oscar Saver [Tier] (Oscar Insurance Company)
19
Oscar Simple Secure (Oscar Insurance
Company)
20
Oscar Simple [Tier] (Oscar Insurance Company)
21
Select by Medica [Tier] (Medica Insurance
Company)
(continued)
Created on 11/05/2019
4
HI5
HEALTHCARE MARKETPLACE PLANS
Kansas (KS)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
22 Select by Medica [Tier] H S (Medica Insurance
Company)
23 Select by Medica [Tier] H SPlus (Medica Insurance
Company)
24 Select by Medica [Tier] Share (Medica Insurance
Company)
25 Select by Medica [Tier] Share Plus (Medica
Insurance Company)
Created on 11/05/2019
1
HI6
PUBLIC ASSISTANCE PLANS
Kansas (KS)
1 Kansas AIDS Drug Assistance Program
2 Kansas Drug Card
Created on 11/05/2019
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 11/05/2019
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 Lasso Healthcare (Lasso Healthcare)
13 Mutual of Omaha CareAdvantage (Mutual of Omaha
Medicare Advantage)
14 AARP Medicare Advantage (UnitedHealthcare)
15 AARP Medicare Advantage Plan (UnitedHealthcare)
16 UnitedHealthcare MedicareDirect (UnitedHealthcare)
17 WellCare (WellCare)
Created on 11/05/2019
1
HI3
MEDICAID PROGRAM NAMES
Kentucky (KY)
1
Kentucky Medicaid
Created on 11/05/2019
1
HI4
MEDICAID HMOs
Kentucky (KY)
1 Aetna Better Health of Kentucky
2 Anthem Blue Cross Blue Shield Medicaid
3 Humana CareSource
4 NEMT-Human Services Transportation Delivery
5 Passport Health Plan
6 WellCare of Kentucky
Created on 11/05/2019
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 Transition X (Anthem
Health Plans of KY(Anthem BCBS))
2
Anthem [Tier] Pathway X (Anthem Health Plans
of KY(Anthem BCBS))
3
Anthem [Tier] Pathway X Transition (Anthem
Health Plans of KY(Anthem BCBS))
4
Anthem [Tier] Pathway X Transition for (Anthem
Health Plans of KY(Anthem BCBS))
5
Anthem [Tier] Pathway X for (Anthem Health
Plans of KY(Anthem BCBS))
6
CareSource Marketplace Low Deductible [Tier]
(CareSource Kentucky Co.)
7
CareSource Marketplace Low Deductible [Tier]
Dental & Fitness (CareSource Kentucky Co.)
(continued)
Created on 11/05/2019
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 Premium [Tier]
(CareSource Kentucky Co.)
9
CareSource Marketplace Low Premium [Tier]
Dental & Fitness (CareSource Kentucky Co.)
10 CareSource Marketplace Standard [Tier]
(CareSource Kentucky Co.)
11 CareSource Marketplace Standard [Tier]
Dental & Fitness (CareSource Kentucky Co.)
12 CareSource Marketplace [Tier] (CareSource
Kentucky Co.)
13 CareSource Marketplace [Tier] Dental & Fitness
(CareSource Kentucky Co.)
Created on 11/05/2019
1
HI6
PUBLIC ASSISTANCE PLANS
Kentucky (KY)
1 Health Kentucky Inc
2 Kentucky AIDS Drug Assistance Program
3 Kentucky Prescription Drug Assistance Program
(KADAP)
4 Kentucky Rx Card
Created on 11/05/2019
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
Aetna Medicare Advantra Plan (Aetna Medicare)
3
Allwell Medicare (Allwell)
4
Blue Advantage (Blue Cross and Blue Shield of
Louisiana)
5
Humana (Humana)
6
Humana Gold Plus (Humana)
7
Humana Value Plus (Humana)
8
Humana-Ochsner Network (Humana)
9
HumanaChoice (Humana)
10
Lasso Healthcare (Lasso Healthcare)
(continued)
Created on 11/05/2019
2
HI2
MEDICARE ADVANTAGE PLANS
Louisiana (LA)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
11 Peoples Health Choices (Peoples Health)
12 Vantage (Vantage Health Plan, Inc.)
13 WellCare (WellCare)
Created on 11/05/2019
1
HI3
MEDICAID PROGRAM NAMES
Louisiana (LA)
1
Healthy Louisiana
Created on 11/05/2019
1
HI4
MEDICAID HMOs
Louisiana (LA)
1
Aetna Better Health
2
AmeriHealth Caritas
3
Amerigroup
4
Louisiana Healthcare Connections
5
MCNA
6
PACE - Baton Rouge
7
PACE - Greater New Orleans
8
PACE - Lafayette
9
UnitedHealthcare Community Plan
Created on 11/05/2019
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
CHP LA [Tier] HD Two Free PCP Visits
(CHRISTUS Health Plan Louisiana)
8
CHP LA [Tier] LD Two Free PCP Visits
(CHRISTUS Health Plan Louisiana)
(continued)
Created on 11/05/2019
2
HI5
HEALTHCARE MARKETPLACE PLANS
Louisiana (LA)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
9
CHP LA [Tier] Two Free PCP Visits (CHRISTUS
Health Plan Louisiana)
10 Community Blue (HMO Louisiana, Inc.)
11 Essential [Tier] (Vantage Health Plan, Inc.)
12 Freedom [Tier] (Vantage Health Plan, Inc.)
13 Precision Blue (HMO Louisiana, Inc.)
14 Savings [Tier] (Vantage Health Plan, Inc.)
15 Signature Blue (HMO Louisiana, Inc.)
Created on 11/05/2019
1
HI6
PUBLIC ASSISTANCE PLANS
Louisiana (LA)
1 Louisiana ADAP
2 Louisiana Drug Card
3 Louisiana Health Access Program (LA (HAP)
4 Lousiana SenioRx
Created on 11/05/2019
1
HI2
MEDICARE ADVANTAGE PLANS
Massachusetts (MA)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
1
Aetna Medicare Explorer (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 Medicare Plus (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 11/05/2019
2
HI2
MEDICARE ADVANTAGE PLANS
Massachusetts (MA)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
9
AARP Medicare Advantage Choice
(UnitedHealthcare)
10 AARP Medicare Advantage Plan (UnitedHealthcare)
11 AARP Medicare Advantage Walgreens
(UnitedHealthcare)
12 Erickson Advantage (UnitedHealthcare)
Created on 11/05/2019
1
HI3
MEDICAID PROGRAM NAMES
Massachusetts (MA)
1
MassHealth
Created on 11/05/2019
1
HI4
MEDICAID HMOs
Massachusetts (MA)
1
Boston Medical Center Health Plan
2
Boston Medical HealthNet Plan
3
Celticare
4
Commonwealth Care Alliance
5
Elder Service Plan of Cambridge Health Alliance
6
Elder Service Plan of Harbor Health
7
Element Care Inc.
8
Fallon Community Health Plan
9
Fallon Health Summit Eldercare
10
Health New England
11
Massachusetts Behavioral Health Partnership
12
Mercy Life Inc.
(continued)
Created on 11/05/2019
2
HI4
MEDICAID HMOs
Massachusetts (MA)
13 Money Follows the Person - Behavioral Health
Supports (BFP-BH)
14 Multiple Primary Care Providers
15 Navicare HMO
16 Neighborhood Health Plan
17 Neighborhood PACE
18 Senior Whole Health
19 Serenity Care PACE Program
20 Tufts Health Plan
21 United Healthcare
22 Upham's Elder Services Plan
Created on 11/05/2019
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 11/05/2019
1
HI6
PUBLIC ASSISTANCE PLANS
Massachusetts (MA)
1 Commonwealth Care
2 Healthy Start
3 Massachusetts Drug Card
4 Massachusetts HIV Drug Assistance Program
5 Prescription Advantage
Created on 11/05/2019
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 Preferred (Cigna)
3 Humana Honor (Humana)
4 HumanaChoice (Humana)
5 Johns Hopkins Advantage MD (Johns Hopkins
HealthCare)
6 Kaiser Permanente Medicare Advantage (Kaiser
Permanente)
7 Kaiser Permanente Medicare Plus (Kaiser
Permanente)
8 Lasso Healthcare (Lasso Healthcare)
9 Erickson Advantage (UnitedHealthcare)
Created on 11/05/2019
1
HI3
MEDICAID PROGRAM NAMES
Maryland (MD)
1
Maryland Medicaid
Created on 11/05/2019
1
HI4
MEDICAID HMOs
Maryland (MD)
1 Amerigroup Community Care
2 Hopkins Elder Plus
3 Jai Medical Systems
4 Kaiser Permanente
5 Maryland Physicians Care
6 MedStar Family Choice
7 Priority Partners
8 United Healthcare Community Plan
9 University of Maryland Health Partners
Created on 11/05/2019
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 11/05/2019
1
HI6
PUBLIC ASSISTANCE PLANS
Maryland (MD)
1 Maryland AIDS Drug Assistance Program
2 Maryland Medicaid Pharmacy Program (MPP)
3 Maryland Rx Card
4 Maryland Senior Prescription Drug Assistance
Program
5 Primary Adult Care Program (PAC)
Created on 11/05/2019
1
HI2
MEDICARE ADVANTAGE PLANS
Maine (ME)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
1
Anthem | MaineHealth Advantage (AMH Health)
2
Aetna Medicare Explorer Plan (Aetna Medicare)
3
Aetna Medicare Value Plan (Aetna Medicare)
4
Anthem MediBlue Access (Anthem Blue Cross
and Blue Shield)
5
Anthem MediBlue (Empire BlueCross BlueShield)
6
Harvard Pilgrim Stride (Harvard Pilgrim Health
Care, Inc.)
7
Humana Gold Plus (Humana)
8
HumanaChoice (Humana)
(continued)
Created on 11/05/2019
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 (Martin's
Point Generations Advantage)
10
Martin's Point Generations Advantage Flex
(Martin's Point Generations Advantage)
11
Martin's Point Generations Advantage Select
(Martin's Point Generations Advantage)
12
AARP Medicare Advantage Choice
(UnitedHealthcare)
13
AARP Medicare Advantage Choice Plan
(UnitedHealthcare)
14
WellCare Today's Options Advantage Plus
(WellCare)
15
WellCare Today's Options Premier (WellCare)
(continued)
Created on 11/05/2019
3
HI2
MEDICARE ADVANTAGE PLANS
Maine (ME)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
16
WellCare Value (WellCare)
Created on 11/05/2019
1
HI3
MEDICAID PROGRAM NAMES
Maine (ME)
1
MaineCare
Created on 11/05/2019
1
HI4
MEDICAID HMOs
Maine (ME)
1
Logisticare
2
MidCoast Connector
3
Multiple Primary Care Providers
4
Penquis CAP
Created on 11/05/2019
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 11/05/2019
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 Plus (Maine Community Health
Options)
13
Community Reliant (Maine Community Health
Options)
14
Community Safe Harbor (Maine Community
Health Options)
(continued)
Created on 11/05/2019
3
HI5
HEALTHCARE MARKETPLACE PLANS
Maine (ME)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
15 Community Secure (Maine Community Health
Options)
16 Community Value (Maine Community Health
Options)
17 Community Vital (Maine Community Health Options)
18 Maines Choice [Tier] (Harvard Pilgrim Health Care
Inc.)
19 [Tier] (Harvard Pilgrim Health Care Inc.)
Created on 11/05/2019
1
HI6
PUBLIC ASSISTANCE PLANS
Maine (ME)
1 DirigoChoice Health Plan
2 Maine AIDS Drug Assistance Program
3 Maine Low Cost Drugs for the Elderly and Disabled
Program (LCD)
4 Maine Rx Card
5 Maine Rx Plus
Created on 11/05/2019
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
Aetna Medicare Premier (Aetna Medicare)
3
BCN Advantage (Blue Care Network)
4
Medicare Plus Blue PPO (Blue Cross Blue Shield
of Michigan)
5
HAP (HAP Senior Plus)
6
HAP Senior Plus Option (HAP Senior Plus
(PPO))
7
Humana Gold Choice (Humana)
8
Humana Gold Plus (Humana)
9
Humana Honor (Humana)
10
Humana Value Plus (Humana)
(continued)
Created on 11/05/2019
2
HI2
MEDICARE ADVANTAGE PLANS
Michigan (MI)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
11
HumanaChoice (Humana)
12
Covenant Advantage (PHP Medicare)
13
PHP Advantage (PHP Medicare)
14
Sparrow Advantage (PHP Medicare)
15
Paramount Elite (Paramount Elite/Medicare
Plans)
16
PriorityMedicare (Priority Health Medicare)
17
Cardinal (Reliance Medicare Advantage)
18
Principle (Reliance Medicare Advantage)
19
Erickson Advantage (UnitedHealthcare)
(continued)
Created on 11/05/2019
3
HI2
MEDICARE ADVANTAGE PLANS
Michigan (MI)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
20 Upper Peninsula Health Plan (Upper Peninsula
Health Plan)
21 WellCare (WellCare)
Created on 11/05/2019
1
HI3
MEDICAID PROGRAM NAMES
Michigan (MI)
1 Michigan Department of Health and Human Service
Created on 11/05/2019
1
HI4
MEDICAID HMOs
Michigan (MI)
1
A & D Home Health Care, Inc.
2
Aetna Better Health of Michigan
3
Area Agency on Aging 1-B
4
Area Agency on Aging of NW Michigan
5
Area Agency on Aging of West Michigan
6
Blue Cross Complete of Michigan
7
CMH Partnership of Southeast Michigan
8
Care Resources
9
CentraCare
10
Community PACE
11
Detroit Area Agency on Aging
12
Detroit Wayne Mental Health Authority
13
Genesys PACE
(continued)
Created on 11/05/2019
2
HI4
MEDICAID HMOs
Michigan (MI)
14
Great Lakes PACE
15
HAP Midwest Health Plan
16
Harbor Health Plan
17
Healthy Kids Dental
18
Huron Valley PACE
19
Lakeshore Regional Entity
20
Life Circles
21
MORC Home Care Inc.
22
Macomb County CMH Services
23
McLaren Health Plan
24
Meridian Health Plan of Michigan
25
Mid-State Health Network
26
Molina Healthcare
(continued)
Created on 11/05/2019
3
HI4
MEDICAID HMOs
Michigan (MI)
27
Northcare Network
28
Northern Healthcare Management
29
Northern Michigan Regional Entity
30
Oakland County CMH Authority
31
PACE of Southeast MI
32
PACE of Southwest MI
33
Priority Health Choice
34
Region 10 PIHP
35
Region 2 Area Agency on Aging
36
Region 3B Area Agency on Aging
37
Region 4 Area Agency on Aging
38
Region 7 Area Agency on Aging
39
Region 9 Area Agency on Aging
(continued)
Created on 11/05/2019
4
HI4
MEDICAID HMOs
Michigan (MI)
40
Reliance Community Care Partners
41
Senior Community Care
42
Senior Resources of West Michigan
43
Senior Services Inc.
