90091 2021 United Mine Workers of America Health & Retirement UMWA Funds 0 UMWA Funds 0 2 UNITED MINE WORKERS OF AMERICA HLTH & RETIREMENT E0654 2021 TEAMStar Medicare Part D Prescription Drug Program Nationwide 0 IBT VEBA 0 2 IBT VOLUNTARY EMPLOYEE BENEFITS TRUST E3014 2021 Pennsylvania Public School Employees Retirement Sy Pennsylvania Public School Employees Retirement System (PSERS) 0 PSERS HOP PROGRAM 0 2 PSERS HOP PROGRAM E4744 2021 MISSOURI DEPARTMENT OF TRANSPORTATION MISSOURI DEPARTMENT OF TRANSPORTATION 0 MISSOURI DEPARTMENT OF TRANSPORTATION 0 2 MODOT/MSHP MEDICAL AND LIFE INSURANCE PLAN H0001 2021 Original Medicare Original Medicare 0 1 0 H0022 2021 Buckeye Health Plan - MyCare Ohio Counties: CL, CU, FU, GE, GR, LA, LO, LU, ME, MO, OT, WO 0 0 1 BUCKEYE COMMUNITY HEALTH PLAN, INC. H0028 2021 Humana Multi-state 0 www.humana.com 0 1 CHA HMO, INC. H0029 2021 Allwell Spokane, Pierce 0 0 1 COORDINATED CARE OF WASHINGTON, INC. H0034 2021 Hamaspik, Inc. Hamaspik, Inc. 0 www.hamaspik.com Hamaspik, Inc. 0 1 HAMASPIK, INC. H0062 2021 Wellcare by Allwell Select counties in TX 0 0 1 SUPERIOR HEALTHPLAN COMMUNITY SOLUTIONS, INC. H0074 2021 Wellcare Select counties in MS 0 0 1 WELLCARE OF MISSISSIPPI, INC. H0088 2021 Wellcare Select counties in NY 0 www.WellCare.com/medicare 0 1 WELLCARE HEALTH INSURANCE OF NEW YORK, INC. H0104 2021 Blue Cross and Blue Shield of Alabama State of Alabama 0 www.bcbsalmedicare.com 0 2 BLUE CROSS AND BLUE SHIELD OF ALABAMA H0105 2021 The Methodist Oaks d.b.a. The Oaks PACE The Oaks PACE - Orangeburg, Calhoun, & Bamberg Counties SC 0 The Methodist Oaks d.b.a. The Oaks PACE 0 2 THE METHODIST OAKS H0107 2021 Blue Cross and Blue Shield of Montana State of Montana 0 0 2 HEALTH CARE SERVICE CORPORATION H0111 2021 Wellcare Select counties in GA 0 www.WellCare.com/medicare 0 1 WELLCARE OF GEORGIA, INC. H0112 2021 Palm Beach PACE MorseLife Home Care, Inc. 0 MorseLife.org Palm Beach PACE 0 2 MORSE LIFE HOME CARE, INC. H0137 2021 Commonwealth Care Alliance, Inc. BERK, BAR, BRI, ESS, FRA, HMD, HMP, MID, NOR, PLY, SUF, and WOR 0 Commonwealth Care Alliance, Inc. 0 2 COMMONWEALTH CARE ALLIANCE, INC. H0148 2021 Blue Shield of California Promise Health Plan Los Angeles and San Diego Counties 0 www.blueshieldca.com/promise/calmediconnect Blue Shield of California Promise Health Plan 0 2 BLUE SHIELD OF CALIFORNIA PROMISE HEALTH PLAN H0154 2021 VIVA Medicare Northwest, Central and South Alabama 0 www.vivamedicaremember.com VIVA Health 0 2 VIVA HEALTH, INC. H0169 2021 UnitedHealthcare State of MO, Select Counties in IA, KS and NE 0 0 1 UNITEDHEALTHCARE OF THE MIDWEST, INC. H0174 2021 Wellcare Select Counties in TX 0 http://www.universal-american-medicare.com/todaysoptions TODAY'S OPTIONS OF TEXAS, INC. 0 1 WELLCARE OF TEXAS, INC. H0192 2021 AmeriHealth Caritas VIP Care Plus Wayne and Macomb Counties 0 www.amerihealthcaritasvipcareplus.com 0 1 AMERIHEALTH MICHIGAN, INC. H0216 2021 Immanuel Pathways Iowa Southwest and Central Iowa 0 Immanuel Pathways 0 2 PACE IOWA H0235 2021 PACE of Northeast Indiana, LLC PACE of Northeast Indiana, LLC 0 0 1 PACE OF NORTHEAST INDIANA, LLC H0247 2021 AllCare PACE, LLC AllCare PACE, LLC 0 AllCare PACE, LLC 0 1 ALLCARE PACE, LLC H0251 2021 UnitedHealthcare State of TN 0 AmeriChoice 0 1 UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC. H0270 2021 Wellcare Select counties in AR 0 www.WellCare.com/medicare 0 1 WELLCARE HEALTH INSURANCE COMPANY OF AMERICA H0271 2021 UnitedHealthcare Select Counties in AR/AZ/CT/ID/IN/ME/MI/MO/MT/NC/ND/NH/NM/OR/SC/SD/UT/VT/VA/WV/WI/WY. 0 0 1 UnitedHealthcare Insurance Company of America H0292 2021 Humana Multi-state 0 www.humana.com 0 1 HUMANA HEALTH PLAN OF OHIO, INC. H0294 2021 UnitedHealthcare Select Counties in MI, and WI 0 0 1 CARE IMPROVEMENT PLUS WISCONSIN INSURANCE COMPANY H0302 2021 Blue Cross Blue Shield of Arizona Advantage Central and Southern Arizona 0 www.azbluemedicare.com Blue Cross Blue Shield of Arizona Advantage 0 1 MEDISUN, INC. H0321 2021 UnitedHealthcare State of AZ 0 0 1 ARIZONA PHYSICIANS IPA, INC. H0332 2021 KelseyCare Advantage Greater Houston Area 0 KelseyCare Advantage 0 1 KS PLAN ADMINISTRATORS, LLC H0336 2021 Humana Chicago Metro Area 0 https://www.humana.com/medicaid-dual/illinois/pharmacy/ 0 1 HUMANA HEALTH PLAN, INC. H0342 2021 CarePartners of Connecticut Connecticut 0 www.carepartnersct.com 0 2 CAREPARTNERS OF CONNECTICUT, INC. H0351 2021 Wellcare by Allwell Central and Southern Arizona 0 https://www.healthnet.com/medicare Arizona Complete Health 0 1 HEALTH NET OF ARIZONA, INC. H0354 2021 Cigna Maricopa County, Apache Junction and Queen Creek 0 www.cigna.com/medicare Cigna HealthCare of Arizona 0 1 CIGNA HEALTHCARE OF ARIZONA, INC. H0363 2021 Longevity Health Plan Colorado (partial) 0 Longevity Health Plan 0 1 LONGEVITY HEALTH PLAN OF COLORADO, INC. H0390 2021 PACE of Southwest Michigan PACE of Southwest Michigan 0 PACE of Southwest Michigan 0 2 PACE OF SOUTHWEST MICHIGAN, INC. H0422 2021 UCare Minneapolis/St. Paul Metro Area 0 0 2 UCARE HEALTH, INC. H0423 2021 MetroPlus Health Plan MetroPlus Health Plan 0 www.metroplusmedicare.org 0 2 METROPLUS HEALTH PLAN, INC. H0432 2021 UnitedHealthcare Select Counties in AL 0 0 1 UNITEDHEALTHCARE OF ALABAMA, INC. H0439 2021 Cigna Georgia 0 www.cigna.com/medicare 0 1 CIGNA HEALTHCARE OF GEORGIA, INC. H0440 2021 Empath LIFE Greater Hillsborough 0 Empath LIFE 0 2 EMPATH LIFE, LLC H0473 2021 Humana Multi-state 0 www.humana.com 0 1 HUMANA INSURANCE COMPANY OF KENTUCKY H0477 2021 Serenity Care PACE Serenity Care PACE 0 0 2 SERENITY CARE, INC. H0480 2021 Meridian Select Michigan Counties 0 0 1 MERIDIAN HEALTH PLAN OF MICHIGAN, INC. H0482 2021 Ascension Complete Counties: GENE, KALA, SAGI 0 0 1 CENTENE VENTURE COMPANY MICHIGAN H0504 2021 Blue Shield of California Southern California and portions of Central and Northern California 0 www.blueshieldca.com/medicare BLUE SHIELD OF CALIFORNIA 0 2 CALIFORNIA PHYSICIANS' SERVICE H0523 2021 Aetna Medicare Aetna Health of California, Inc. 0 http://www.aetnamedicare.com/ 0 1 AETNA HEALTH OF CALIFORNIA INC. H0524 2021 Kaiser Permanente Northern & Southern California Areas 0 0 2 KAISER FOUNDATION HP, INC. H0542 2021 AltaMed Health Services Corporation Los Angeles County 0 http://www.altamed.org/ AltaMed Health Services Corporation 0 2 ALTAMED HEALTH SERVICES CORPORATION H0543 2021 UnitedHealthcare Select Counties in CA 0 0 1 UHC OF CALIFORNIA H0544 2021 Anthem Blue Cross Parts of the State of California 0 https://shop.anthem.com/medicare/ca Anthem Blue Cross 0 1 BLUE CROSS OF CALIFORNIA H0545 2021 Inter Valley Health Plan Los Angeles, San Bernardino, Riverside and Orange Counties 0 http://www.ivhp.com Inter Valley Health Plan, Inc. 0 2 INTER VALLEY HEALTH PLAN, INC. H0562 2021 Wellcare by Health Net Select counties in California 0 0 1 HEALTH NET OF CALIFORNIA,INC. H0571 2021 Chinese Community Health Plan San Francisco Bay Area 0 https://cchphealthplan.com/medicare-member/ Chinese Community Health Plan 0 1 CHINESE COMMUNITY HEALTH PLAN H0609 2021 UnitedHealthcare State of AZ, Select Counites in CO and NV 0 0 1 PACIFICARE OF COLORADO, INC. H0613 2021 InnovAge Colorado PACE Denver Metro Area 0 http://www.totallongtermcare.org InnovAge Colorado PACE 0 1 TOTAL LONGTERM CARE, INC. H0624 2021 UnitedHealthcare Select Counties in CO 0 0 1 UNITEDHEALTHCARE INSURANCE COMPANY H0628 2021 Aetna Medicare Select counties in Kentucky and Ohio 0 http://www.aetnamedicare.com/ 0 1 AETNA HEALTH OF OHIO INC. H0630 2021 Kaiser Permanente Denver Metro Area 0 kp.org 0 2 KAISER FOUNDATION HP OF CO H0657 2021 Friday Health Plans South, Central and Eastern Colorado rural areas 0 Friday Health Plans of Colorado 0 1 FRIDAY HEALTH PLANS OF COLORADO, INC. H0672 2021 Cigna Colorado 0 www.cigna.com/medicare CIGNA HEALTHCARE OF COLORADO, INC. 0 1 CIGNA HEALTHCARE OF COLORADO, INC. H0710 2021 UnitedHealthcare Nationwide and All US Territories 0 0 1 SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. H0712 2021 Wellcare Select counties in CT 0 www.WellCare.com/medicare 0 1 WELLCARE OF CONNECTICUT, INC. H0724 2021 Wellcare by Allwell Northeast and Southwest Ohio 0 0 1 BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS, Inc. H0755 2021 UnitedHealthcare States of CT and NJ 0 0 1 OXFORD HEALTH PLANS (CT), INC. H0783 2021 Humana Select counties in Texas 0 www.humana.com 0 1 HUMANA BENEFIT PLAN OF TEXAS, INC. H0798 2021 Medica Select counties in Iowa and Nebraska 0 medica.com 0 2 MEDICA COMMUNITY HEALTH PLAN H0809 2021 Mercy LIFE Mercy LIFE 0 trinityhealthpace.org Mercy LIFE, Inc. 0 2 MERCY LIFE, INC. H0819 2021 Senior LIFE York, Inc. York County PACE 0 0 1 SENIOR LIFE YORK, INC. H0838 2021 Brand New Day California 0 www.BrandNewDayHMO.com BRAND NEW DAY 0 1 UNIVERSAL CARE, INC. H0839 2021 Senior CommUnity Care of North Carolina Counties of Durham, Granville, and Wake. North Carolina 0 Senior CommUnity Care of North Carolina 0 2 VOANS SENIOR COMMUNITY CARE OF NORTH CAROLINA, INC H0885 2021 Braven Health Eastern New Jersey 0 Braven Health 0 1 HEALTHIER NEW JERSEY INSURANCE COMPANY H0907 2021 Amerigroup Iowa Select counties in Iowa 0 0 1 AMERIGROUP IOWA, INC. H0908 2021 Wellcare by Allwell Northwest, Northeast, Southwest, and Eastern Ohio 0 0 1 BUCKEYE COMMUNITY HEALTH PLAN, INC. H0913 2021 Wellcare Select counties in NJ 0 www.WellCare.com/medicare 0 1 WELLCARE HEALTH PLANS OF NEW JERSEY, INC. H0927 2021 Blue Cross Community MMAI State of Illinois 0 0 2 HEALTH CARE SERVICE CORPORATION H0934 2021 WelbeHealth Pacific PACE Part of Los Angeles County 0 WelbeHealth Pacific PAC 0 1 PACIFIC PACE, LLC H0969 2021 Wellcare Select counties in NH 0 www.WellCare.com/medicare 0 1 WELLCARE HEALTH INSURANCE COMPANY OF NEW HAMPSHIRE H0982 2021 Solis Health Plans Solis Health Plans - Central & South Florida 0 www.solishealthplans.com Solis Health Plans, Inc. 0 1 SOLIS HEALTH PLANS, INC. H1016 2021 AvMed Medicare South Florida 0 www.avmed.org AvMed 0 2 AVMED, INC. H1019 2021 CarePlus Health Plans, Inc. S. Florida, Tampa, Orlando, Jacksonville, Daytona, and Space Coast Areas 0 http://www.careplushealthplans.com CarePlus Health Plans, Inc. 0 1 CAREPLUS HEALTH PLANS, INC. H1032 2021 Wellcare Select Counties in FL 0 www.WellCare.com/medicare 0 1 WELLCARE OF FLORIDA, INC. H1035 2021 Florida Blue HMO Select Counties in Florida 0 www.floridablue.com/medicare Florida Blue Medicare 0 1 FLORIDA BLUE MEDICARE, INC. H1036 2021 Humana Multi-state 0 www.humana.com 0 1 HUMANA MEDICAL PLAN, INC. H1043 2021 Florida Pace Centers, Inc. Florida PACE Centers, Inc. 0 www.floridapace.org Florida PACE Centers, Inc. 0 2 FLORIDA PACE CENTERS, INC. H1045 2021 UnitedHealthcare State of FL 0 0 1 PREFERRED CARE PARTNERS, INC. H1099 2021 Health First Health Plans, Inc. Health First Health Plans, Inc. 0 myHFHP.org 0 2 HEALTH FIRST HEALTH PLANS H1100 2021 Innovation Health Medicare Northern Virginia 0 0 1 INNOVATION HEALTH INSURANCE COMPANY H1109 2021 Aetna Medicare Aetna Health Inc. (Georgia) 0 http://www.aetnamedicare.com/ 0 1 AETNA HEALTH INC.