44
Southwest Michigan Behavioral Health
45
The Information Center
46
The Senior Alliance
47
Thome PACE
48
Total Health Care
49
Tri County Office on Aging
50
UPCAP Care Services
51
UnitedHealthcare Community Plan
52
Upper Peninsula Health Plan
(continued)
Created on 11/05/2019
5
HI4
MEDICAID HMOs
Michigan (MI)
53
Valley Area Agency on Aging
Created on 11/05/2019
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 11/05/2019
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)
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 11/05/2019
3
HI5
HEALTHCARE MARKETPLACE PLANS
Michigan (MI)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
15
Confident Care [Tier] (Molina Healthcare of
Michigan, Inc.)
16
Constant Care [Tier] (Molina Healthcare of
Michigan, Inc.)
17
Core Care [Tier] (Molina Healthcare of Michigan,
Inc.)
18
McLaren Young Adult[Tier] (McLaren Health Plan
Community)
19
McLaren [Tier] (McLaren Health Plan
Community)
20
McLaren [Tier] Exchange (McLaren Health Plan
Community)
21
McLaren [Tier] Saver (McLaren Health Plan
Community)
(continued)
Created on 11/05/2019
4
HI5
HEALTHCARE MARKETPLACE PLANS
Michigan (MI)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
22
Meridian Base [Tier] (Meridian Health Plan of
Michigan, Inc.)
23
Meridian Healthy Essentials (Meridian Health
Plan of Michigan, Inc.)
24
Meridian Healthy [Tier] (Meridian Health Plan of
Michigan, Inc.)
25
Meridian Savings [Tier] (Meridian Health Plan of
Michigan, Inc.)
26
MyPriority [Tier] (Priority Health)
27
MyPriority [Tier] Beaumont Health Network
(Priority Health)
28
MyPriority [Tier] Bronson Healthcare Partners
(Priority Health)
(continued)
Created on 11/05/2019
5
HI5
HEALTHCARE MARKETPLACE PLANS
Michigan (MI)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
29
MyPriority [Tier] Spectrum Health Partners
(Priority Health)
30
MyPriority [Tier] St John Providence Network
(Priority Health)
31
MyPriority [Tier] St Joseph Mercy Health System
(Priority Health)
32
MyPriority [Tier] St Joseph Mercy Health System
Network (Priority Health)
33
Oscar Classic [Tier] (Oscar Insurance Company)
34
Oscar Classic [Tier] Next (Oscar Insurance
Company)
35
Oscar Saver [Tier] (Oscar Insurance Company)
(continued)
Created on 11/05/2019
6
HI5
HEALTHCARE MARKETPLACE PLANS
Michigan (MI)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
36
Oscar Simple Secure (Oscar Insurance
Company)
37
Oscar Simple [Tier] (Oscar Insurance Company)
38
Sparrow PHP Healthy (Physicians Health Plan)
39
Sparrow PHP Healthy Exclusive (Physicians
Health Plan)
40
Sparrow PHP [Tier] (Physicians Health Plan)
41
Sparrow PHP [Tier] Basic Exclusive (Physicians
Health Plan)
42
Sparrow PHP [Tier] Exclusive (Physicians Health
Plan)
(continued)
Created on 11/05/2019
7
HI5
HEALTHCARE MARKETPLACE PLANS
Michigan (MI)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
43 Total Saver Complete (Total Health Care USA, Inc.)
44 Total Saver Plus (Total Health Care USA, Inc.)
45 Total Standard (Total Health Care USA, Inc.)
46 Totally You (Total Health Care USA, Inc.)
47 Totally You Complete (Total Health Care USA, Inc.)
48 Totally You Simple Choice (Total Health Care USA,
Inc.)
49 Totally You Value (Total Health Care USA, Inc.)
Created on 11/05/2019
1
HI6
PUBLIC ASSISTANCE PLANS
Michigan (MI)
1 Elder Prescription Insurance Program (EPIC)
2 MiRx Card
3 Michigan Drug Assistance Program (MIDAP)
4 Michigan The AIDS Drug Assistance Program (ADAP)
Created on 11/05/2019
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 (Blue Cross and Blue Shield of
Minnesota)
5
HealthPartners Freedom (HealthPartners)
6
HealthPartners Journey (HealthPartners)
7
Humana Gold Choice (Humana)
8
Humana Gold Plus (Humana)
9
Humana Value Plus (Humana)
(continued)
Created on 11/05/2019
2
HI2
MEDICARE ADVANTAGE PLANS
Minnesota (MN)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
10 HumanaChoice (Humana)
11 Lasso Healthcare (Lasso Healthcare)
12 Medica Advantage Solution (Medica)
13 Medica Prime Solution (Medica)
14 Gundersen MN Senior Preferred (Senior Preferred)
15 Care (UCare)
16 EssentiaCare (UCare)
17 UCare (UCare)
18 AARP Medicare Advantage (UnitedHealthcare)
19 UnitedHealthcare Sync (UnitedHealthcare)
Created on 11/05/2019
1
HI3
MEDICAID PROGRAM NAMES
Minnesota (MN)
1
Minnesota Medical Assistance
Created on 11/05/2019
1
HI4
MEDICAID HMOs
Minnesota (MN)
1
Blue Plus
2
HealthPartners
3
Hennepin Health
4
Itasca Medical Care
5
Medica
6
PrimeWest Health
7
South Country Health
8
UCare
Created on 11/05/2019
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 11/05/2019
1
HI6
PUBLIC ASSISTANCE PLANS
Minnesota (MN)
1 Minnesota AIDS Drug Assistance Program (ADAP)
2 Minnesota Drug Card
3 Minnesota's General Assistance Medical Care
4 MinnesotaCare
Created on 11/05/2019
1
HI2
MEDICARE ADVANTAGE PLANS
Missouri (MO)
(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 Plus (Anthem HealthKeepers)
5
Blue Medicare Advantage (Blue Cross and Blue
Shield of Kansas City (Blue K)
6
Cigna-HealthSpring (Cigna)
7
CoxHealth MedicarePlus (Essence Healthcare)
8
Essence Advantage (Essence Healthcare)
9
Humana (Humana)
(continued)
Created on 11/05/2019
2
HI2
MEDICARE ADVANTAGE PLANS
Missouri (MO)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
10
Humana Community (Humana)
11
Humana Gold Choice (Humana)
12
Humana Gold Plus (Humana)
13
Humana Honor (Humana)
14
HumanaChoice (Humana)
15
Missouri Department Of Transportation/ Highway
Patr (Employer Pdp) (Modot/Mshp Medical And
Life Insurance Plan)
16
AARP Medicare Advantage (UnitedHealthcare)
17
UnitedHealthcare Medicare Advantage Choice
Plan (UnitedHealthcare)
18
UnitedHealthcare MedicareDirect
(UnitedHealthcare)
(continued)
Created on 11/05/2019
3
HI2
MEDICARE ADVANTAGE PLANS
Missouri (MO)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
19
WellCare (WellCare)
Created on 11/05/2019
1
HI3
MEDICAID PROGRAM NAMES
Missouri (MO)
1
MO HealthNet
Created on 11/05/2019
1
HI4
MEDICAID HMOs
Missouri (MO)
1
Home State Health Central
2
Home State Health Eastern
3
Home State Health Southwest
4
Home State Health Western
5
Logisticare Solutions
6
Missouri Care Central
7
Missouri Care Eastern
8
Missouri Care Southwest
9
Missouri Care Western
10
United Healthcare Central
11
United Healthcare Eastern
12
United Healthcare Southwest
13
United Healthcare Western
Created on 11/05/2019
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 (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 11/05/2019
2
HI5
HEALTHCARE MARKETPLACE PLANS
Missouri (MO)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
8
Cox HealthPlans [Tier] Connect (Cox Health
Systems Insurance Company)
9
Oscar Classic [Tier] (Oscar Insurance Company)
10
Oscar Classic [Tier] Next (Oscar Insurance
Company)
11
Oscar Saver [Tier] (Oscar Insurance Company)
12
Oscar Simple Secure (Oscar Insurance
Company)
13
Oscar Simple [Tier] (Oscar Insurance Company)
14
Select by Medica [Tier] (Medica Insurance
Company)
(continued)
Created on 11/05/2019
3
HI5
HEALTHCARE MARKETPLACE PLANS
Missouri (MO)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
15
Select by Medica [Tier] H S (Medica Insurance
Company)
16
Select by Medica [Tier] H SPlus (Medica
Insurance Company)
17
Select by Medica [Tier] Share (Medica Insurance
Company)
18
Select by Medica [Tier] Share Plus (Medica
Insurance Company)
19
Select by Medica [Tier] [Tier] (Medica Insurance
Company)
20
WellFirst [Tier] Classic (SSM Health Insurance
Company)
21
WellFirst [Tier] E (SSM Health Insurance
Company)
(continued)
Created on 11/05/2019
4
HI5
HEALTHCARE MARKETPLACE PLANS
Missouri (MO)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
22 WellFirst [Tier] Plus (SSM Health Insurance
Company)
23 WellFirst [Tier] Safety Net (SSM Health Insurance
Company)
24 WellFirst [Tier] Value (SSM Health Insurance
Company)
Created on 11/05/2019
1
HI6
PUBLIC ASSISTANCE PLANS
Missouri (MO)
1 Missouri AIDS Drug Assistance Program
2 Missouri Drug Card
3 Missouri Rx Plan
Created on 11/05/2019
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)
4 Humana (Humana)
5 Humana Gold Choice (Humana)
6 Humana Gold Plus (Humana)
7 HumanaChoice (Humana)
8 Lasso Healthcare (Lasso Healthcare)
9 WellCare (WellCare)
Created on 11/05/2019
1
HI3
MEDICAID PROGRAM NAMES
Mississippi (MS)
1
Mississippi Medicaid
Created on 11/05/2019
1
HI4
MEDICAID HMOs
Mississippi (MS)
1
Magnolia Health
2
UnitedHealthcare of Mississippi
Created on 11/05/2019
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 (Ambetter of Magnolia Inc.)
4 Confident Care [Tier] (Molina Healthcare of
Mississippi, Inc)
5 Constant Care [Tier] (Molina Healthcare of
Mississippi, Inc)
6 Core Care [Tier] (Molina Healthcare of Mississippi,
Inc)
Created on 11/05/2019
1
HI6
PUBLIC ASSISTANCE PLANS
Mississippi (MS)
1
AIDS Drug Assistance Program
2
Mississippi Drug Card
Created on 11/05/2019
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 11/05/2019
1
HI3
MEDICAID PROGRAM NAMES
Montana (MT)
1
Montana Medicaid
Created on 11/05/2019
1
HI4
MEDICAID HMOs
Montana (MT)
1
Multiple Primary Care Providers
Created on 11/05/2019
1
HI5
HEALTHCARE MARKETPLACE PLANS
Montana (MT)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
1
Blue Focus [Tier] (Blue Cross and Blue Shield of
Montana)
2
Blue Focus [Tier] Two PCP Visits (Blue Cross
and Blue Shield of Montana)
3
Blue Preferred Security (Blue Cross and Blue
Shield of Montana)
4
Blue Preferred [Tier] (Blue Cross and Blue
Shield of Montana)
5
Blue Preferred [Tier] Two PCP Visits (Blue Cross
and Blue Shield of Montana)
6
Co op Plus [Tier] (Montana Health Cooperative)
7
Connected Care Expanded [Tier] (Montana
Health Cooperative)
(continued)
Created on 11/05/2019
2
HI5
HEALTHCARE MARKETPLACE PLANS
Montana (MT)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
8
Connected Care [Tier] (Montana Health Cooperative)
9
Connected Care [Tier] Option (Montana Health
Cooperative)
10 Connected Care [Tier] Plus (Montana Health
Cooperative)
11 Navigator [Tier] (PacificSource Health Plans)
12 Voyager [Tier] (PacificSource Health Plans)
Created on 11/05/2019
1
HI6
PUBLIC ASSISTANCE PLANS
Montana (MT)
1 AIDS Drug Assistance Program
2 Big Sky Rx
3 Mental Health Services Plan (MHSP)
4 Montana Rx Card
Created on 11/05/2019
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
ApexAscend (ApexHealth, Inc.)
4
ApexBold (ApexHealth, Inc.)
5
Blue Medicare (Blue Cross and Blue Shield of
North Carolina)
6
Blue Medicare PPO Enhanced (Blue Cross and
Blue Shield of North Carolina)
7
HealthTeam Advantage Plan (CARE N' CARE
INSURANCE COMPANY OF NORTH
CAROLINA)
8
Teal Premier Pro (CARE N' CARE INSURANCE
COMPANY OF NORTH CAROLINA)
(continued)
Created on 11/05/2019
2
HI2
MEDICARE ADVANTAGE PLANS
North Carolina (NC)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
9
Cigna-HealthSpring (Cigna)
10
Cigna-HealthSpring True Choice (Cigna)
11
Clear Spring Health Essential (Clear Spring
Health)
12
Experience Health Medicare Advantage
(Experience Health, Inc.)
13
FirstMedicare Direct (FirstMedicare Direct)
14
FirstMedicare Direct PPO (FirstMedicare Direct)
15
Humana Gold Choice (Humana)
16
Humana Gold Plus (Humana)
17
HumanaChoice (Humana)
(continued)
Created on 11/05/2019
3
HI2
MEDICARE ADVANTAGE PLANS
North Carolina (NC)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
18 Lasso Healthcare (Lasso Healthcare)
19 Troy Medicare (Troy Medicare)
20 AARP Medicare Advantage (UnitedHealthcare)
21 AARP Medicare Advantage Choice
(UnitedHealthcare)
22 Erickson Advantage (UnitedHealthcare)
23 WellCare (WellCare)
24 WellCare Premier (WellCare)
Created on 11/05/2019
1
HI3
MEDICAID PROGRAM NAMES
North Carolina (NC)
1
North Carolina Medicaid
Created on 11/05/2019
1
HI4
MEDICAID HMOs
North Carolina (NC)
1
Alliance Behavioral Healthcare
2
Cardinal Innovations Healthcare Solutions
3
Carolina SeniorCare
4
Community CarePartners, Inc.
5
Eastpointe Human Services
6
Elderhaus Inc
7
LIFE St. Joseph of the Pines Inc
8
North Carolina Community Care Carolina Access
9
PACE At Home Inc
10
PACE of the Southern Piedmont
11
PACE of the Triad
12
Partners Behavioral Health Management
(continued)
Created on 11/05/2019
2
HI4
MEDICAID HMOs
North Carolina (NC)
13 Piedmont Health Services Inc
14 Sandhills Center for MH/DD/SA
15 Senior Total Life Care, Inc.
16 StayWell Senior Care
17 Trillium Health Resources
18 VOANS Senior Community Care of North Carolina
19 Vaya Health
Created on 11/05/2019
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 (Ambetter of North
Carolina Inc.)
4
Blue Advantage [Tier] broad network (Blue Cross
and Blue Shield of NC)
5
Blue Home [Tier] local network UNC Health
Alliance (Blue Cross and Blue Shield of NC)
6
Blue Local [Tier] local network Atrium Health
(Blue Cross and Blue Shield of NC)
7
Blue Local [Tier] local network Wake Forest
Baptist Health (Blue Cross and Blue Shield of
NC)
(continued)
Created on 11/05/2019
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 (Blue Cross and
Blue Shield of NC)
9
Cigna Connect (Cigna HealthCare of North Carolina,
Inc.)
10 [Tier] (Bright Health Company of North Carolina)
11 [Tier] Premier (Bright Health Company of North
Carolina)
Created on 11/05/2019
1
HI6
PUBLIC ASSISTANCE PLANS
North Carolina (NC)
1 Med-assist
2 North Carolina Drug Card
3 North Carolina HIV Medication Assistance Program
(NC HMAP)
Created on 11/05/2019
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)
7 AARP Medicare Advantage (UnitedHealthcare)
8 UnitedHealthcare Sync (UnitedHealthcare)
Created on 11/05/2019
1
HI3
MEDICAID PROGRAM NAMES
North Dakota (ND)
1
Medicaid
Created on 11/05/2019
1
HI4
MEDICAID HMOs
North Dakota (ND)
1 Health Management
2 Multiple Primary Care Providers (PCCM)
3 ND Medicaid Expansion MCO
4 PACE
Created on 11/05/2019
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] Share Plus (Medica
Health Plans)
3
BlueCare [Tier] (Blue Cross Blue Shield of North
Dakota)
4
BlueDirect [Tier] (Blue Cross Blue Shield of North
Dakota)
5
BlueEssential (Blue Cross Blue Shield of North
Dakota)
6
Medica Individual Choice Catastrophic (Medica
Health Plans)
7
Medica Individual Choice [Tier] (Medica Health
Plans)
(continued)
Created on 11/05/2019
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] Share Plus (Medica
Health Plans)
9
Sanford Simplicity (Sanford Health Plan)
10 Sanford Simplicity Qualified (Sanford Health Plan)
11 Sanford TRUE (Sanford Health Plan)
12 Sanford TRUE Qualified (Sanford Health Plan)
13 SimplyBlue (Blue Cross Blue Shield of North
Dakota)
Created on 11/05/2019
1
HI6
PUBLIC ASSISTANCE PLANS
North Dakota (ND)
1 AIDS Drug Assistance Program
2 North Dakota Rx Card
3 Prescription Connection for North Dakota
Created on 11/05/2019
1
HI2
MEDICARE ADVANTAGE PLANS
Nebraska (NE)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
1
Aetna Medicare (Aetna Medicare)
2
Blue Cross Blue Shield Nebraska MA (Blue
Cross and Blue Shield of Nebraska)
3
Blue Cross Blue Shield Nebraska MA Access
(Blue Cross and Blue Shield of Nebraska)
4
Bright Advantage (Bright Health)
5
Bright Advantage Flex (Bright Health)
6
Humana Gold Plus (Humana)
7
Humana Value Plus (Humana)
8
HumanaChoice (Humana)
9
Medica Advantage Solution with CHI Health
(Medica)
(continued)
Created on 11/05/2019
2
HI2
MEDICARE ADVANTAGE PLANS
Nebraska (NE)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
10
Medica Prime Solution (Medica)
11
Grand Island Community Senior Plan (Medical
Associates Health Plan, Inc.)
12
Kearney Community Senior Plan (Medical
Associates Health Plan, Inc.)
13
Lincoln Community Senior Plan (Medical
Associates Health Plan, Inc.)
14
MercyOne Siouxland Senior Plan (Medical
Associates Health Plan, Inc.)
15
Omaha Community Senior Plan (Medical
Associates Health Plan, Inc.)
16
AARP Medicare Advantage (UnitedHealthcare)
(continued)
Created on 11/05/2019
3
HI2
MEDICARE ADVANTAGE PLANS
Nebraska (NE)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
17 AARP Medicare Advantage Choice
(UnitedHealthcare)
18 UnitedHealthcare MedicareDirect (UnitedHealthcare)
Created on 11/05/2019
1
HI3
MEDICAID PROGRAM NAMES
Nebraska (NE)
1
Medicaid
Created on 11/05/2019
1
HI4
MEDICAID HMOs
Nebraska (NE)
1 Immanuel Pathways
2 MCNA Nebraska
3 Nebraska Total Care
4 UnitedHealthcare Community Plan of Nebraska
5 WellCare of Nebraska
Created on 11/05/2019
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
Elevate by Medica [Tier] Share Plus (Medica
Insurance Company)
5
Medica CHI Health [Tier] (Medica Insurance
Company)
6
Medica CHI Health [Tier] Plus (Medica Insurance
Company)
7
Medica CHI Health [Tier] Share Plus (Medica
Insurance Company)
(continued)
Created on 11/05/2019
2
HI5
HEALTHCARE MARKETPLACE PLANS
Nebraska (NE)
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 Medica Insure [Tier] Share (Medica Insurance
Company)
11 Medica Insure [Tier] Share Plus (Medica Insurance
Company)
12 [Tier] (Bright Health Insurance Company)
13 [Tier] Premier (Bright Health Insurance Company)
Created on 11/05/2019
1
HI6
PUBLIC ASSISTANCE PLANS
Nebraska (NE)
1
AIDS Drug Assistance Program
2
Nebraska Rx Card
Created on 11/05/2019
1
HI2
MEDICARE ADVANTAGE PLANS
New Hampshire (NH)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
1
Aetna Medicare Explorer (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 11/05/2019
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 Medicare Advantage Choice
(UnitedHealthcare)
11 AARP Medicare Advantage Plan (UnitedHealthcare)
12 UnitedHealthcare Medicare Advantage Assure
(UnitedHealthcare)
13 WellCare (WellCare)
Created on 11/05/2019
1
HI3
MEDICAID PROGRAM NAMES
New Hampshire (NH)
1
New Hampshire Medicaid
Created on 11/05/2019
1
HI4
MEDICAID HMOs
New Hampshire (NH)
1
New Hampshire Healthy Families
2
Well Sense
Created on 11/05/2019
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 Essential Care (Celtic Insurance Company)
3 Ambetter Secure Care (Celtic Insurance Company)
4 Anthem [Tier] Pathway X Enhanced (Matthew
Thornton Hlth Plan(Anthem BCBS))
5 Anthem [Tier] Pathway X Enhanced for (Matthew
Thornton Hlth Plan(Anthem BCBS))
6 ElevateHealth [Tier] (Harvard Pilgrim Health Care of
NE)
Created on 11/05/2019
1
HI6
PUBLIC ASSISTANCE PLANS
New Hampshire (NH)
1 AIDS Drug Assistance Program
2 New Hampshire Medication Bridge Program
3 New Hampshire Rx Card
Created on 11/05/2019
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 Premier (Aetna Medicare)
3
Amerivantage (Amerigroup Community Care)
4
Cigna-HealthSpring (Cigna)
5
Clover Health (Clover Health)
6
Clover Health Choice (Clover Health)
7
Horizon Medicare Blue (Horizon Blue Cross Blue
Shield of New Jersey)
8
Humana Gold Plus (Humana)
9
HumanaChoice (Humana)
10
Psers Health Options Program Value (Employer
Pdp) (Psers Hop Program)
(continued)
Created on 11/05/2019
2
HI2
MEDICARE ADVANTAGE PLANS
New Jersey (NJ)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
11 AARP Medicare Advantage (UnitedHealthcare)
12 Erickson Advantage (UnitedHealthcare)
13 WellCare (WellCare)
Created on 11/05/2019
1
HI3
MEDICAID PROGRAM NAMES
New Jersey (NJ)
1
New Jersey FamilyCare
Created on 11/05/2019
1
HI4
MEDICAID HMOs
New Jersey (NJ)
1
Aetna Better Health NJ
2
Amerigroup New Jersey
3
Amerivantage Dual Coordination
4
AtlantiCare Life Connection
5
Beacon of LIFE
6
Horizon NJ Health
7
Horizon NJ TotalCare
8
Inspira LIFE
9
LIFE St. Francis
10
LIFE at Lourdes
11
Logisticare
12
Lutheran Senior LIFE of Jersey City
13
UnitedHealthcare Community Plan
(continued)
Created on 11/05/2019
2
HI4
MEDICAID HMOs
New Jersey (NJ)
14
UnitedHealthcare Dual Complete ONE
15
WellCare Liberty D-SNP
16
WellCare of New Jersey
Created on 11/05/2019
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 11/05/2019
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
OMNIA [Tier] (Horizon Healthcare Services, Inc.)
11
OMNIA [Tier] Value (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 11/05/2019
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 11/05/2019
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 Drug Card
5 New Jersey Pharmaceutical Assistance for the Aged
and Disabled (PAAD)
6 New Jersey Senior Gold Prescription Discount
Program
Created on 11/05/2019
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 (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 (Humana)
8
Humana Gold Choice (Humana)
(continued)
Created on 11/05/2019
2
HI2
MEDICARE ADVANTAGE PLANS
New Mexico (NM)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
9
Humana Gold Plus (Humana)
10 HumanaChoice (Humana)
11 Lasso Healthcare (Lasso Healthcare)
12 Presbyterian Senior Care Plan (Presbyterian Health
Plan)
13 Presbyterian MediCare PPO Plan (Presbyterian
Insurance Company, Inc.)
14 AARP Medicare Advantage (UnitedHealthcare)
15 AARP Medicare Advantage Choice
(UnitedHealthcare)
16 UnitedHealthcare Medicare Advantage Assure
(UnitedHealthcare)
Created on 11/05/2019
1
HI3
MEDICAID PROGRAM NAMES
New Mexico (NM)
1
Medicaid
Created on 11/05/2019
1
HI4
MEDICAID HMOs
New Mexico (NM)
1 Blue Cross Blue Shield of NM
2 InnovAge Greater New Mexico PACE dba Total
Community Care
3 Molina Healthcare of New Mexico Inc
4 Presbyterian Health Plan
5 UnitedHealthcare Community Plan
Created on 11/05/2019
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 11/05/2019
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] Essential HC (New Mexico
Health Connections)
9
Care Connect [Tier] Plus (New Mexico Health
Connections)
10
Confident Care [Tier] (Molina Healthcare of New
Mexico, Inc.)
11
Constant Care [Tier] (Molina Healthcare of New
Mexico, Inc.)
12
Core Care [Tier] (Molina Healthcare of New
Mexico, Inc.)
13
True [Tier] (True Health New Mexico, Inc.)
14
True [Tier] HDHP (True Health New Mexico, Inc.)
(continued)