(GA) H1111 2021 UnitedHealthcare Select Counties in GA 0 0 1 UNITEDHEALTHCARE OF GEORGIA, INC. H1112 2021 Wellcare Select counties in GA 0 www.WellCare.com/medicare 0 1 WELLCARE OF GEORGIA, INC. H1119 2021 Valor Health Plan Central, Northeast and Southeast Ohio 0 Valor Health Plan 0 1 TSG GUARD, INC. H1142 2021 Bright Health State of Ohio 0 0 1 BRIGHT HEALTH INSURANCE COMPANY OF OHIO, INC. H1170 2021 Kaiser Permanente Atlanta Metro Area 0 Kaiser Permanente 0 2 KAISER FOUNDATION HP OF GA, INC. H1181 2021 Network Health Medicare Advantage Plans State of Wisconsin 0 Network Health Medicare Advantage Plans 0 1 NETWORK HEALTH INSURANCE CORPORATION H1189 2021 CHRISTUS Health Plan Generations Texas and New Mexico 0 0 2 CHRISTUS HEALTH PLAN H1205 2021 Integra Managed Care New York City Metro Area 0 Integra Managed Care 0 1 INTEGRA MLTC, INC H1225 2021 Johns Hopkins HealthCare Counties: AA BL BC CR CV HW FR MG SS WH WC WR 0 www.hopkinsmedicare.com 0 1 HOPKINS HEALTH ADVANTAGE, INC. H1228 2021 Central Valley PACE Stanislaus and San Joaquin Counties California 0 Central Valley PACE 0 2 GOLDEN VALLEY HEALTH CENTERS H1230 2021 Kaiser Permanente Islands-Oahu, Maui & Hawaii (excl. 3 Zips) 0 www.kp.org Kaiser Permanente 0 2 KAISER FOUNDATION HP, INC. H1234 2021 LIFE St. Francis LIFE St. Francis 0 LIFE St. Francis 0 2 LIFE ST. FRANCIS H1239 2021 InnovAge Virginia PACE- Roanoke Valley InnovAge Virginia PACE- Roanoke Valley 0 http://myinnovage.com InnovAge Virginia PACE - Roanoke Valley 0 1 INNOVAGE VIRGINIA PACE-ROANOKE VALLEY, LLC H1248 2021 Blue Cross and Blue Shield of Louisiana State of Louisiana 0 LOUISIANA HEALTH SERVICE & INDEMNITY COMPANY 0 2 LOUISIANA HEALTH SERVICE & INDEMNITY COMPANY H1277 2021 Align Senior Care Virginia (partial) 0 Align Senior Care 0 1 ALIGN SENIOR CARE, INC. H1278 2021 UnitedHealthcare Select Counties in IA, NE, SD, and TX 0 0 1 HARKEN HEALTH INSURANCE COMPANY H1290 2021 Devoted Health Central and South Florida 0 www.Devoted.com Devoted Heatlh 0 1 DEVOTED HEALTH PLAN OF FLORIDA, INC. H1302 2021 Blue Cross of Idaho Select Counties in Idaho 0 bcidaho.com/medicare Secure Blue 0 2 BLUE CROSS OF IDAHO CARE PLUS, INC. H1304 2021 Regence BlueShield Of Idaho Select Counties in Idaho and Asotin County in Washington 0 www.regence.com/medicare Regence MedAdvantage (PPO) 0 2 REGENCE BLUESHIELD OF IDAHO H1310 2021 Senior Care Partners P.A.C.E. Greater Kalamazoo and Calhoun County Areas 0 seniorcarepartnersmi.org Senior Care Partners P.A.C.E. 0 2 COMPREHENSIVE SENIOR CARE CORPORATION H1350 2021 Blue Cross of Idaho Select Counties in Idaho 0 https://medicare.bcidaho.com True Blue 0 2 BLUE CROSS OF IDAHO CARE PLUS, INC. H1352 2021 Blue Medicare Advantage Kansas City Area 0 0 2 BLUE-ADVANTAGE PLUS OF KANSAS CITY, INC. H1353 2021 Wellcare Select counties in WA 0 www.WellCare.com/medicare 0 1 WELLCARE OF WASHINGTON, INC. H1357 2021 Carolina SeniorCare Carolina SeniorCare 0 Carolina SeniorCare 0 2 CAROLINA SENIORCARE H1360 2021 UnitedHealthcare Select Counties in NV 0 0 1 HEALTH PLAN OF NEVADA, INC. H1365 2021 Martin's Point Generations Advantage Martin's Point Generations Advantage 0 Martin's Point Generations Advantage 0 2 MARTIN'S POINT GENERATIONS ADVANTAGE, INC. H1372 2021 AgeRight Advantage Oregon (partial) 0 www.marquisadvantage.com AgeRight Advantage 0 1 MARQUIS ADVANTAGE, INC. H1375 2021 UnitedHealthcare Select Counties in CA 0 0 1 UNITEDHEALTHCARE COMMUNITY PLAN OF CALIFORNIA, INC H1393 2021 Bright Health State of Tennessee 0 0 1 BRIGHT HEALTH INSURANCE COMPANY OF TENNESSEE H1415 2021 Cigna Chicago Metropolitan Area 0 www.cigna.com/medicare HealthSpring Advantage 0 1 HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. H1416 2021 Wellcare Select counties in IL, AR, MS, SC, TN 0 www.WellCare.com/medicare 0 1 HARMONY HEALTH PLAN, INC. H1423 2021 Amerigroup Maricopa and Pima, Arizona 0 AMERIGROUP Community Care 0 1 AMERIGROUP OHIO, INC. H1426 2021 Vitality Health Plan of California Vitality Health Plan of California 0 0 1 VITALITY HEALTH PLAN OF CALIFORNIA, INC. H1436 2021 Wellcare by Allwell Abbeville, Charleston, Chesterfield, Greenville, and Richland Areas 0 0 1 ABSOLUTE TOTAL CARE, INC. H1463 2021 Health Alliance Medicare Central, Western and Southern Illinois, DeKalb metro area 0 www.healthalliancemedicare.org Health Alliance Medicare 0 2 HEALTH ALLIANCE CONNECT, INC. H1468 2021 Humana Peoria Metro Area 0 www.humana.com 0 1 HUMANA BENEFIT PLAN OF ILLINOIS, INC. H1500 2021 LIFE St. Joseph of the Pines LIFE St. Joseph of the Pines 0 0 2 LIFE ST. JOSEPH OF THE PINES, INC. H1518 2021 Catholic Health LIFE Erie County, New York 0 Catholic Health LIFE - Living Independently For Elders 0 2 CATHOLIC HEALTH SYSTEM BUFFALO PACE H1533 2021 StayWell Senior Care StayWell Senior Care 0 StayWell Senior Care 0 2 STAYWELL SENIOR CARE, INC. H1537 2021 UnitedHealthcare Nationwide, All US Territories 0 0 1 CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO. H1544 2021 WelbeHealth Coastline PACE Part of Los Angeles County 0 WelbeHealth Coastline PACE 0 1 LA COAST PACE, LLC H1587 2021 Tribute Health Plans State of Arkansas 0 www.superiorselectmedicare.com Tribute Health Plans 0 1 ARKANSAS SUPERIOR SELECT, INC. H1607 2021 Anthem Blue Cross and Blue Shield Indianapolis, Evansville, Ft. Wayne and NW Indiana Areas 0 https://shop.anthem.com/medicare Anthem Blue Cross and Blue Shield 0 1 ANTHEM INSURANCE COMPANIES, INC. H1608 2021 Aetna Medicare Aetna Health Inc. Eastern and Midwest United States 0 http://www.aetnamedicare.com/ 0 1 COVENTRY HEALTH AND LIFE INSURANCE COMPANY H1609 2021 Aetna Medicare Iowa and Florida 0 http://www.aetnamedicare.com/ 