Created on 11/05/2019
3
HI5
HEALTHCARE MARKETPLACE PLANS
New Mexico (NM)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
15 True [Tier] Premier (True Health New Mexico, Inc.)
Created on 11/05/2019
1
HI6
PUBLIC ASSISTANCE PLANS
New Mexico (NM)
1 New Mexico AIDS/HIV Drugs Assistance Program
2 New Mexico Drug Card
Created on 11/05/2019
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
Allwell Medicare (Allwell)
3
Anthem MediBlue (Anthem Blue Cross and Blue
Shield)
4
Humana (Humana)
5
Humana Honor (Humana)
6
HumanaChoice (Humana)
7
Lasso Healthcare (Lasso Healthcare)
8
Prominence Plus (Prominence Health Plan)
9
SelectHealth Advantage Essential (SelectHealth)
(continued)
Created on 11/05/2019
2
HI2
MEDICARE ADVANTAGE PLANS
Nevada (NV)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
10 Senior Care Plus: Value (Senior Care Plus)
11 AARP Medicare Advantage (UnitedHealthcare)
12 UnitedHealthcare Medicare Advantage Focus
(UnitedHealthcare)
Created on 11/05/2019
1
HI3
MEDICAID PROGRAM NAMES
Nevada (NV)
1
Medicaid
Created on 11/05/2019
1
HI4
MEDICAID HMOs
Nevada (NV)
1 Aetna Better Health of Nevada
2 Amerigroup Community Care (AGP)
3 Axis Point Health
4 Health Plan of Nevada (HPN)
5 Medical Transportation Management (MTM Nevada)
6 Silver Summit Health
Created on 11/05/2019
1
HI6
PUBLIC ASSISTANCE PLANS
Nevada (NV)
1 Nevada AIDS Drug Assistance Program (ADAP)
2 Nevada Disability Rx
3 Nevada Drug Card
4 Nevada Medical Assistance Program
5 Nevada Senior Rx
Created on 11/05/2019
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
BlueCross BlueShield (BlueCross BlueShield of
WNY and BlueShield of NEN)
3
BlueCross BlueShield Forever Blue (BlueCross
BlueShield of WNY and BlueShield of NEN)
4
BlueShield (BlueCross BlueShield of WNY and
BlueShield of NEN)
5
BlueShield Forever Blue (BlueCross BlueShield
of WNY and BlueShield of NEN)
6
CDPHP (CDPHP Medicare Advantage)
7
Elderplan Extra Help (Elderplan)
8
EmblemHealth VIP (EmblemHealth Medicare
HMO)
(continued)
Created on 11/05/2019
2
HI2
MEDICARE ADVANTAGE PLANS
New York (NY)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
9
Empire MediBlue (Empire BlueCross BlueShield)
10
Medicare (Excellus Health Plan, Inc)
11
Univera SeniorChoice (Excellus Health Plan, Inc)
12
Fidelis Medicare (Fidelis Legacy Plan)
13
Healthfirst (Healthfirst Medicare Plan)
14
Humana Gold Plus (Humana)
15
HumanaChoice (Humana)
16
Independent Health's Encompass (Independent
Health)
17
MVP (MVP HEALTH CARE)
(continued)
Created on 11/05/2019
3
HI2
MEDICARE ADVANTAGE PLANS
New York (NY)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
18 AARP Medicare Advantage (UnitedHealthcare)
19 UnitedHealthcare Medicare Advantage
(UnitedHealthcare)
20 WellCare (WellCare)
21 WellCare Today's Options Advantage (WellCare)
22 WellCare Today's Options Premier (WellCare)
Created on 11/05/2019
1
HI3
MEDICAID PROGRAM NAMES
New York (NY)
1
New York Medicaid
Created on 11/05/2019
1
HI4
MEDICAID HMOs
New York (NY)
1
Aetna Better Health
2
Affinity
3
Affinity Health Plan
4
AgeWell New York
5
AlphaCare
6
Amida Care Special Needs
7
ArchCare Community Life
8
ArchCare Senior Life
9
Capital District Physician's Health Plan
10
Catholic Health - Life
11
CenterLight (CCM)
12
CenterLight Select
13
Centers Plan for Healthy Living
(continued)
Created on 11/05/2019
2
HI4
MEDICAID HMOs
New York (NY)
14
Complete Senior Care
15
Crystal Run Health Plan
16
Eddy Senior Care
17
ElderPlan
18
ElderServe
19
ElderWood
20
Excellus
21
Excellus Health Plan
22
Extended MLTC
23
Fallon Health Weinberg
24
Fidelis Care at Home
25
GuildNet
26
HIP Combined
(continued)
Created on 11/05/2019
3
HI4
MEDICAID HMOs
New York (NY)
27
HIP GNY
28
Hamaspik Choice
29
Health Advantage/Elant Choice
30
HealthFirst
31
HealthNow
32
HealthPlus
33
Icircle Care
34
Independent Care Systems
35
Independent Health Association
36
Independent Health/Hudson Valley & WNY
37
Independent Living for Seniors
38
Integra
39
Kalos Health Plan
(continued)
Created on 11/05/2019
4
HI4
MEDICAID HMOs
New York (NY)
40
Liberty Health Advantage
41
MVP Health Plan
42
MetroPlus
43
MetroPlus Health Plan
44
MetroPlus Health Plan Special Needs
45
Molina HealthCare of New York
46
Montefiore HMO
47
NYS Catholic Health Plan
48
NYS Catholic Health Plan/Fidelis
49
North Shore - LIJ Health Plan
50
PACE CNY
51
Prime Health Choice
52
Senior Health Partners
(continued)
Created on 11/05/2019
5
HI4
MEDICAID HMOs
New York (NY)
53
Senior Network Health
54
Senior Whole Health
55
Total Senior Care
56
United HealthCare
57
VNA HomeCare Options
58
VNS Choice
59
VNS Choice Plus
60
VNS Choice Special Needs
61
Village Care
62
WellCare
63
WellCare Advocate
64
YourCare Health Plan
Created on 11/05/2019
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 11/05/2019
1
HI6
PUBLIC ASSISTANCE PLANS
New York (NY)
1 AIDS Drug Assistance Program
2 New York Elderly Pharmaceutical Insurance
Coverage (EPIC)
3 New York Rx Card
Created on 11/05/2019
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 Advantra Silver (Aetna Medicare)
3
Aetna Medicare Premier (Aetna Medicare)
4
Aetna Medicare Premier Plus (Aetna Medicare)
5
Aetna Medicare Value (Aetna Medicare)
6
Allwell Medicare (Allwell)
7
Anthem MediBlue (Anthem Blue Cross and Blue
Shield)
8
Anthem MediBlue Access (Anthem Blue Cross
and Blue Shield)
9
Bright Advantage (Bright Health)
(continued)
Created on 11/05/2019
2
HI2
MEDICARE ADVANTAGE PLANS
Ohio (OH)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
10
CareSource Advantage (CareSource)
11
Reid Health Alliance Medicare HMO (Health
Alliance Medicare)
12
Humana (Humana)
13
Humana Gold Choice (Humana)
14
Humana Honor (Humana)
15
Humana Value Plus (Humana)
16
HumanaChoice (Humana)
17
Lasso Healthcare (Lasso Healthcare)
18
MediGold (MediGold)
19
MediGold Flexible Choice (MediGold)
(continued)
Created on 11/05/2019
3
HI2
MEDICARE ADVANTAGE PLANS
Ohio (OH)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
20
MedMutual Advantage (Medical Mutual of Ohio)
21
Mutual of Omaha CareAdvantage (Mutual of
Omaha Medicare Advantage)
22
Paramount Elite (Paramount Elite/Medicare
Plans)
23
Paramount Elite - Preferred PPO (Paramount
Elite/Medicare Plans)
24
PrimeTime Health Plan (PrimeTime Health Plan)
25
SummaCare Medicare (SummaCare Medicare
Advantage Plans)
26
The Health Plan SecureCare - Option (The
Health Plan)
(continued)
Created on 11/05/2019
4
HI2
MEDICARE ADVANTAGE PLANS
Ohio (OH)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
27 The Health Plan SecureChoice - Option II (The
Health Plan)
28 UPMC for Life HMO (UPMC for Life)
29 AARP Medicare Advantage (UnitedHealthcare)
30 AARP Medicare Advantage Plan (UnitedHealthcare)
31 WellCare (WellCare)
Created on 11/05/2019
1
HI3
MEDICAID PROGRAM NAMES
Ohio (OH)
1
Ohio Medicaid
Created on 11/05/2019
1
HI4
MEDICAID HMOs
Ohio (OH)
1 Aetna
2 Buckeye Health Plan
3 CareSource
4 McGregor PACE
5 Molina
6 Paramount Advantage
7 United Healthcare Community Plan of Ohio
Created on 11/05/2019
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 Essential Care (Buckeye Community
Health Plan)
3
Ambetter Secure Care (Buckeye Community
Health Plan)
4
Anthem [Tier] Pathway X (Community Insurance
Company(Anthem BCBS))
5
Anthem [Tier] Pathway X Online Plus
(Community Insurance Company(Anthem
BCBS))
6
Anthem [Tier] Pathway X for (Community
Insurance Company(Anthem BCBS))
7
AultCare [Tier] (AultCare Insurance Company)
(continued)
Created on 11/05/2019
2
HI5
HEALTHCARE MARKETPLACE PLANS
Ohio (OH)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
8
AultCare [Tier] Select (AultCare Insurance
Company)
9
AultCare [Tier] Standard Select (AultCare
Insurance Company)
10
CareSource Marketplace Low Deductible [Tier]
(CareSource)
11
CareSource Marketplace Low Deductible [Tier]
Dental & Fitness (CareSource)
12
CareSource Marketplace Low Premium [Tier]
(CareSource)
13
CareSource Marketplace Low Premium [Tier]
Dental & Fitness (CareSource)
14
CareSource Marketplace Standard [Tier]
(CareSource)
(continued)
Created on 11/05/2019
3
HI5
HEALTHCARE MARKETPLACE PLANS
Ohio (OH)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
15
CareSource Marketplace Standard [Tier]
Dental & Fitness (CareSource)
16
CareSource Marketplace [Tier] (CareSource)
17
CareSource Marketplace [Tier] Dental & Fitness
(CareSource)
18
Confident Care [Tier] (Molina Healthcare of Ohio,
Inc.)
19
Constant Care [Tier] (Molina Healthcare of Ohio,
Inc.)
20
Core Care [Tier] (Molina Healthcare of Ohio, Inc.)
21
Market Adena (Medical Health Insuring Corp. of
Ohio)
(continued)
Created on 11/05/2019
4
HI5
HEALTHCARE MARKETPLACE PLANS
Ohio (OH)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
22
Market Dayton (Medical Health Insuring Corp. of
Ohio)
23
Market Mercy (Medical Health Insuring Corp. of
Ohio)
24
Market NE Ohio (Medical Health Insuring Corp.
of Ohio)
25
Market OhioHealth (Medical Health Insuring
Corp. of Ohio)
26
Market Young Adult Essentials Adena (Medical
Health Insuring Corp. of Ohio)
27
Market Young Adult Essentials Dayton (Medical
Health Insuring Corp. of Ohio)
28
Market Young Adult Essentials Mercy (Medical
Health Insuring Corp. of Ohio)
(continued)
Created on 11/05/2019
5
HI5
HEALTHCARE MARKETPLACE PLANS
Ohio (OH)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
29
Market Young Adult Essentials NE Ohio (Medical
Health Insuring Corp. of Ohio)
30
Market Young Adult Essentials OhioHealth
(Medical Health Insuring Corp. of Ohio)
31
Oscar Classic [Tier] (Oscar Buckeye State
Insurance Corp.)
32
Oscar Classic [Tier] (Oscar Insurance
Corporation of Ohio)
33
Oscar Classic [Tier] Next (Oscar Buckeye State
Insurance Corp.)
34
Oscar Classic [Tier] Next (Oscar Insurance
Corporation of Ohio)
35
Oscar Saver [Tier] (Oscar Buckeye State
Insurance Corp.)
(continued)
Created on 11/05/2019
6
HI5
HEALTHCARE MARKETPLACE PLANS
Ohio (OH)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
36
Oscar Saver [Tier] (Oscar Insurance Corporation
of Ohio)
37
Oscar Simple Secure (Oscar Buckeye State
Insurance Corp.)
38
Oscar Simple Secure (Oscar Insurance
Corporation of Ohio)
39
Oscar Simple [Tier] (Oscar Buckeye State
Insurance Corp.)
40
Oscar Simple [Tier] (Oscar Insurance
Corporation of Ohio)
41
Paramount [Tier] (Paramount Insurance
Company)
42
Paramount [Tier] HRA (Paramount Insurance
Company)
(continued)
Created on 11/05/2019
7
HI5
HEALTHCARE MARKETPLACE PLANS
Ohio (OH)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
43 SummaCare Value SCConnect Network and Free
PCP Visits (Summa Insurance Company, Inc.)
44 SummaCare [Tier] SCConnect Network (Summa
Insurance Company, Inc.)
45 SummaCare [Tier] SCConnect Network and Free
PCP Visits (Summa Insurance Company, Inc.)
Created on 11/05/2019
1
HI6
PUBLIC ASSISTANCE PLANS
Ohio (OH)
1 Healthy Families
2 Ohio Drug Card
3 Ohio HIV Drug Assistance Program (OHDAP)
4 Ohio's Best Rx
Created on 11/05/2019
1
HI2
MEDICARE ADVANTAGE PLANS
Oklahoma (OK)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
1
Aetna Medicare Freedom (Aetna Medicare)
2
Aetna Medicare Premier Plan (Aetna Medicare)
3
Blue Cross Medicare Advantage Basic (Blue
Cross and Blue Shield of Oklahoma)
4
Advantage (CommunityCare Advantage
Medicare Plan (HMO))
5
Senior Health Plan (CommunityCare Senior
Health Plan (HMO))
6
Generations (GlobalHealth)
7
Humana (Humana)
8
Humana Gold Choice (Humana)
9
Humana Honor (Humana)
(continued)
Created on 11/05/2019
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 Medicare Advantage (UnitedHealthcare)
13 AARP Medicare Advantage SecureHorizons Plan
(UnitedHealthcare)
14 UnitedHealthcare MedicareDirect (UnitedHealthcare)
Created on 11/05/2019
1
HI3
MEDICAID PROGRAM NAMES
Oklahoma (OK)
1
SoonerCare
Created on 11/05/2019
1
HI4
MEDICAID HMOs
Oklahoma (OK)
1
Cherokee Elder Care (CEC)
2
Life Pace
3
Multiple Primary Care Providers
4
SoonerRide
5
Valir PACE
Created on 11/05/2019
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] Plus (Medica
Insurance Company)
7
Harmony by Medica [Tier] Share (Medica
Insurance Company)
(continued)
Created on 11/05/2019
2
HI5
HEALTHCARE MARKETPLACE PLANS
Oklahoma (OK)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
8
Harmony by Medica [Tier] Share Plus (Medica
Insurance Company)
9
Medica Quest [Tier] (Medica Insurance
Company)
10
Medica Quest [Tier] H S (Medica Insurance
Company)
11
Medica Quest [Tier] Plus (Medica Insurance
Company)
12
Medica Quest [Tier] Share (Medica Insurance
Company)
13
Medica Quest [Tier] Share Plus (Medica
Insurance Company)
14
[Tier] (Bright Health Insurance Company)
(continued)
Created on 11/05/2019
3
HI5
HEALTHCARE MARKETPLACE PLANS
Oklahoma (OK)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
15 [Tier] Plus (Bright Health Insurance Company)
16 [Tier] Premier (Bright Health Insurance Company)
Created on 11/05/2019
1
HI6
PUBLIC ASSISTANCE PLANS
Oklahoma (OK)
1 Oklahoma AIDS Drug Assistance Program
2 Oklahoma Drug Card
3 Rx for Oklahoma
Created on 11/05/2019
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
Humana Honor (Humana)
8
HumanaChoice (Humana)
9
Kaiser Permanente Senior Advantage (Kaiser
Permanente)
(continued)
Created on 11/05/2019
2
HI2
MEDICARE ADVANTAGE PLANS
Oregon (OR)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
10
Moda Health (Moda Health Plan, Inc.)
11
PacificSource Medicare (PacificSource Medicare)
12
PacificSource Medicare Explorer (PacificSource
Medicare)
13
Providence Medicare (Providence Medicare
Advantage Plans)
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 11/05/2019
3
HI2
MEDICARE ADVANTAGE PLANS
Oregon (OR)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
17 AARP Medicare Advantage (UnitedHealthcare)
18 AARP Medicare Advantage Plan (UnitedHealthcare)
Created on 11/05/2019
1
HI3
MEDICAID PROGRAM NAMES
Oregon (OR)
1
Oregon Health Plan
Created on 11/05/2019
1
HI4
MEDICAID HMOs
Oregon (OR)
1
Access Dental Plan, LLC
2
Advantage Dental Services
3
AllCare Health Plan
4
Capitol Dental Care, Inc.
5
CareOregon Dental
6
Cascade Health Alliance
7
Columbia Pacific
8
Eastern Oregon CCO
9
Family Dental Care
10
FamilyCare
11
Greater Oregon Behavioral Health, Inc.