0 1 AETNA HEALTH INC. (FL) H1610 2021 Aetna Better Health of Virginia State of Virginia 0 AETNA BETTER HEALTH OF VIRGINIA 0 1 COVENTRY HEALTH CARE OF VIRGINIA, INC. H1622 2021 North East Medical Services - Program of All-Inclusive Care for the Elderly (PACE) San Francisco County 0 0 2 NORTH EAST MEDICAL SERVICES H1644 2021 Longevity Health Plan Florida (partial) 0 www.longevityhealthplan.com Longevity Health Plan 0 1 LONGEVITY HEALTH PLAN OF FLORIDA, INC. H1651 2021 Medical Associates Health Plan, Inc. Central and Northeast Iowa, Northwest and Central Illinois 0 0 1 MEDICAL ASSOCIATES HEALTH PLAN, INC. H1659 2021 UnitedHealthcare Select Counties in VA 0 0 1 UNITEDHEALTHCARE INSURANCE CO. OF THE RIVER VALLEY H1660 2021 Harvard Pilgrim Health Care, Inc. Harvard Pilgrim Health Care, Inc. 0 www.harvardpilgrim.org/medicare Harvard Pilgrim Health Care, Inc. 0 2 HARVARD PILGRIM HEALTH CARE, INC. H1664 2021 Wellcare by Allwell Southwest, Eastern Missouri and St Louis Metro Areas 0 0 1 HOME STATE HEALTH PLAN, INC. H1666 2021 Blue Cross and Blue Shield of Texas State of Texas 0 0 1 HCSC INSURANCE SERVICES COMPANY H1692 2021 Aetna Medicare Aetna Health Inc. 0 http://www.aetnamedicare.com/ 0 1 COVENTRY HEALTH CARE OF WEST VIRGINIA, INC. H1693 2021 Family Health-Center for Older Adults Parts of San Diego County 0 FamilyHealth-Center for Older Adults 0 2 FAMILY HEALTH CENTERS OF SAN DIEGO H1714 2021 Ascension Living HOPE Sedgwick County 0 Via Christi HOPE 0 2 VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC. H1722 2021 Healthfirst Medicare Plan Lower Hudson Valley 0 https://healthfirst.org/medicare-long-term-care-plans Healthfirst Medicare Plan 0 2 HEALTHFIRST HEALTH PLAN, INC. H1723 2021 Wellcare Prime by Absolute Total Care State of South Carolina 0 0 1 ABSOLUTE TOTAL CARE, INC. H1732 2021 Empire BlueCross BlueShield Select counties in New York 0 Empire BlueCross BlueShield HealthPlus 0 1 HEALTHPLUS HP, LLC H1737 2021 Health Alliance Medicare Omaha, Lincoln, NE/ Council Bluffs, Des Moines, Cedar Rapids, IA Metro Areas/North Central IA 0 Health Alliance Medicare 0 1 HEALTH ALLIANCE - MIDWEST, INC. H1748 2021 Sonder Health Plan, Inc. Sonder Health Plan, Inc. 0 www.sonderhealthplans.com 0 1 SONDER HEALTH PLANS, INC. H1774 2021 Ascension Complete Central, Southeast and Southwest Indiana Counties 0 0 1 CENTENE VENTURE COMPANY INDIANA, INC. H1777 2021 ArchCare Advantage NYC, Putnam,Dutchess,Orange, Onondaga, Westchester, Ulster 0 www.archcareadvantage.org ArchCare Advantage 0 2 CATHOLIC SPECIAL NEEDS PLAN, LLC H1787 2021 Great Plains Medicare Advantage South Dakota (partial) 0 www.greatplainsmedicareadvantage.com Great Plains Medicare Advantage 0 1 GOOD SAMARITAN INSURANCE PLAN OF SOUTH DAKOTA, INC H1821 2021 UnitedHealthcare Select Counties in WA 0 0 1 UNITEDHEALTHCARE OF OREGON, INC. H1846 2021 MediGold Central, SW, and NW Ohio and Central, Eastern, North and Western Iowa 0 www.medigold.com MediGold 0 2 MOUNT CARMEL HEALTH INSURANCE COMPANY H1848 2021 Wellcare Select counties in AL 0 0 1 WELLCARE OF ALABAMA, INC. H1862 2021 Wellcare Select counties in VT 0 0 1 WELLCARE HEALTH PLANS OF VERMONT, INC. H1889 2021 UnitedHealthcare Select Counties in FL 0 0 1 UNITEDHEALTHCARE OF FLORIDA, INC. H1894 2021 AMERIGROUP Seattle Metropolitan Area 0 AMERIGROUP 0 1 AMERIGROUP WASHINGTON, INC. H1904 2021 Pace Greater New Orleans PACE GREATER NEW ORLEANS 0 http://www.pacegno.org PACE GREATER NEW ORLEANS 0 2 PACE GREATER NEW ORLEANS H1914 2021 Wellcare Select counties in CT 0 www.WellCare.com/medicare 0 1 WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC. H1924 2021 Lasso Healthcare State of 0 0 1 PORT HOLDINGS, INC. H1944 2021 UnitedHealthcare States of MA, NH, RI and VT, Select Counties in PA 0 0 1 UNITEDHEALTHCARE OF NEW ENGLAND, INC. H1947 2021 Healthy Blue Select counties in Louisiana 0 Healthy Blue 0 1 COMMUNITY CARE HEALTH PLAN OF LOUISIANA, INC. H1951 2021 Humana Lake Charles, Baton Rouge, New Orleans and Alexandria Metro Areas 0 www.humana.com 0 1 HUMANA HEALTH BENEFIT PLAN OF LOUISIANA, INC. H1961 2021 Peoples Health Nationwide, Select US Territories 0 Peoples Health Choices 65 / Peoples Health Choices Plus / Peoples Health Secure Health / Peoples Health Choices Select / Peoples Health Group Medicare 0 1 PEOPLES HEALTH, INC. H1969 2021 Regence BlueShield of Idaho Ada and Canyon Counties 0 www.regence.com/medicare Regence Blue MedAdvantage HMO 0 2 REGENCE BLUESHIELD OF IDAHO H1977 2021 Upper Peninsula Health Plan (UPHP) MI Health Link Upper Peninsula of Michigan 0 http://www.uphp.com/medicare Upper Peninsula Health Plan 0 1 UPPER PENINSULA HEALTH PLAN, LLC H1980 2021 Bluegrass PACE Care Greater Lexington Area 0 Bluegrass Care Navigators 0 2 HOSPICE OF THE BLUEGRASS, INC H1993 2021 Astiva Health Southern California 0 0 1 ASTIVA HEALTH, INC. H1994 2021 SelectHealth Northern, Central, and Southwestern UT - Treasure Valley and Magic Valley ID, Clark County NV 0 selecthealthadvantage.org/rx 0 2 SELECTHEALTH, INC. H1997 2021 Regence BlueShield King/Pierce/Snohomish 0 www.regence.com/medicare Regence BlueAdvantage HMO 0 2 REGENCE BLUESHIELD H2001 2021 UnitedHealthcare Nationwide, All US Territories 0 0 1 SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. H2011 2021 Bright Health State of Tennessee 0 0 1 BRIGHT HEALTH INSURANCE COMPANY OF TENNESSEE H2020 2021 Clear Spring Health Metro Denver, Boulder and Ft. Collins CO - Metro Richmond VA 0 0 1 DELAWARE LIFE INSURANCE COMPANY H2029 2021 Humana Island of Puerto Rico 0 www.humana.com 0 1 HUMANA INSURANCE OF PUERTO RICO, INC. H2032 2021 Baylor Scott & White Health Plan State of Texas (Partial) 0 www.swhp.org SeniorCare Advantage PPO 0 1 Baylor Scott & White Insurance Company H2034 2021 Community Care Eastern Wisconsin 0 www.communitycareinc.org Community Care 0 2 COMMUNITY CARE HEALTH PLAN, INC. H2056 2021 Aetna Medicare Select counties in Idaho and Oregon 0 http://www.aetnamedicare.com/ Aetna Better Health Plan of Michigan Inc. (Oregon) 0 1 AETNA BETTER HEALTH OF MICHIGAN INC. H2064 2021 LIFE Geisinger LIFE Geisinger 0 www.lifegeisinger.org LIFE Geisinger 0 2 GEISINGER COMMUNITY HEALTH SERVICES H2108 2021 Cigna Maryland, DC and Delaware 0 www.cigna.com/medicare Bravo Health Mid-Atlantic , Inc. 0 1 BRAVO HEALTH MID-ATLANTIC, INC. H2109 2021 Hopkins ElderPlus Hopkins ElderPlus 0 http://www.hopkinsbayview.org/hopkinselderplus Hopkins ElderPlus 0 2 THE JOHNS HOPKINS HEALTH SYSTEM CORPORATION H2120 2021 BlueEssential Tennessee 0 bcbstmedicare.com 0 1 SECURITYCARE OF TENNESSEE, INC. H2134 2021 Wellcare by Allwell 15 Counties in New Mexico 0 0 1 WESTERN SKY COMMUNITY CARE, INC. H2161 2021 Upper Peninsula Health Plan Upper Peninsula of Michigan 0 uphp.com/medicare Upper Peninsula Health Plan 0 1 UPPER PENINSULA HEALTH PLAN, LLC H2162 2021 Wellcare Select counties in NH 0 www.WellCare.com/medicare 0 1 WELLCARE OF NEW HAMPSHIRE, INC. H2168 2021 VillageCareMAX VillageCareMAX 0 www.villagecaremax.org 0 2 VILLAGE SENIOR SERVICES CORPORATION H2171 2021 Care N' Care Insurance Company Dallas/Fort Worth Metro Area 0 www.cnchealthplan.com 0 1 CARE N' CARE INSURANCE COMPANY, INC. H2172 2021 Kaiser Permanente DC, Area of Baltimore and Southern Maryland, Area of Northern VA 0 http://members.kaiserpermanente.org/kpweb/drugency/entrypage.doc 0 2 KAISER FDTN HLTH PLAN OF THE MID-ATLANTIC STATES H2174 2021 Wellcare by Trillium Lane County 0 0 1 TRILLIUM COMMUNITY HEALTH PLAN H2185 2021 LifeWorks Advantage Virginia (partial) 0 www.lifeworksadvantage.com LifeWorks Advantage 0 1 LIFEWORKS ADVANTAGE, LLC H2196 2021 UnitedHealthcare State of MS 0 0 1 UNITEDHEALTHCARE OF MISSISSIPPI, INC. H2218 2021 Elder Service Plan of Harbor Health Services, Inc Norfolk, Suffolk, Bristol, Middlesex, Plymouth counties 0 www.elderserviceplan.org HARBOR HEALTH ELDER SERVICE PLAN 0 2 HARBOR HEALTH SERVICES, INC. H2219 2021 Summit ElderCare or Fallon Health All of Worcester & Hampden counties and parts of Essex, Hampshire & Middlesex counties 0 www.summiteldercare.org Summit ElderCare 0 2 FALLON COMMUNITY HEALTH PLAN H2220 2021 Uphams Corner Health Committee, Inc. Uphams Elder Service Plan 0 Upham's Elder Service Plan 0 2 UPHAMS CORNER HEALTH COMMITTEE, INC. H2221 2021 CHA PACE Counties: Middlesex and Suffolk 0 http://www.challiance.org/ElderServicePlan/ESP.aspx CHA PACE fka Elder Service Plan of Cambridge Health Alliance 0 2 CAMBRIDGE PUBLIC HEALTH COMMISSION H2222 2021 Element Care, Inc Element Care, Inc 0 www.elementcare.org Element Care Inc. 0 2 ELEMENT CARE, INC. H2223 2021 Neighborhood PACE Neighborhood PACE 0 Neighborhood PACE 0 2 ELDER SVC PLN/E BOSTON HEALTH CENTER H2224 2021 Senior Whole Health Senior Whole Health 0 www.seniorwholehealth.com Senior Whole Health 0 1 SENIOR WHOLE HEALTH, LLC H2225 2021 Commonwealth Care Alliance, Inc. BRI, ESS, FRA, HMD, HMP, MID, NOR, PLY, SUF, WOR County 0 www.commonwealthcarealliance.org 0 2 COMMONWEALTH CARE ALLIANCE, INC. H2226 2021 UnitedHealthcare Select Counties in MA 0 0 1 UNITEDHEALTHCARE INSURANCE COMPANY H2228 2021 UnitedHealthcare Nationwide, All US Territories 0 0 1 UNITEDHEALTHCARE INSURANCE COMPANY H2230 2021 Blue Cross Blue Shield of Massachusetts Massachusetts except Berkshire, Dukes and Nantucket Counties 0 http://www.bcbsma.com/common/en_US/index.jsp Medicare PPO Blue 0 2 BCBS OF MASSACHUSETTS HMO BLUE, INC. H2235 2021 BayCare Health Plans West Central Florida 0 www.baycarehealthplans.com 0 2 BAYCARE SELECT HEALTH PLANS, INC. H2237 2021 iCare Independent Care Heath Plan 0 www.icarehealthplan.org iCare 0 1 INDEPENDENT CARE HEALTH PLAN, INC. H2241 2021 Golden State LA/OC/RV/SLO/ST/SF/SJ/SD/SB Counties 0 www.goldenstatemhp.com 0 1 GOLDEN STATE MEDICARE HEALTH PLAN H2247 2021 UnitedHealthcare State of MI 0 0 1 UNITEDHEALTHCARE COMMUNITY PLAN, INC. H2256 2021 Tufts Health Plan Most of Massachusetts 0 tuftsmedicarepreferred.org Tufts Health Plan Medicare Preferred 0 2 TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION H2261 2021 Blue Cross Blue Shield of Massachusetts Massachusetts except Berkshire, Dukes and Nantucket Counties 0 http://www.bcbsma.com/common/en_US/index.jsp Medicare HMO Blue 0 2 BCBS OF MASSACHUSETTS HMO BLUE, INC. H2288 2021 Bright Health New York City & Long Island 0 0 1 BRIGHT HEALTH INSURANCE COMPANY OF NEW YORK H2292 2021 UnitedHealthcare Select Counties in NY 0 0 1 OXFORD HEALTH INSURANCE, INC. H2318 2021 PACE Southeast Michigan Michigan- Macomb, Oakland, Wayne Counties 0 www.pacesemi.com PACE SOUTHEAST MICHIGAN 0 2 PACE SOUTHEAST MICHIGAN H2320 2021 Priority Health Medicare Lower Peninsula Michigan Counties 0 www.priorityhealth.com Priority Health 0 2 PRIORITY HEALTH H2322 2021 HAP Senior Plus (PPO) Southeastern Michigan 0 www.hap.org/medicare Alliance Health and Life Insurance, Co 0 1 ALLIANCE HEALTH AND LIFE INSURANCE COMPANY H2334 2021 Clear Spring Health South Carolina Counties 0 0 1 EON HEALTH, INC. (SC) H2354 2021 HAP Senior Plus Mid-Michigan and Southeast Michigan Counties 0 www.hap.org/medicare Health Alliance Plan of Michigan 0 2 HEALTH ALLIANCE PLAN OF MICHIGAN H2368 2021 InnovAge California PACE - Sacramento