12
HealthShare of Oregon
13
InterCommunity Health Network
(continued)
Created on 11/05/2019
2
HI4
MEDICAID HMOs
Oregon (OR)
14 Jackson Care Connect
15 Managed Dental Care of Oregon
16 ODS Community Health Inc.
17 PacificSource Community Solutions - Central
Oregon
18 PacificSource Community Solutions - Columbia
Gorge
19 PrimaryHealth of Josephine County
20 Providence ElderPlace
21 Trillium Community Health Plan
22 Umpqua Health Alliance
23 Western Oregon Advanced Health
24 Willamette Valley Community Health
25 Yamhill Community Care
Created on 11/05/2019
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
BridgeSpan Standard [Tier] RealValue
(BridgeSpan Health Company)
3
Connect [Tier] (Providence Health Plan)
4
KP OR [Tier] (Kaiser Foundation Healthplan of
the NW)
5
KP Oregon Standard [Tier] (Kaiser Foundation
Healthplan of the NW)
6
Moda Health Beacon [Tier] (Moda Health Plan,
Inc.)
7
Moda Health Oregon Standard [Tier] Affinity
(Moda Health Plan, Inc.)
(continued)
Created on 11/05/2019
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] Beacon
(Moda Health Plan, Inc.)
9
Navigator [Tier] (PacificSource Health Plans)
10
PacificSource Oregon Standard [Tier] NAV
(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 11/05/2019
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] Care On Demand OHSU Plus (BridgeSpan
Health Company)
18
[Tier] Care On Demand RealValue (BridgeSpan
Health Company)
19
[Tier] Essential OHSU Plus (BridgeSpan Health
Company)
20
[Tier] Essential RealValue (BridgeSpan Health
Company)
21
[Tier] HDHP OHSU Plus (BridgeSpan Health
Company)
(continued)
Created on 11/05/2019
4
HI5
HEALTHCARE MARKETPLACE PLANS
Oregon (OR)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
22 [Tier] HDHP RealValue (BridgeSpan Health
Company)
Created on 11/05/2019
1
HI6
PUBLIC ASSISTANCE PLANS
Oregon (OR)
1 Oregon Prescription Drug Program (OPDP)
2 Oregon Rx Card
3 Oregon Senior Prescription Drug Assistance Program
(SPDAP)
Created on 11/05/2019
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
Aetna Medicare Advantra (Aetna Medicare)
3
Allwell Medicare (Allwell)
4
BlueJourney (Capital Advantage Insurance
Company)
5
Cigna-HealthSpring (Cigna)
6
Cigna-HealthSpring True Choice (Cigna)
7
Clover Health Choice (Clover Health)
8
Geisinger Gold Classic (Geisinger Gold)
9
Geisinger Gold Preferred (Geisinger Gold)
(continued)
Created on 11/05/2019
2
HI2
MEDICARE ADVANTAGE PLANS
Pennsylvania (PA)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
10
Health Partners Medicare (Health Partners
Medicare)
11
Community Blue Medicare (Highmark Inc.)
12
Community Blue Medicare HMO (Highmark Inc.)
13
Freedom Blue PPO (Highmark Inc.)
14
Security Blue HMO-POS (Highmark Inc.)
15
Humana (Humana)
16
Humana Gold Choice (Humana)
17
Humana Gold Plus (Humana)
18
Humana Value Plus (Humana)
19
HumanaChoice (Humana)
(continued)
Created on 11/05/2019
3
HI2
MEDICARE ADVANTAGE PLANS
Pennsylvania (PA)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
20
Keystone 65 (Keystone 65 HMO)
21
Lasso Healthcare (Lasso Healthcare)
22
Personal Choice 65 (Personal Choice 65 PPO)
23
Psers Health Options Program Value (Employer
Pdp) (Psers Hop Program)
24
Sunrise Advantage Community Plan (Sunrise
Advantage Plan)
25
UPMC for Life HMO (UPMC for Life)
26
UPMC for Life PPO (UPMC for Life)
27
AARP Medicare Advantage (UnitedHealthcare)
(continued)
Created on 11/05/2019
4
HI2
MEDICARE ADVANTAGE PLANS
Pennsylvania (PA)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
28 AARP Medicare Advantage Choice Plan
(UnitedHealthcare)
29 Erickson Advantage (UnitedHealthcare)
30 Vibra Health Plan (Vibra Health Plan)
Created on 11/05/2019
1
HI3
MEDICAID PROGRAM NAMES
Pennsylvania (PA)
1 Pennsylvania Medical Assistance (MA) (Medicaid)
Created on 11/05/2019
1
HI4
MEDICAID HMOs
Pennsylvania (PA)
1
Adult Community Autism Program
2
Aetna Better Health
3
Albright LIFE H-9068
4
Allegheny County HealthChoices
5
Beaver County HealthChoices
6
Behavioral Health Services of Bedford and
Somerset
7
Berks County HealthChoices
8
Blair County HealthChoices
9
Bucks County HealthChoices
10
Cambria County HealthChoices
11
Carbon-Monroe-Pike Joinder Board
12
Chester County HealthChoices
(continued)
Created on 11/05/2019
2
HI4
MEDICAID HMOs
Pennsylvania (PA)
13
Community LIFE H-3917
14
Cumberland County HealthChoices
15
Dauphin County HealthChoices
16
Delaware County HealthChoices
17
Erie County HealthChoices
18
Fayette County HealthChoices
19
Gateway Health
20
Geisinger Health Plan
21
Greene County (Commonwealth)
22
Health Partners Plans, Inc.
23
LIFE - Pittsburgh H-3918
24
LIFE Geisinger H-2064
25
LIFE NWPA H-4999
(continued)
Created on 11/05/2019
3
HI4
MEDICAID HMOs
Pennsylvania (PA)
26
LIFE St. Mary H-6551
27
Lancaster County HealthChoices
28
Lebanon County HealthChoices
29
Lehigh County HealthChoices
30
Logisticare
31
Lycoming-Clinton Joinder Board
32
Mercy LIFE H-3919
33
Mercy LIFE West Philadelphia H-3908
34
Montgomery County HealthChoices
35
New Courtland LIFE H-9830
36
North Central State Option
37
Northampton county HealthChoices
(continued)
Created on 11/05/2019
4
HI4
MEDICAID HMOs
Pennsylvania (PA)
38
Northeast Behavioral Healthcare Consortium
39
Northwest Behavioral Health Partnership
40
Perry County HealthChoices
41
Philadelphia County HealthChoices
42
Senior LIFE Altoona H-5902
43
Senior LIFE Greensburg - H-2937
44
Senior LIFE Johnstown - H-3925
45
Senior LIFE Lehigh H-5978
46
Senior LIFE Washington H-2992
47
Senior LIFE York H-0819
48
Southwest Behavioral Health Management
49
SpiriTrust LIFE H-2537
(continued)
Created on 11/05/2019
5
HI4
MEDICAID HMOs
Pennsylvania (PA)
50 Tuscarora Managed Care Alliance
51 UPMC for You, Inc.
52 United Healthcare Community Plan of Pennsylvania
53 VieCare Armstrong H-6188
54 VieCare Beaver H-7660
55 VieCare Butler H-3060
56 Vista
57 York-Adams Joinder Board
Created on 11/05/2019
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 (Pennsylvania
Health & Wellness, Inc.)
4
Geisinger Marketplace All Access (Geisinger
Health Plan)
5
Geisinger Marketplace All Access (Geisinger
Quality Options)
6
Geisinger Marketplace All Access Value
(Geisinger Health Plan)
7
Geisinger Marketplace Extra (Geisinger Health
Plan)
(continued)
Created on 11/05/2019
2
HI5
HEALTHCARE MARKETPLACE PLANS
Pennsylvania (PA)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
8
Geisinger Marketplace Premier (Geisinger Health
Plan)
9
Keystone [Tier] (Keystone Health Plan East, Inc)
10
Keystone [Tier] Proactive (Keystone Health Plan
East, Inc)
11
Keystone [Tier] Proactive Lite (Keystone Health
Plan East, Inc)
12
Oscar Classic [Tier] (Oscar Health Plan of
Pennsylvania, Inc.)
13
Oscar Classic [Tier] Next (Oscar Health Plan of
Pennsylvania, Inc.)
14
Oscar Saver [Tier] (Oscar Health Plan of
Pennsylvania, Inc.)
(continued)
Created on 11/05/2019
3
HI5
HEALTHCARE MARKETPLACE PLANS
Pennsylvania (PA)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
15
Oscar Simple Secure (Oscar Health Plan of
Pennsylvania, Inc.)
16
Oscar Simple [Tier] (Oscar Health Plan of
Pennsylvania, Inc.)
17
Personal Choice [Tier] (Independence Blue Cross
(QCC Ins. Co.))
18
Personal Choice [Tier] Basic (Independence Blue
Cross (QCC Ins. Co.))
19
Personal Choice [Tier] Reserve (Independence
Blue Cross (QCC Ins. Co.))
20
Secure Care (Pennsylvania Health & Wellness,
Inc.)
21
Together Blue Care Advantage [Tier] Free PCP
Visits (Highmark Coverage Advantage Inc.)
(continued)
Created on 11/05/2019
4
HI5
HEALTHCARE MARKETPLACE PLANS
Pennsylvania (PA)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
22
Together Blue Care Advantage [Tier] Free PCP
Visits and (Highmark Coverage Advantage Inc.)
23
Together Blue Major Events Free PCP Visits
(Highmark Coverage Advantage Inc.)
24
Together Blue [Tier] (Highmark Coverage
Advantage Inc.)
25
Together Blue [Tier] Free PCP Visit (Highmark
Coverage Advantage Inc.)
26
Together Blue [Tier] Free PCP Visits (Highmark
Coverage Advantage Inc.)
27
Together Blue [Tier] Free PCP Visits and
(Highmark Coverage Advantage Inc.)
28
Tower UPMC Advantage [Tier] Premium Network
(UPMC Health Options, Inc.)
(continued)
Created on 11/05/2019
5
HI5
HEALTHCARE MARKETPLACE PLANS
Pennsylvania (PA)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
29
Tower UPMC Advantage [Tier] Tower Network
(UPMC Health Options, Inc.)
30
UPMC Advantage [Tier] Partner Network (UPMC
Health Options, Inc.)
31
UPMC Advantage [Tier] Premium Network
(UPMC Health Options, Inc.)
32
UPMC Advantage [Tier] Select Network (UPMC
Health Options, Inc.)
33
[Tier] (Capital Advantage Assurance Company)
34
my Blue Access Major Events Free PCP Visits
(Highmark Inc.)
35
my Blue Access [Tier] (Highmark Inc.)
(continued)
Created on 11/05/2019
6
HI5
HEALTHCARE MARKETPLACE PLANS
Pennsylvania (PA)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
36
my Blue Access [Tier] Free PCP Visit (Highmark
Inc.)
37
my Blue Access [Tier] Free PCP Visits (Highmark
Inc.)
38
my Direct Blue Conemaugh Major Events Free
PCP Visits (Highmark Inc.)
39
my Direct Blue Conemaugh [Tier] (Highmark
Inc.)
40
my Direct Blue Conemaugh [Tier] Free PCP Visit
(Highmark Inc.)
41
my Direct Blue Conemaugh [Tier] Free PCP
Visits (Highmark Inc.)
42
my Direct Blue Erie Major Events Free PCP
Visits (Highmark Choice Company)
(continued)
Created on 11/05/2019
7
HI5
HEALTHCARE MARKETPLACE PLANS
Pennsylvania (PA)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
43
my Direct Blue Erie [Tier] (Highmark Choice
Company)
44
my Direct Blue Erie [Tier] Free PCP Visit
(Highmark Choice Company)
45
my Direct Blue Erie [Tier] Free PCP Visits
(Highmark Choice Company)
46
my Direct Blue Lehigh Valley Major Events Free
PCP Visits (Highmark Inc.)
47
my Direct Blue Lehigh Valley [Tier] (Highmark
Inc.)
48
my Direct Blue Lehigh Valley [Tier] Free PCP
Visit (Highmark Inc.)
49
my Direct Blue Lehigh Valley [Tier] Free PCP
Visits (Highmark Inc.)
(continued)
Created on 11/05/2019
8
HI5
HEALTHCARE MARKETPLACE PLANS
Pennsylvania (PA)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
50
my Direct Blue Major Events Free PCP Visits
(Highmark Choice Company)
51
my Direct Blue Major Events Free PCP Visits
(Highmark Inc.)
52
my Direct Blue [Tier] (Highmark Choice
Company)
53
my Direct Blue [Tier] (Highmark Inc.)
54
my Direct Blue [Tier] Free PCP Visit (Highmark
Choice Company)
55
my Direct Blue [Tier] Free PCP Visit (Highmark
Inc.)
56
my Direct Blue [Tier] Free PCP Visits (Highmark
Choice Company)
(continued)
Created on 11/05/2019
9
HI5
HEALTHCARE MARKETPLACE PLANS
Pennsylvania (PA)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
57 my Direct Blue [Tier] Free PCP Visits (Highmark
Inc.)
58 my Priority Blue Flex [Tier] (Highmark Benefits
Group Inc.)
59 my Priority Blue Flex [Tier] Free PCP Visit
(Highmark Benefits Group Inc.)
60 my Priority Blue Flex [Tier] Free PCP Visits
(Highmark Benefits Group Inc.)
61 my Priority Blue Major Events Free PCP Visits
(Highmark Benefits Group Inc.)
Created on 11/05/2019
1
HI6
PUBLIC ASSISTANCE PLANS
Pennsylvania (PA)
1 AIDS Drug Assistance Program
2 Pennsylvania Drug Card
3 Pennsylvania PACE Needs Enhancement Tier
(PACENET)
4 Pennsylvania Pharmaceutical Assistance Contract for
the Elderly (PACE)
5 Special Pharmaceutical Benefits Program – Mental
Health (SPBP-MH)
Created on 11/05/2019
1
HI2
MEDICARE ADVANTAGE PLANS
Puerto Rico (PR)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
1
Humana Gold Plus (Humana)
2
HumanaChoice Value (Humana)
3
MCS Classicare (MCS Classicare)
4
MMM (Medicare y Mucho Más)
5
MMM Advantage (Medicare y Mucho Más)
6
PMC Max (PMC Medicare Choice)
7
Basic (Triple S Advantage)
8
Brillante (Triple S Advantage)
9
Enlace (Triple S Advantage)
10
Magno (Triple S Advantage)
11
Royal (Triple S Advantage)
(continued)
Created on 11/05/2019
2
HI2
MEDICARE ADVANTAGE PLANS
Puerto Rico (PR)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
12
Óptimo (Triple-S Advantage)
Created on 11/05/2019
1
HI3
MEDICAID PROGRAM NAMES
Puerto Rico (PR)
1
Medicaid
Created on 11/05/2019
1
HI4
MEDICAID HMOs
Puerto Rico (PR)
1
Constellation Health, LLC
2
First Medical Plan Inc.