InnovAge California PACE Sacramento 0 www.myinnovage.com InnovAge California PACE Sacramento 0 1 INNOVAGE CALIFORNIA PACE-SACRAMENTO, LLC H2384 2021 WelbeHealth Sequoia PACE Parts of Fresno, Kings, Madera and Tulare Counties 0 WelbeHealth Sequoia PACE 0 1 SEQUOIA PACE, LLC H2386 2021 Appalachian Agency for Senior Citizens, Inc, VA Counties: Buchanan, Dickenson, Russell, Tazewell 0 www.aasc.org AllCARE for Seniors 0 2 APPALACHIAN AGENCY FOR SENIOR CITIZENS, INC. H2392 2021 Kansas Health Advantage Eastern and Central Kansas 0 https:\\kansashealthadvantage.com Kansas Health Advantage 0 1 KANSAS SUPERIOR SELECT, INC. H2400 2021 Signature Advantage (HMO SNP) Kentucky (partial) 0 www.signatureadvantageplan.com Signature Advantage, LLC 0 1 SIGNATURE ADVANTAGE, LLC H2406 2021 UnitedHealthcare Nationwide, All US Territories 0 0 1 UNITEDHEALTHCARE INSURANCE COMPANY H2416 2021 PrimeWest Health Select counties in northern, west central, and southwestern Minnesota 0 https://primewest.org/home PRIMEWEST HEALTH 0 2 PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE H2417 2021 Itasca Medical Care/IMCare Classic Northern Minnesota Itasca County Area 0 http://www.imcare.org 0 2 ITASCA MEDICAL CARE H2419 2021 South Country Health Alliance Select Counties in Minnesota 0 https://www.mnscha.org 0 2 SOUTH COUNTRY HEALTH ALLIANCE H2422 2021 HealthPartners Minneapolis/St. Paul Metro Area 0 healthpartners.com/medicare HealthPartners 0 2 HEALTHPARTNERS, INC. H2425 2021 Blue Plus 62 Counties within the State of Minnesota 0 www.bluecrossmn.com SecureBlue 0 2 BLUE PLUS H2450 2021 Medica Select counties of IA, KS, MN, ND, NE, WI and All of SD 0 www.medica.com Medica Prime Solution 0 2 MEDICA INSURANCE COMPANY H2456 2021 UCare's MSHO Twin Cities Metropolitan area and Greater Minnesota 0 www.ucare.org UCare Minnesota 0 2 UCARE MINNESOTA H2458 2021 Medica Specific Minnesota counties 0 www.medica.com Medica DUAL Solution 0 2 MEDICA HEALTH PLANS H2459 2021 UCare State of Minnesota 0 www.ucare.org UCare Minnesota 0 2 UCARE MINNESOTA H2461 2021 Blue Cross and Blue Shield of Minnesota State of Minnesota 0 www.bluecrossmn.com Blue Cross and Blue Shield of Minnesota 0 2 BLUE CROSS AND BLUE SHIELD OF MINNESOTA H2462 2021 HealthPartners Select counties in MN, Western WI, ND, and SD 0 healthpartners.com/medicare HealthPartners 0 2 GROUP HEALTH PLAN, INC. (MN) H2463 2021 Humana Multi-state 0 www.humana.com 0 1 HUMANA HEALTH PLAN OF TEXAS, INC. H2486 2021 Humana Salt Lake City Metro Area 0 www.humana.com 0 1 HUMANA MEDICAL PLAN OF UTAH, INC. H2491 2021 Wellcare Select counties in HI and LA 0 www.ohanahealthplan.com/medicare 0 1 WELLCARE HEALTH INSURANCE OF ARIZONA, INC. H2506 2021 Aetna Better Health Premier Plan State of Illinois 0 0 1 Aetna Better Health Premier Plan MMAI Inc. H2531 2021 UnitedHealthcare Community Plan Select Counties in OH 0 0 1 UNITEDHEALTHCARE COMMUNITY PLAN OF OHIO, INC. H2533 2021 Molina Healthcare of South Carolina State of South Carolina 0 www.molinamedicare.com 0 1 MOLINA HEALTHCARE OF SOUTH CAROLINA, INC. H2537 2021 SpiriTrust Lutheran LIFE Franklin, Cumberland, and Perry Counties 0 0 2 SPIRITRUST LUTHERAN LIFE H2563 2021 Optima Medicare Most Counties in State of Virginia 0 Optima Medicare 0 2 OPTIMA HEALTH PLAN H2577 2021 UnitedHealthcare States of SC and VA, Select Counties in CO, NC, PA and TN 0 0 1 CARE IMPROVEMENT PLUS OF TEXAS INSURANCE COMPANY H2582 2021 UnitedHealthcare Select Counties in CO 0 0 1 ROCKY MOUNTAIN HEALTH MAINTENANCE ORGANIZATION INC H2591 2021 Health Alliance Medicare Omaha, Lincoln, NE/ Council Bluffs, Des Moines, Cedar Rapids, IA Metro Areas/North Central IA 0 Health Alliance Medicare 0 1 HEALTH ALLIANCE - MIDWEST, INC. H2593 2021 Amerigroup Select counties in Arizona, Tennessee, and Texas 0 www.myamerigroup.com/medicare AMERIGROUP Community Care 0 1 AMERIGROUP TEXAS, INC. H2610 2021 Essence Healthcare Certain Metro areas in Missouri and Illinois 0 Essence Healthcare 0 1 ESSENCE HEALTHCARE, INC. H2624 2021 CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA Piedmont Triad 0 Healthteamadvantage.com 0 1 CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA H2663 2021 Aetna Medicare Arkansas, Illinois, Kansas, Missouri, & Oklahoma 0 http://www.aetnamedicare.com/ 0 1 COVENTRY HEALTH CARE OF MISSOURI, INC H2678 2021 MoreCare Cook County IL 0 www.mymorecare.com MoreCare 0 1 MoreCare, Inc. H2697 2021 Devoted Health Greater Cleveland Ohio 0 www.Devoted.com Devoted Health 0 1 DEVOTED HEALTH PLAN OF OHIO, INC. H2722 2021 Vantage Health Plan Southern Arkansas 0 www.vantagemedicare.com Vantage Health Plan of Arkansas, Inc. 0 1 VANTAGE HEALTH PLAN OF ARKANSAS, INC. H2765 2021 Summit Health Plan, Inc. Eastern Oregon 0 www.yoursummithealth.com 0 1 SUMMIT HEALTH PLAN, INC. H2775 2021 Wellcare Select Counties in NY and ME 0 http://www.TodaysOptionsPPO.com Todays Options PPO 0 1 AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY H2782 2021 Western Health Advantage Northern California 0 medicare.westernhealth.com 0 2 WESTERN HEALTH ADVANTAGE H2793 2021 Imperial Insurance Companies, Inc AZ, TX, NM, NV, UT 0 Imperial Insurance Companies, Inc 0 1 IMPERIAL INSURANCE COMPANIES INC. H2802 2021 UnitedHealthcare Select Counties in AL, AR, IA, IN, IL, KS, MO, and NE 0 0 1 UNITEDHEALTHCARE OF THE MIDLANDS, INC. H2815 2021 Senior CommUnity Care of Colorado Montrose and Delta counties 0 Senior Community Care of Colorado, Inc. 0 2 VOANS SENIOR COMMUNITY CARE OF COLORADO, INC H2816 2021 Wellcare Select counties in NY and ME 0 www.TodaysOptions.com Today's