3
Humana Health Plan of PR, Inc.
4
MCS Advantage, Inc.
5
MMM Health Care, Inc.
6
MMM Multihealth, Inc.
7
Molina Health Care PR, Inc.
8
Triple S Advantage
9
Triple S Salud, Inc.
Created on 11/05/2019
1
HI6
PUBLIC ASSISTANCE PLANS
Puerto Rico (PR)
1 Puerto Rico AIDS Drug Assistance Program
Created on 11/05/2019
1
HI2
MEDICARE ADVANTAGE PLANS
Rhode Island (RI)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
1 Aetna Medicare Explorer (Aetna Medicare)
2 BlueCHiP for Medicare (Blue Cross & Blue Shield of
Rhode Island)
3 HealthMate for Medicare (Blue Cross & Blue Shield of
Rhode Island)
4 Lasso Healthcare (Lasso Healthcare)
5 AARP Medicare Advantage (UnitedHealthcare)
6 AARP Medicare Advantage Choice
(UnitedHealthcare)
Created on 11/05/2019
1
HI3
MEDICAID PROGRAM NAMES
Rhode Island (RI)
1
Rhode Island Medical Assistance
Created on 11/05/2019
1
HI4
MEDICAID HMOs
Rhode Island (RI)
1 LogistiCare
2 Neighborhood Health Plan of Rhode Island
3 PACE Organization of Rhode Island
4 UnitedHealthcare Community Health Plan of Rhode
Island
5 UnitedHealthcare Community Plan of Rhode Island
6 UnitedHealthcare Dental
Created on 11/05/2019
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 11/05/2019
1
HI6
PUBLIC ASSISTANCE PLANS
Rhode Island (RI)
1 RI AIDS Drug Assistance Program
2 Rhode Island Pharmaceutical Assistance (RIPAE)
3 Rhode Island Rx Card
4 Rhody Health Partners
5 Rite Care
Created on 11/05/2019
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
ApexAscend (ApexHealth, Inc.)
5
ApexBold (ApexHealth, Inc.)
6
BlueCross Secure (Blue Cross Blue Shield of
South Carolina)
7
BlueCross Total (Blue Cross Blue Shield of South
Carolina)
8
Bright Advantage (Bright Health)
9
Cigna-HealthSpring (Cigna)
(continued)
Created on 11/05/2019
2
HI2
MEDICARE ADVANTAGE PLANS
South Carolina (SC)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
10
EON CHOICE (Clear Spring Health)
11
EON SELECT (Clear Spring Health)
12
Clover Health Choice (Clover Health)
13
Humana Gold Choice (Humana)
14
Humana Gold Plus (Humana)
15
Humana Honor (Humana)
16
HumanaChoice (Humana)
17
Lasso Healthcare (Lasso Healthcare)
18
AARP Medicare Advantage (UnitedHealthcare)
19
UnitedHealthcare Medicare Advantage
(UnitedHealthcare)
(continued)
Created on 11/05/2019
3
HI2
MEDICARE ADVANTAGE PLANS
South Carolina (SC)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
20
WellCare (WELLCARE)
Created on 11/05/2019
1
HI3
MEDICAID PROGRAM NAMES
South Carolina (SC)
1
Healthy Connections
Created on 11/05/2019
1
HI4
MEDICAID HMOs
South Carolina (SC)
1
Absolute Total Care
2
BlueChoice HealthPlan Medicaid
3
First Choice, by Select Health
4
Greenville Health System
5
LogistiCare
6
Molina Healthcare of South Carolina
7
Palmetto SeniorCare
8
South Carolina Solutions
9
The Methodist Oaks
10
WellCare of South Carolina
Created on 11/05/2019
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 (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)
6
Confident Care [Tier] (MOLINA HEALTHCARE
OF SOUTH CAROLINA, INC)
7
Constant Care [Tier] (MOLINA HEALTHCARE
OF SOUTH CAROLINA, INC)
(continued)
Created on 11/05/2019
2
HI5
HEALTHCARE MARKETPLACE PLANS
South Carolina (SC)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
8
Core Care [Tier] (MOLINA HEALTHCARE OF
SOUTH CAROLINA, INC)
9
[Tier] (Bright Health Company of South Carolina)
10 [Tier] Premier (Bright Health Company of South
Carolina)
Created on 11/05/2019
1
HI6
PUBLIC ASSISTANCE PLANS
South Carolina (SC)
1 AIDS Drug Assistance Plan
2 Gap Assistance Pharmacy Program for Seniors
(GAPS)
3 South Carolina Drug Card
Created on 11/05/2019
1
HI2
MEDICARE ADVANTAGE PLANS
South Dakota (SD)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
1 Aetna Medicare (Aetna Medicare)
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)
9 AARP Medicare Advantage Choice
(UnitedHealthcare)
Created on 11/05/2019
1
HI3
MEDICAID PROGRAM NAMES
South Dakota (SD)
1
Medicaid
Created on 11/05/2019
1
HI4
MEDICAID HMOs
South Dakota (SD)
1
Multiple Primary Care Providers
Created on 11/05/2019
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 HDHP (Avera Health Plans, Inc.)
3 Avera Preferred (Avera Health Plans, Inc.)
4 Sanford Simplicity (Sanford Health Plan)
5 Sanford Simplicity Qualified (Sanford Health Plan)
6 Sanford TRUE (Sanford Health Plan)
7 Sanford TRUE Qualified (Sanford Health Plan)
Created on 11/05/2019
1
HI6
PUBLIC ASSISTANCE PLANS
South Dakota (SD)
1 AIDS Drug Assistance Program ( ADAP )
2 South Dakota Rx Card
Created on 11/05/2019
1
HI2
MEDICARE ADVANTAGE PLANS
Tennessee (TN)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
1
Aetna Medicare (Aetna Medicare)
2
American Health Advantage of Tennessee
(American Health Advantage of Tennessee)
3
Amerivantage (Amerigroup)
4
ApexAscend (ApexHealth, Inc.)
5
ApexBold (ApexHealth, Inc.)
6
BlueAdvantage (BlueCross BlueShield of
Tennessee)
7
Bright Advantage (Bright Health)
8
Cigna-HealthSpring (Cigna)
9
Cigna-HealthSpring True Choice (Cigna)
10
Clover Health Choice (Clover Health)
(continued)
Created on 11/05/2019
2
HI2
MEDICARE ADVANTAGE PLANS
Tennessee (TN)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
11 Humana (Humana)
12 Humana Honor (Humana)
13 Humana Value Plus (Humana)
14 HumanaChoice (Humana)
15 AARP Medicare Advantage Plan (UnitedHealthcare)
16 AARP Medicare Advantage Walgreens
(UnitedHealthcare)
17 WellCare (WellCare)
18 WellCare Premier (WellCare)
Created on 11/05/2019
1
HI3
MEDICAID PROGRAM NAMES
Tennessee (TN)
1
TennCare
Created on 11/05/2019
1
HI4
MEDICAID HMOs
Tennessee (TN)
1 Alexian Brothers Community Services
2 AmeriGroup
3 DentaQuest
4 Magellan Health Services
5 UnitedHealthcare Community Plan
6 Volunteer State Health Plan (BlueCare)
7 Volunteer State Health Plan (TennCare Select)
Created on 11/05/2019
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 (Celtic Insurance
Company)
4
Bright [Tier] (Bright Health Insurance Company of
Tennessee)
5
Cigna Connect (Cigna Health and Life Insurance
Company)
6
Oscar Classic [Tier] (Oscar Insurance Company)
7
Oscar Classic [Tier] Next (Oscar Insurance
Company)
(continued)
Created on 11/05/2019
2
HI5
HEALTHCARE MARKETPLACE PLANS
Tennessee (TN)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
8
Oscar Saver [Tier] (Oscar Insurance Company)
9
Oscar Simple Secure (Oscar Insurance
Company)
10
Oscar Simple [Tier] (Oscar Insurance Company)
11
[Tier] (Bright Health Insurance Company of
Tennessee)
12
[Tier] G Network S (BlueCross BlueShield of
Tennessee)
13
[Tier] Plus (Bright Health Insurance Company of
Tennessee)
14
[Tier] Premier (Bright Health Insurance Company
of Tennessee)
(continued)
Created on 11/05/2019
3
HI5
HEALTHCARE MARKETPLACE PLANS
Tennessee (TN)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
15 [Tier] S Network S (BlueCross BlueShield of
Tennessee)
16 [Tier]Network S (BlueCross BlueShield of
Tennessee)
Created on 11/05/2019
1
HI6
PUBLIC ASSISTANCE PLANS
Tennessee (TN)
1 Project Access Nashville
2 TennCare
3 Tennessee Drug Card
4 Tennessee HIV Drug Assistance Program
Created on 11/05/2019
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 11/05/2019
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)
11
Clover Health Choice (Clover Health)
12
Clover Health Classic (Clover Health)
13
Devoted Health (Devoted Health)
14
Humana Gold Choice (Humana)
15
Humana Gold Plus (Humana)
16
HumanaChoice (Humana)
17
Imperial Health Insurance Traditional (Imperial
Insurance Company of Texas, Inc)
(continued)
Created on 11/05/2019
3
HI2
MEDICARE ADVANTAGE PLANS
Texas (TX)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
18
KelseyCare Advantage (KelseyCare Advantage)
19
Lasso Healthcare (Lasso Healthcare)
20
Memorial Hermann Advantage (Memorial
Hermann Health Plan)
21
Mutual of Omaha CareAdvantage (Mutual of
Omaha Medicare Advantage)
22
Mutual of Omaha CareAdvantage Complete
(Mutual of Omaha Medicare Advantage)
23
Oscar Easy Care (Oscar)
24
Prominence Plus (Prominence Health Plan)
25
SeniorCare Advantage (Scott and White Health
Plan)
(continued)
Created on 11/05/2019
4
HI2
MEDICARE ADVANTAGE PLANS
Texas (TX)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
26
AARP Medicare Advantage (UnitedHealthcare)
27
AARP Medicare Advantage Choice
(UnitedHealthcare)
28
AARP Medicare Advantage Plan
(UnitedHealthcare)
29
Erickson Advantage (UnitedHealthcare)
30
UnitedHealthcare Medicare Advantage Choice
(UnitedHealthcare)
31
UnitedHealthcare MedicareDirect
(UnitedHealthcare)
32
WellCare (WellCare)
33
WellCare TexanPlus (WellCare)
(continued)
Created on 11/05/2019
5
HI2
MEDICARE ADVANTAGE PLANS
Texas (TX)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
34 WellCare TexanPlus Classic (WellCare)
Created on 11/05/2019
1
HI3
MEDICAID PROGRAM NAMES
Texas (TX)
1
Medicaid
Created on 11/05/2019
1
HI4
MEDICAID HMOs
Texas (TX)
1
Aetna
2
American Medical Response
3
Amerigroup
4
Amerigroup Texas, Inc.
5
Bienvivir Senior Health Services (El Paso)
6
BlueCross BlueShield
7
Children's Medical Center
8
Christus
9
Cigna - HealthSpring
10
Community First Health Plan
11
Community First Health Plans
12
Community Health Choice
(continued)
Created on 11/05/2019
2
HI4
MEDICAID HMOs
Texas (TX)
13
Cook Children's Health Plan
14
DentaQuest
15
Driscoll Children's Health Plan
16
El Paso First
17
FirstCare
18
Logisticare
19
MCNA Dental
20
Medical Transportation Management
21
Molina Healthcare of Texas
22
Multiple Primary Care Providers
23
Parkland Community Health Plan
24
Project Armistad
25
Scott & White Health Plan
(continued)
Created on 11/05/2019
3
HI4
MEDICAID HMOs
Texas (TX)
26
Sendero
27
Seton Health Plan
28
Silver Star Health Network (Lubbock)
29
Superior Health Plan
30
Superior HealthPlan
31
Texas Children's Health Plan
32
The Basics at Jan Werner (Amarillo)
33
United Healthcare - Texas
34
United Healthcare Community Plan
Created on 11/05/2019
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 Balanced Care Adult (Celtic Insurance
Company)
3
Ambetter Essential Care (Celtic Insurance
Company)
4
Ambetter Essential Care Adult (Celtic Insurance
Company)
5
Ambetter Secure Care (Celtic Insurance
Company)
6
Ambetter Secure Care Adult (Celtic Insurance
Company)
7
Blue Advantage Plus [Tier] (Blue Cross Blue
Shield of Texas)
(continued)
Created on 11/05/2019
2
HI5
HEALTHCARE MARKETPLACE PLANS
Texas (TX)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
8
Blue Advantage Security (Blue Cross Blue
Shield of Texas)
9
Blue Advantage [Tier] (Blue Cross Blue Shield of
Texas)
10
Blue Advantage [Tier] Three PCP Visits (Blue
Cross Blue Shield of Texas)
11
Blue Advantage [Tier] Two PCP Visits (Blue
Cross Blue Shield of Texas)
12
CHP TX [Tier] (CHRISTUS Health Plan)
13
CHP TX [Tier] HD Two Free PCP Visits
(CHRISTUS Health Plan)
14
CHP TX [Tier] LD Two Free PCP Visits
(CHRISTUS Health Plan)
(continued)
Created on 11/05/2019
3
HI5
HEALTHCARE MARKETPLACE PLANS
Texas (TX)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
15
CHP TX [Tier] Two Free PCP Visits (CHRISTUS
Health Plan)
16
Community Health Choice [Tier] (Community
Health Choice, Inc.)
17
Community Health Choice [Tier] High Deductible
Health Compatible (Community Health Choice,
Inc.)
18
Confident Care [Tier] (Molina Healthcare of
Texas, Inc.)
19
Constant Care [Tier] (Molina Healthcare of
Texas, Inc.)
20
Core Care [Tier] (Molina Healthcare of Texas,
Inc.)
21
IND [Tier] (SHA, LLC DBA FirstCare Health
Plans)
(continued)
Created on 11/05/2019
4
HI5
HEALTHCARE MARKETPLACE PLANS
Texas (TX)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
22
IdealCare Free Doctor by Phone (Sendero Health
Plans, inc.)
23
IdealCare [Tier] (Sendero Health Plans, inc.)
24
IdealCare [Tier] Free Doctor by Phone PCP
Generic Rx (Sendero Health Plans, inc.)
25
IdealCare [Tier] High Deductible Free Doctor by
Phone (Sendero Health Plans, inc.)