Options 0 1 AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY H2825 2021 Mary Washington Medicare Advantage Greater Fredericksburg Region 0 Mary Washington Medicare Advantage 0 1 MARY WASHINGTON HEALTH PLAN H2829 2021 Innovation Health Medicare Northern Virginia 0 0 1 INNOVATION HEALTH PLAN, INC. H2835 2021 Thome PACE Jackson, Lenawee, and Hillsdale Counties 0 The Cascade PACE dba Thome PACE 0 2 THE CASCADE PACE, INC. H2836 2021 Anthem Blue Cross and Blue Shield State of Connecticut 0 https://shop.anthem.com/medicare Anthem Blue Cross and Blue Shield 0 1 ANTHEM HEALTH PLANS, INC. H2853 2021 Ascension Complete 10 counties in central Tennessee 0 0 1 CENTENE VENTURE COMPANY TENNESSEE H2879 2021 Molina Healthcare of Wisconsin and Massachusetts Eastern Wisconsin and Northeastern Massachusetts Area 0 www.molinahealthcare.com/medicare 0 1 MOLINA HEALTHCARE OF WISCONSIN, INC. H2882 2021 PACE Central Michigan Central Michigan 0 0 2 PACE CENTRAL MICHIGAN, INC. H2915 2021 Wellcare by Allwell Select Counties in Pennsylvania 0 0 1 PENNSYLVANIA HEALTH & WELLNESS, INC. H2926 2021 PrimeWest Health Select counties in northern, west central, and southwestern Minnesota 0 https://primewest.org/home PrimeWest Health 0 2 PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE H2936 2021 LIFECIRCLES LIFECIRCLES 0 0 2 LIFECIRCLES H2937 2021 Senior LIFE Greensburg, Inc. Greensburg and Westmoreland PACE 0 SeniorLIFE Greensburg 0 1 SENIOR LIFE GREENSBURG, INC. H2941 2021 Sentara PACE Southeastern Virginia 0 SENTARA PACE 0 2 SENTARA LIFE CARE CORPORATION, INC H2944 2021 Humana Humana 0 www.humana.com 0 1 HUMANA INSURANCE COMPANY H2960 2021 Senior Care Plus Carson City, Clark, Nye, Washoe Counties, Nevada 0 SeniorCarePlus.com Senior Care Plus 0 2 HOMETOWN HEALTH PLAN, INC. H2962 2021 Ultimate Health Plans Central Florida 0 www.chooseultimate.com Ultimate Health Plans 0 1 ULTIMATE HEALTH PLANS, INC. H2986 2021 Essence Healthcare Northern California 0 Essence Healthcare 0 1 STANFORD HEALTHCARE ADVANTAGE H2992 2021 Senior LIFE Washington / Uniontown / Greene Senior LIFE Washington, Fayette and Greene County 0 Senior LIFE Washington and Senior LIFE Uniontown 0 1 SENIORLIFE WASHINGTON, INC. H3015 2021 Shared Health Dual Plus Mississippi 0 www.sharedhealthms.com 0 1 SHARED HEALTH MISSISSIPPI, INC. H3047 2021 Wellcare Select counties in LA 0 0 1 WELLCARE HEALTH INSURANCE COMPANY OF LOUISIANA H3060 2021 LIFE Butler County Butler County 0 LIFE Butler County 0 2 VIECARE BUTLER, LLC H3071 2021 Clear Spring Health Chicago Area and Rockford Region of Illinois 0 Community Care Alliance of Illinois 0 1 COMMUNITY CARE ALLIANCE OF ILLINOIS, INC. H3084 2021 International Community Health Services parts of King County, Washington 0 0 2 INTERNATIONAL COMMUNITY HEALTH SERVICES H3113 2021 UnitedHealthcare States of DE, NJ, PA and RI, Select Counties in OR 0 0 1 OXFORD HEALTH PLANS (NJ), INC. H3132 2021 AHF Duval, Broward and Miami-Dade Counties, Florida 0 www.php-fl.org/for-members/drug-benefit PHP 0 2 AHF MCO OF FLORIDA, INC. H3146 2021 Aetna Medicare Select counties in North Carolina 0 http://www.aetnamedicare.com/ 0 1 AETNA BETTER HEALTH INC. (GA) H3152 2021 Aetna Medicare Aetna Health, Inc. (New Jersey) 0 http://www.aetnamedicare.com/ 0 1 AETNA HEALTH INC. (NJ) H3154 2021 Horizon Blue Cross Blue Shield of New Jersey State Of New Jersey 0 https://medicare.horizonblue.com/ Horizon Blue Cross Blue Shield of New Jersey 0 1 HORIZON INSURANCE COMPANY H3170 2021 Blue Cross and Blue Shield of Nebraska Omaha/Lincoln Metro Area and surrounding area 0 0 2 SAPPHIRE EDGE, INC. H3192 2021 Aetna Medicare Select counties in Illinois, Indiana and Michigan 0 http://www.aetnamedicare.com/ Aetna Health Inc. 0 1 AETNA HEALTH OF MICHIGAN INC. H3204 2021 Presbyterian Health Plan Greater Albuquerque, NM Area 0 www.phs.org/Medicare Presbyterian Senior Care (HMO/HMO POS) / Presbyterian Dual Plus (HMO SNP) 0 1 PRESBYTERIAN HEALTH PLAN H3206 2021 Presbyterian Insurance Company, Inc. New Mexico 0 www.phs.org/Medicare Presbyterian MediCare PPO 0 1 PRESBYTERIAN INSURANCE COMPANY, INC. H3213 2021 CareSource CareSource Kentucky Co. 0 http:\\caresource.com CareSource 0 2 CARESOURCE KENTUCKY CO. H3219 2021 Allina Health Aetna Medicare Minneapolis / St. Paul 0 www.tbd.com 0 1 ALLINA HEALTH AND AETNA INSURANCE COMPANY H3237 2021 Health Net Cal MediConnect Medicare Medicaid Plan Los Angeles and San Diego Counties 0 www.healthnet.com/calmediconnect 0 1 HEALTH NET COMMUNITY SOLUTIONS, INC. H3239 2021 Aetna Medicare Select counties in Alabama and select parishes in Louisiana 0 http://www.aetnamedicare.com/ 0 1 AETNA BETTER HEALTH, INC. (LA) H3240 2021 Amerigroup Community Care Eastern and Central New Jersey 0 www.myamerigroup.com/medicare AMERIGROUP Community Care 0 1 AMERIGROUP NEW JERSEY, INC. H3251 2021 Blue Cross and Blue Shield of New Mexico Greater New Mexico Area 0 0 2 HEALTH CARE SERVICE CORPORATION H3256 2021 UnitedHealthcare Select Counties in GA 0 0 1 UNITEDHEALTHCARE OF GEORGIA, INC. H3259 2021 BlueCare Plus Tennessee State of Tennessee 0 bluecareplus.bcbst.com BlueCare Plus Tennessee 0 1 VOLUNTEER STATE HEALTH PLAN H3276 2021 ConnectiCare State of Connecticut 0 ConnectiCare 0 1 CONNECTICARE INSURANCE COMPANY, INC. H3281 2021 Bright Health State of Florida 0 0 1 BRIGHT HEALTH INSURANCE COMPANY OF FLORIDA H3288 2021 Aetna Medicare Select counties in Georgia, Oklahoma and Texas 0 http://www.aetnamedicare.com/ 0 1 AETNA HEALTH AND LIFE INSURANCE COMPANY H3291 2021 PruittHealth Premier Georgia (partial) 0 www.pruitthealthpremier.com