26
Molina [Tier] (Molina Healthcare of Texas, Inc.)
27
MyBlue Health [Tier] (Blue Cross Blue Shield of
Texas)
28
Oscar Classic [Tier] (Oscar Insurance Company)
(continued)
Created on 11/05/2019
5
HI5
HEALTHCARE MARKETPLACE PLANS
Texas (TX)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
29 Oscar Classic [Tier] Next (Oscar Insurance
Company)
30 Oscar Saver [Tier] (Oscar Insurance Company)
31 Oscar Simple Secure (Oscar Insurance Company)
32 Oscar Simple [Tier] (Oscar Insurance Company)
33 SelectCare [Tier] Free Doctor by Phone (Sendero
Health Plans, inc.)
34 SelectCare [Tier] High Deductible Free Doctor by
Phone (Sendero Health Plans, inc.)
35 SelectCare [Tier] Simple Free Doctor by Phone PCP
Generic Rx (Sendero Health Plans, inc.)
Created on 11/05/2019
1
HI6
PUBLIC ASSISTANCE PLANS
Texas (TX)
1 AIDS Drug Assistance Program (ADAP)
2 Texas Drug Card
3 Texas Kidney Health Care Program
Created on 11/05/2019
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
Humana Honor (Humana)
5
HumanaChoice (Humana)
6
Lasso Healthcare (Lasso Healthcare)
7
Molina Medicare Choice Care (Molina Healthcare
of Utah & Idaho)
8
Regence MedAdvantage (Regence BlueCross
BlueShield of Utah)
9
SelectHealth Advantage (SelectHealth)
(continued)
Created on 11/05/2019
2
HI2
MEDICARE ADVANTAGE PLANS
Utah (UT)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
10 AARP Medicare Advantage (UnitedHealthcare)
11 UnitedHealthcare Medicare Advantage Assure
(UnitedHealthcare)
12 UnitedHealthcare Medicare Advantage Choice
(UnitedHealthcare)
Created on 11/05/2019
1
HI3
MEDICAID PROGRAM NAMES
Utah (UT)
1
Medicaid
Created on 11/05/2019
1
HI4
MEDICAID HMOs
Utah (UT)
1
Bear River Mental Health
2
Central Utah Mental Health
3
Davis Behavioral Health
4
Delta Dental
5
Four Corners Community Behavioral Health
6
HOME
7
Health Choice
8
Healthy U
9
Logisticare Solutions
10
Molina
11
Molina Plus
12
Northeastern Counseling
13
Optum Health
(continued)
Created on 11/05/2019
2
HI4
MEDICAID HMOs
Utah (UT)
14
Premier Access
15
SelectHealth
16
Southwest Behavioral Health
17
Valley Behavioral Health
18
Wasatch Mental Health
19
Weber Mental Health
Created on 11/05/2019
1
HI5
HEALTHCARE MARKETPLACE PLANS
Utah (UT)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
1
BridgeSpan [Tier] Essential (BridgeSpan Health
Company)
2
BridgeSpan [Tier] HDHP (BridgeSpan Health
Company)
3
Cigna Connect (Cigna Health and Life Insurance
Company)
4
Confident Care [Tier] (Molina Healthcare of Utah)
5
Constant Care [Tier] (Molina Healthcare of Utah)
6
Core Care [Tier] (Molina Healthcare of Utah)
7
Healthy Preferred Expanded [Tier] (University of
Utah Health Insurance Plans)
(continued)
Created on 11/05/2019
2
HI5
HEALTHCARE MARKETPLACE PLANS
Utah (UT)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
8
Healthy Preferred [Tier] (University of Utah
Health Insurance Plans)
9
Healthy Preferred [Tier]s before Deductible
(University of Utah Health Insurance Plans)
10
Healthy Premier Expanded [Tier] (University of
Utah Health Insurance Plans)
11
Healthy Premier [Tier] (University of Utah Health
Insurance Plans)
12
Healthy Premier [Tier]s before Deductible
(University of Utah Health Insurance Plans)
13
Med Benchmark Expanded [Tier] (SelectHealth)
14
Med Benchmark [Tier] (SelectHealth)
(continued)
Created on 11/05/2019
3
HI5
HEALTHCARE MARKETPLACE PLANS
Utah (UT)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
15
Med Benchmark [Tier] deductible for office visits
(SelectHealth)
16
Med Expanded [Tier] deductible for office visits
(SelectHealth)
17
Med Expanded [Tier] deductible for one urgent
and all PCP visits (SelectHealth)
18
Med HealthSave Expanded [Tier] Qualified
(SelectHealth)
19
Med HealthSave [Tier] Qualified (SelectHealth)
20
Med [Tier] (SelectHealth)
21
Med [Tier] deductible for office visits
(SelectHealth)
(continued)
Created on 11/05/2019
4
HI5
HEALTHCARE MARKETPLACE PLANS
Utah (UT)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
22
Med [Tier] deductible for one urgent and all PCP
visits (SelectHealth)
23
Value Benchmark Expanded [Tier] (SelectHealth)
24
Value Benchmark [Tier] (SelectHealth)
25
Value Benchmark [Tier] deductible for office
visits (SelectHealth)
26
Value Expanded [Tier] deductible for office visits
(SelectHealth)
27
Value Expanded [Tier] deductible for one urgent
and all PCP visits (SelectHealth)
28
Value HealthSave Expanded [Tier] Qualified
(SelectHealth)
(continued)
Created on 11/05/2019
5
HI5
HEALTHCARE MARKETPLACE PLANS
Utah (UT)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
29 Value HealthSave Expanded [Tier] qualified
(SelectHealth)
30 Value HealthSave [Tier] Qualified (SelectHealth)
31 Value [Tier] (SelectHealth)
32 Value [Tier] deductible for office visits (SelectHealth)
33 [Tier] Care on Demand (BridgeSpan Health
Company)
34 [Tier] Essential (BridgeSpan Health Company)
35 [Tier] HDHP (BridgeSpan Health Company)
Created on 11/05/2019
1
HI6
PUBLIC ASSISTANCE PLANS
Utah (UT)
1 Utah AIDS Drug Assistance Program
2 Utah Drug Card
Created on 11/05/2019
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
ApexAscend (ApexHealth, Inc.)
5
ApexBold (ApexHealth, Inc.)
6
Clear Spring Health Essential (Clear Spring
Health)
7
Humana Gold Choice (Humana)
8
Humana Gold Plus (Humana)
9
Humana Value Plus (Humana)
10
HumanaChoice (Humana)
(continued)
Created on 11/05/2019
2
HI2
MEDICARE ADVANTAGE PLANS
Virginia (VA)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
11
Innovation Health-Aetna Medicare (Innovation
Health Medicare)
12
Innovation Health-Aetna Medicare Connect
(Innovation Health Medicare)
13
Kaiser Permanente Medicare Advantage (Kaiser
Permanente)
14
Kaiser Permanente Medicare Plus (Kaiser
Permanente)
15
Mary Washington Medicare Advantage (Mary
Washington Medicare Advantage)
16
Optima Medicare (Optima Medicare)
17
Piedmont Select Medicare Option (Piedmont
Medicare Advantage)
(continued)
Created on 11/05/2019
3
HI2
MEDICARE ADVANTAGE PLANS
Virginia (VA)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
18 Sunrise Advantage Community Plan (Sunrise
Advantage Plan)
19 AARP Medicare Advantage Plan (UnitedHealthcare)
20 AARP Medicare Advantage Walgreens
(UnitedHealthcare)
21 Erickson Advantage (UnitedHealthcare)
22 UnitedHealthcare MedicareDirect (UnitedHealthcare)
23 Virginia Premier Advantage (Virginia Premier)
Created on 11/05/2019
1
HI3
MEDICAID PROGRAM NAMES
Virginia (VA)
1
Medicaid
Created on 11/05/2019
1
HI4
MEDICAID HMOs
Virginia (VA)
1
Aetna Better Health of Virginia
2
AllCare PACE
3
Anthem
4
Blue Ridge Pace
5
Centra Pace Farmville
6
Centra Pace Gretna
7
Centra Pace Lynchburg
8
InTotal
9
Inova Cares for Seniors
10
Kaiser Permanente
11
Kissito PACE - now InnovAge PACE Roanoke
Valley, LLC
12
Mountain Empire Older Citizens PACE (MEOC)
(continued)
Created on 11/05/2019
2
HI4
MEDICAID HMOs
Virginia (VA)
13
Optima Family Care
14
Riverside PACE McTavish
15
Riverside PACE Newport News
16
Sentara Pace Churchland
17
Sentara Pace Norfolk
18
Virginia Premier
Created on 11/05/2019
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 11/05/2019
2
HI5
HEALTHCARE MARKETPLACE PLANS
Virginia (VA)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
8
KP VA [Tier] (Kaiser Foundation Health Plan of
the Mid-Atlantic States, Inc.)
9
OptimaFit [Tier] Direct M (Optima Health Plan)
10
OptimaFit [Tier] M (Optima Health Plan)
11
OptimaFit [Tier] Select CH M (Optima Health
Plan)
12
OptimaFit [Tier] Select RK M (Optima Health
Plan)
13
Oscar Classic [Tier] (Oscar Insurance Company)
14
Oscar Classic [Tier] Next (Oscar Insurance
Company)
(continued)
Created on 11/05/2019
3
HI5
HEALTHCARE MARKETPLACE PLANS
Virginia (VA)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
15 Oscar Saver [Tier] (Oscar Insurance Company)
16 Oscar Simple Secure (Oscar Insurance Company)
17 Oscar Simple [Tier] (Oscar Insurance Company)
18 Piedmont [Tier] (Piedmont Community HealthCare
HMO, Inc.)
19 Virginia Premier Preferred [Tier] (Virginia Premier
Health Plan, Inc.)
Created on 11/05/2019
1
HI6
PUBLIC ASSISTANCE PLANS
Virginia (VA)
1 Virginia AIDS Drug Assistance Program
2 Virginia Drug Card
3 Virginia State Pharmacy Assistance Programs
(SPAP)
Created on 11/05/2019
1
HI2
MEDICARE ADVANTAGE PLANS
Vermont (VT)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
1 MVP (MVP HEALTH CARE)
2 AARP Medicare Advantage Choice
(UnitedHealthcare)
3 AARP Medicare Advantage Plan (UnitedHealthcare)
4 UnitedHealthcare Medicare Advantage Assure
(UnitedHealthcare)
5 UnitedHealthcare MedicareDirect (UnitedHealthcare)
Created on 11/05/2019
1
HI3
MEDICAID PROGRAM NAMES
Vermont (VT)
1
Vermont Medicaid
Created on 11/05/2019
1
HI4
MEDICAID HMOs
Vermont (VT)
1 Department of Vermont Health Access
Created on 11/05/2019
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 11/05/2019
1
HI6
PUBLIC ASSISTANCE PLANS
Vermont (VT)
1 Catamount Health
2 Healthy Vermonters
3 Vermont AIDS Drug Assistance Program
4 Vermont Rx Card
5 Vermont Vpharm
Created on 11/05/2019
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 Health Plan of WA MA (Community
Health Plan of WA Medicare Advantage)
5
Health Alliance NW (Health Alliance Northwest)
6
Health Net (Health Net Life Insurance Company)
7
Humana Gold Plus (Humana)
8
Humana Honor (Humana)
9
HumanaChoice (Humana)
(continued)
Created on 11/05/2019
2
HI2
MEDICARE ADVANTAGE PLANS
Washington (WA)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
10
Kaiser Permanente Medicare Advantage (Kaiser
Foundation Health Plan of Washington)
11
Kaiser Permanente Senior Advantage (Kaiser
Permanente)
12
PacificSource Medicare MyCare (PacificSource
Medicare)
13
Premera Blue Cross Medicare Advantage
(Premera Blue Cross Medicare Advantage)
14
Providence Medicare (Providence Medicare
Advantage Plans)
15
Regence BlueAdvantage HMO (Regence
BlueCross BlueShield of Oregon)
16
Regence (Regence BlueShield)
(continued)
Created on 11/05/2019
3
HI2
MEDICARE ADVANTAGE PLANS
Washington (WA)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
17 Regence MedAdvantage (Regence BlueShield Of
Idaho)
18 AARP Medicare Advantage (UnitedHealthcare)
19 WellCare (WellCare)
Created on 11/05/2019
1
HI3
MEDICAID PROGRAM NAMES
Washington (WA)
1
Apple Health (Medicaid)
Created on 11/05/2019
1
HI4
MEDICAID HMOs
Washington (WA)
1
Amerigroup
2
BHO
3
Community Health Plan of Washington
4
Coordinated Care of Washington
5
Molina
6
Molina Health Care
7
Multiple Primary Care Providers
8
Multiple Sites
9
Multiple Transportation Brokers
10
Providence Elder Place
11
United Health Care
Created on 11/05/2019
1
HI6
PUBLIC ASSISTANCE PLANS
Washington (WA)
1 Early Intervention Program (EIP)
2 Washington Drug Card
3 Washington State Health Insurance Pool (WSHIP)
Created on 11/05/2019
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
Allwell Medicare Essentials (Allwell)
3
Anthem MediBlue Access (Anthem Blue Cross
and Blue Shield)
4
Anthem MediBlue Plus (Anthem Blue Cross and
Blue Shield)
5
Dean Advantage (Dean Advantage, Prevea360
Medicare Advantage)
6
Prevea360 Medicare Advantage (Dean
Advantage, Prevea360 Medicare Advantage)
7
DeanCare Gold (Dean Health Plan, Inc.)
8
HealthPartners Freedom (HealthPartners)
9
HealthPartners Robin (HealthPartners)
(continued)
Created on 11/05/2019
2
HI2
MEDICARE ADVANTAGE PLANS
Wisconsin (WI)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
10
Humana Gold Choice (Humana)
11
Humana Gold Plus (Humana)
12
Humana Value Plus (Humana)
13
HumanaChoice (Humana)
14
Medica Prime Solution (Medica)
15
Medical Associates (Medical Associates Clinic
Health Plan of Wisconsi)
16
Network (Network Health Medicare Advantage
Plans)
17
Network Health Medicare Explore (Network
Health Medicare Advantage Plans)
18
NetworkPrime (Network Health Medicare
Advantage Plans)
(continued)
Created on 11/05/2019
3
HI2
MEDICARE ADVANTAGE PLANS
Wisconsin (WI)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
19
Assurance (Security Health Plan of Wisconsin,
Inc.)
20
Essence (Security Health Plan of Wisconsin, Inc.)
21
Esteem (Security Health Plan of Wisconsin, Inc.)
22
Promise (Security Health Plan of Wisconsin, Inc.)
23
Secure Saver (Security Health Plan of Wisconsin,
Inc.)
24
Spirit (Security Health Plan of Wisconsin, Inc.)
25
Surety (Security Health Plan of Wisconsin, Inc.)
(continued)
Created on 11/05/2019
4
HI2
MEDICARE ADVANTAGE PLANS
Wisconsin (WI)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
26 Gundersen Senior Preferred (Senior Preferred)
27 ProHealth Senior Preferred (Senior Preferred)
28 UW Health Senior Preferred (Senior Preferred)
29 EssentiaCare (UCare)
30 AARP Medicare Advantage (UnitedHealthcare)
31 AARP Medicare Advantage Walgreens
(UnitedHealthcare)
32 UnitedHealthcare Medicare Advantage Open
(UnitedHealthcare)
Created on 11/05/2019
1
HI3
MEDICAID PROGRAM NAMES
Wisconsin (WI)
1
BadgerCare Plus
Created on 11/05/2019
1
HI4
MEDICAID HMOs
Wisconsin (WI)
1
Anthem Blue Cross Blue Shield
2
Care Wisconsin
3
Care Wisconsin (FC)
4
Care Wisconsin Health Plan, Inc. Care
Wisconsin
5
Children Come First
6
Children's Hospital of Wisconsin
7
Children's Community Health Plan
8
Community Care Health Plan, Inc. Community
Care, Inc.
9
Community Care, Inc.
10
Community Care, Inc. (FC)
11
CommunityLink (became Inclusa in September
2017)
(continued)
Created on 11/05/2019
2
HI4
MEDICAID HMOs
Wisconsin (WI)
12
Compcare
13
Dean Health Plan
14
Group Health Cooperative Of Eau Claire
15
Group Health Cooperative Of South Central WI
16
Gundersen Health Plan
17
Health Tradition Health Plan
18
Independent Care (iCare)
19
Independent Care Health Plan iCare
20
Lakeland Care, Inc.
21
MHS of Wisconsin
22
MercyCare Insurance Company
23
Molina Health Plan
(continued)
Created on 11/05/2019
3
HI4
MEDICAID HMOs
Wisconsin (WI)
24
My Choice Family Care
25
Network Health Plan
26
Physicians Plus Health Plan
27
Security Health Plan
28
Trilogy Health Insurance
29
UnitedHealthcare Community Plan
30
Unity Health Plan
31
WrapAround Milwaukee
Created on 11/05/2019
1
HI5
HEALTHCARE MARKETPLACE PLANS
Wisconsin (WI)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
1
Atlas Plus [Tier] (HealthPartners Insurance
Company)
2
Atlas [Tier] (HealthPartners Insurance Company)
3
Beloit One [Tier] I (Quartz Health Benefit Plans
Corporation)
4
Beloit One [Tier] I Dental (Quartz Health Benefit
Plans Corporation)
5
Beloit One [Tier] I Maintenance (Quartz Health
Benefit Plans Corporation)
6
Beloit One [Tier] I Maintenance Dental (Quartz
Health Benefit Plans Corporation)
7
Confident Care [Tier] (Molina Healthcare of
Wisconsin, Inc.)
(continued)
Created on 11/05/2019
2
HI5
HEALTHCARE MARKETPLACE PLANS
Wisconsin (WI)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
8
Constant Care [Tier] (Molina Healthcare of
Wisconsin, Inc.)
9
Core Care [Tier] (Molina Healthcare of
Wisconsin, Inc.)
10
Dean Focus Network [Tier] E (Dean Health Plan)
11
Dean Focus Network [Tier] Plus (Dean Health
Plan)
12
Dean Focus Network [Tier] Value (Dean Health
Plan)
13
Dean [Tier] Classic (Dean Health Plan)
14
Dean [Tier] E (Dean Health Plan)
15
Dean [Tier] Plus (Dean Health Plan)
(continued)
Created on 11/05/2019
3
HI5
HEALTHCARE MARKETPLACE PLANS
Wisconsin (WI)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
16
Dean [Tier] Safety Net (Dean Health Plan)
17
Dean [Tier] Value (Dean Health Plan)
18
En (Common Ground Healthcare Cooperative)
19
En [Tier] (Common Ground Healthcare
Cooperative)
20
Engage by Medica [Tier] (Medica Community
Health Plan)
21
Engage by Medica [Tier] Share Plus (Medica
Community Health Plan)
22
Envison [Tier] (Common Ground Healthcare
Cooperative)
(continued)
Created on 11/05/2019
4
HI5
HEALTHCARE MARKETPLACE PLANS
Wisconsin (WI)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
23
HDHP [Tier] (Aspirus Arise Health Plan of
Wisconsin, Inc.)
24
HDHP [Tier] (WPS Health Plan, Inc.)
25
Medica Individual Choice [Tier] (Medica
Community Health Plan)
26
Medica Individual Choice [Tier] H S (Medica
Community Health Plan)
27
Medica Individual Choice [Tier] Share Plus
(Medica Community Health Plan)
28
MercyCare [Tier] Option (MercyCare HMO, Inc.)
29
Prestige [Tier] Dental (Network Health Plan)
(continued)
Created on 11/05/2019
5
HI5
HEALTHCARE MARKETPLACE PLANS
Wisconsin (WI)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
30
Prestige [Tier] Essential Dental Fitness Free PCP
Visits (Network Health Plan)
31
Prestige [Tier] HDHP Dental (Network Health
Plan)
32
Prevea [Tier] Classic (Dean Health Plan)
33
Prevea [Tier] E (Dean Health Plan)
34
Prevea [Tier] Plus (Dean Health Plan)
35
Prevea [Tier] Safety Net (Dean Health Plan)
36
Prevea [Tier] Value (Dean Health Plan)
37
Quartz One [Tier] I (Quartz Health Benefit Plans
Corporation)
(continued)
Created on 11/05/2019
6
HI5
HEALTHCARE MARKETPLACE PLANS
Wisconsin (WI)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
38
Quartz One [Tier] I Dental (Quartz Health Benefit
Plans Corporation)
39
Quartz One [Tier] I Maintenance (Quartz Health
Benefit Plans Corporation)
40
Quartz One [Tier] I Maintenance Dental (Quartz
Health Benefit Plans Corporation)
41
Quartz Prime [Tier] I (Quartz Health Benefit
Plans Corporation)
42
Quartz Prime [Tier] I Dental (Quartz Health
Benefit Plans Corporation)
43
Quartz Prime [Tier] I Maintenance (Quartz Health
Benefit Plans Corporation)
44
Quartz Prime [Tier] I Maintenance Dental (Quartz
Health Benefit Plans Corporation)
(continued)
Created on 11/05/2019
7
HI5
HEALTHCARE MARKETPLACE PLANS
Wisconsin (WI)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
45
Select (Security Health Plan of Wisconsin, Inc.)
46
Select HDHP (Security Health Plan of Wisconsin,
Inc.)
47
Select Protection (Security Health Plan of
Wisconsin, Inc.)
48
Select [Tier] Ded MOOP (Group Health
Cooperative of South Central Wisconsin)
49
Select [Tier] Simple Choice Ded MOOP (Group
Health Cooperative of South Central Wisconsin)
50
Select [Tier]Ded MOOP (Group Health
Cooperative of South Central Wisconsin)
51
Together Standard [Tier] (Children's Community
Health Plan)
(continued)
Created on 11/05/2019
8
HI5
HEALTHCARE MARKETPLACE PLANS
Wisconsin (WI)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
52
Together [Tier] (Children's Community Health
Plan)
53
Together [Tier] HDHP (Children's Community
Health Plan)
54
Together [Tier] Select (Children's Community
Health Plan)
55
[Tier] (Aspirus Arise Health Plan of Wisconsin,
Inc.)
56
[Tier] (WPS Health Plan, Inc.)
57
[Tier] Ded MOOP (Group Health Cooperative of
South Central Wisconsin)
58
[Tier] Free PCP Visits (Aspirus Arise Health Plan
of Wisconsin, Inc.)
(continued)
Created on 11/05/2019
9
HI5
HEALTHCARE MARKETPLACE PLANS
Wisconsin (WI)
Marketplace plan names often have tiers in their
names (Bronze/Silver/Gold/Platinum, Catastrophic)
59 [Tier] Free PCP Visits (WPS Health Plan, Inc.)
60 [Tier] Simple Choice Ded MOOP (Group Health
Cooperative of South Central Wisconsin)
61 [Tier]Ded MOOP (Group Health Cooperative of
South Central Wisconsin)
Created on 11/05/2019
1
HI6
PUBLIC ASSISTANCE PLANS
Wisconsin (WI)
1 Wisconsin AIDS/HIV Drug Assistance Program
2 Wisconsin Chronic Disease Program
3 Wisconsin Drug Card
4 Wisconsin SeniorCare
Created on 11/05/2019
1
HI2
MEDICARE ADVANTAGE PLANS
West Virginia (WV)
(Medicare Managed Care, such as Medicare HMO,
Medicare PPO, or Medicare PFFS Plan)
1
Aetna Medicare Advantra (Aetna Medicare)
2
Freedom Blue PPO (Highmark Inc.)
3
Humana Gold Choice (Humana)
4
Humana Gold Plus (Humana)
5
Humana Value Plus (Humana)
6
HumanaChoice (Humana)
7
The Health Plan SecureCare (The Health Plan)
8
The Health Plan SecureChoice (The Health Plan)
9
WVU Medicine - The Health Plan SecureCare
(The Health Plan)
(continued)
Created on 11/05/2019
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 Medicare Advantage Choice Plan
(UnitedHealthcare)
Created on 11/05/2019
1
HI3
MEDICAID PROGRAM NAMES
West Virginia (WV)
1
West Virginia Medicaid
Created on 11/05/2019
1
HI4
MEDICAID HMOs
West Virginia (WV)
1 Aetna Better Health of WV (formerly CoventryCares)
2 The Health Plan
3 UniCare
4 WV Family Health
Created on 11/05/2019
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 & Fitness (CareSource West Virginia Co.)
3
CareSource Marketplace Low Premium [Tier]
(CareSource West Virginia Co.)
4
CareSource Marketplace Low Premium [Tier]
Dental & Fitness (CareSource West Virginia Co.)
5
CareSource Marketplace Standard [Tier]
(CareSource West Virginia Co.)
6
CareSource Marketplace Standard [Tier]
Dental & Fitness (CareSource West Virginia Co.)
7
CareSource Marketplace [Tier] (CareSource
West Virginia Co.)
(continued)
Created on 11/05/2019
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 & Fitness
(CareSource West Virginia Co.)
9
my Blue Access WV Major Events Free PCP Visits
(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 Visit
(Highmark Blue Cross Blue Shield West Virginia)
12 my Blue Access WV [Tier] Free PCP Visits
(Highmark Blue Cross Blue Shield West Virginia)
Created on 11/05/2019
1
HI6
PUBLIC ASSISTANCE PLANS
West Virginia (WV)
1 Golden Mountaineer Discount Card
2 West Virginia AIDS Drug Assistance Program
3 West Virginia Rx Card
Created on 11/05/2019
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 Value Plan (Aetna Medicare)
3 Lasso Healthcare (Lasso Healthcare)
4 UnitedHealthcare MedicareDirect (UnitedHealthcare)
Created on 11/05/2019
1
HI3
MEDICAID PROGRAM NAMES
Wyoming (WY)
1
Medicaid
Created on 11/05/2019
1
HI4
MEDICAID HMOs
Wyoming (WY)
1 CME Statewide
2 Cheyenne Regional Medical Center PACE
Created on 11/05/2019
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 11/05/2019
1
HI6
PUBLIC ASSISTANCE PLANS
Wyoming (WY)
1 AIDS Drug Assistance Program
2 Wyoming Prescription Drug Assistance Program
(PDAP)
3 Wyoming Rx Card
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 8, 2020
KN9
•
Very easy
•
Somewhat easy
•
Somewhat difficult
•
Very difficult
Updated January 11, 2017
KN10
•
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 8, 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 9, 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
PV1
●
Less than 6 months ago
●
6 months to less than 1 year ago
●
1 year to less than 2 years ago
●
2 years ago to less than 5 years ago
●
5 or more years ago
●
Never had blood pressure taken
Updated July 2020
PV2
●
Less than 6 months ago
●
6 months to less than 1 year ago
●
1 year to less than 2 years ago
●
2 years ago to less than 5 years ago
●
5 or more years ago
●
Never had cholesterol checked
Updated July 2020
PV3
●
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 2020
PX1
Updated July 2020
PX2
Updated July 2020
PX3
Updated July 2020
PX4
• Missing arm, hand, or thumb
• Hand paralysis
• Wearing a cast on wrist or hand
• Most of hand covered by bandages
• Broken fingers
• Surgery on hands or wrists in the past
three months
Updated May 2022
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 22, 2019
SC3
• Very Likely
• Likely
• Unlikely
• Very Unlikely
Updated July 22, 2019
SC4
• Always
• Usually
• Sometimes
• Never
Updated July 22, 2019
US1
• Allergy/immunology
• Anesthesiology
• Audiologist
• Cardiology (heart)
• Chiropractor
• Dentist
• Dermatology (skin)
• Endocrinology/metabolism (diabetes, thyroid)
• Family practice
• Gastroenterology
• General practice
• General surgery
• Geriatrics (elderly)
• Gynecology - obstetrics
• Hematology (blood)
• Hospital residence
(Continued)
Updated January 8, 2020
US1
• Internal medicine (internist)
• Nephrology (kidneys)
• Neurology
• Nuclear Medicine
• Nurse Practitioner
• Oncology (tumors, cancer)
• Ophthalmology (eyes)
• Optometrist
• Orthopedics
• Osteopathy (DO)
• Otorhinolaryngology (ear, nose, throat)
• Pain Management Specialist
• Pathology
• Phys med/rehab
• Physical Therapist
• Physician’s Assistant
(Continued)
Updated January 8, 2020
US1
• Plastic Surgery
• Podiatrist
• Proctology
• Psychiatry/psychiatrist
• Psychologist
• Pulmonary (lungs)
• Radiology
• Rheumatology (arthritis)
• Thoracic Surgery (chest)
• Urology
• Vascular Surgeon/Specialist
Updated January 8, 2020
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
• 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 8, 2020
| File Type | application/pdf |
| File Title | 2021 MCBS Community Showcards |
| Subject | MCBS, Community, Showcards |
| Author | NORC |
| File Modified | 2020-03-25 |
| File Created | 2019-12-05 |