PruittHealth Premier 0 1 PRUITTHEALTH PREMIER, INC. H3293 2021 MMM of Florida, Inc. Florida - Broward, Miami-Dade, Palm Beach 0 http://mmm-fl.com 0 1 MMM OF FLORIDA, INC. H3305 2021 MVP HEALTH CARE Rochester and Western New York 0 www.mvphealthcare.com Preferred Gold 0 2 MVP HEALTH PLAN, INC. H3307 2021 UnitedHealthcare Select Counties in NY 0 0 1 OXFORD HEALTH PLANS (NY), INC. H3312 2021 Aetna Medicare Aetna Health, Inc. (New York) 0 http://www.aetnamedicare.com/ 0 1 AETNA HEALTH INC. (NY) H3321 2021 Independent Living Srvcs Of Central Ny Pace CNY 0 PACE CNY 0 2 LORETTO INDEPENDENT LIVING SERVICES, INC. H3322 2021 Eddy SeniorCare Schenectady, Albany, Rensselaer Counties 0 www.eddyseniorcare.com Eddy SeniorCare 0 2 SENIOR CARE CONNECTION, INC. H3329 2021 CenterLight TeamCare NYC, Nassau, Suffolk (partial) and Westchester Counties 0 CenterLight Healthcare, Inc. 0 2 CENTERLIGHT HEALTHCARE, INC. H3330 2021 EmblemHealth Medicare HMO New York City, Long Island, Hudson Valley, Capital Region 0 0 2 HEALTH INSURANCE PLAN OF GREATER NEW YORK H3331 2021 ElderONE an Affiliate of Rochester Regional Health Monroe, Wayne, Ontario Counties 0 ElderONE, an Affiliate of Rochester Regional Health 0 2 INDEPENDENT LIVING FOR SENIORS, INC. H3335 2021 Excellus Health Plan, Inc Excellus BlueCross BlueShield 0 https://www.excellusbcbs.com 0 2 EXCELLUS HEALTH PLAN, INC. H3342 2021 Empire BlueCross BlueShield Select Counties in New York 0 https://shop.empireblue.com/medicare Empire BlueCross BlueShield 0 1 EMPIRE HEALTHCHOICE ASSURANCE, INC. H3344 2021 Independent Health Western New York 0 www.independenthealth.com INDEPENDENT HEALTH BENEFITS CORPORATION 0 1 INDEPENDENT HEALTH BENEFITS CORPORATION H3347 2021 Elderplan New York City Area, Nassau, Monroe, Suffolk, Westchester, Rockland, Putnam,Dutchess,Orange, Ontario, 0 www.elderplan.org 0 2 ELDERPLAN, INC. H3351 2021 Excellus Health Plan, Inc Western New York, Rochester Region 0 https://www.excellusbcbs.com 0 2 EXCELLUS HEALTH PLAN, INC. H3359 2021 Healthfirst Medicare Plan New York City, Long Island, and Lower Hudson Valley 0 https://healthfirst.org/medicare-long-term-care-plans Healthfirst Medicare Plan 0 2 HEALTHFIRST HEALTH PLAN, INC. H3362 2021 Independent Health Western New York 0 www.independenthealth.com Independent Health 0 2 INDEPENDENT HEALTH ASSOCIATION, INC. H3379 2021 UnitedHealthcare Select Counties in NY 0 0 1 UNITEDHEALTHCARE OF NEW YORK, INC. H3384 2021 Highmark Blue Cross Blue Shield of Western New York and Highmark Blue Shield of Northeastern New York Western New York and Northeastern New York 0 www.bcbsnwy.com BlueCross BlueShield of Western New York / BlueShield of Northeastern New York 0 2 Highmark Western and Northeastern New York Inc. H3387 2021 UnitedHealthcare Select Counties in NY 0 0 1 UNITEDHEALTHCARE OF NEW YORK, INC. H3388 2021 CDPHP Medicare Advantage Capital Region of New York 0 CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC. 0 2 CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC. H3404 2021 Blue Cross and Blue Shield of North Carolina Select counties in North Carolina 0 https://www.bluecrossnc.com/medicare-members Blue Medicare PPO 0 2 BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA H3407 2021 El Paso Health Advantage Dual SNP El Paso and Hudspeth Counties 0 ephmedicare.com El Paso Health 0 2 EL PASO FIRST HEALTH PLANS, INC. H3416 2021 HealthPartners UnityPoint Health Certain counties across Iowa and into west-central Illinois 0 healthpartnersunitypointhealth.com HealthPartners UnityPoint Health, Inc. 0 1 HEALTHPARTNERS UNITYPOINT HEALTH, INC. H3418 2021 UnitedHealthcare Select Counties in NY 0 0 1 UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK H3419 2021 Perennial Advantage Colorado (partial) 0 Perennial Advantage 0 1 PERENNIAL ADVANTAGE OF COLORADO, INC. H3430 2021 Suncoast PACE, Inc. Suncoast PACE, Inc - Pinellas County area 0 http://www.suncoastpace.org/ Suncoast PACE, Inc 0 2 SUNCOAST PACE, INC. H3442 2021 UnitedHealthcare States of CT, MA, NH, RI and VT 0 0 1 UNITEDHEALTHCARE INSURANCE COMPANY OF ILLINOIS H3447 2021 Anthem HealthKeepers Select counties in Indiana, Missouri, and Virginia 0 https://shop.anthem.com/medicare Anthem HealthKeepers 0 1 HEALTHKEEPERS, INC. H3449 2021 Blue Cross and Blue Shield of North Carolina Select counties in North Carolina 0 https://www.bluecrossnc.com/medicare-members Blue Medicare HMO 0 2 BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA H3464 2021 UnitedHealthcare Select Counties in AR 0 0 1 UNITEDHEALTHCARE OF ARKANSAS, INC. H3467 2021 ProCare Advantage Texas Partial 0 Procare Advantage 0 1 PROCARE ADVANTAGE, LLC H3471 2021 Health Alliance Northwest North Central Washington 0 www.healthalliancemedicare.org Health Allance Medicare 0 1 HEALTH ALLIANCE NORTHWEST HEALTH PLAN H3473 2021 InnovAge Virginia PACE - Blue Ridge InnovAge Virginia PACE - Blue Ridge (serving Charlottesville area) 0 http://myinnovage.com InnovAge Virginia PACE - Blue Ridge 0 1 INNOVAGE VIRGINIA PACE-CHARLOTTESVILLE, LLC H3493 2021 Trinity Health LIFE New Jersey Camden County New Jersey 0 Trinity Health LIFE New Jersey 0 2 LIFE AT LOURDES, INC. H3499 2021 Wellcare by Allwell State of Indiana 0 0 1 COORDINATED CARE CORPORATION H3517 2021 Redwood Coast PACE Redwood Coast PACE 0 www.humsenior.org Humboldt Senior Resource Center/Redwood Coast PACE 0 2 HUMBOLDT SENIOR RESOURCE CENTER, INC. H3522 2021 Reid Health PACE Center Indiana counties of: Wayne, Fayette, Henry, Randolph, Union, Franklin 0 Reid Health PACE Center 0 2 REID HOSPITAL & HEALTH CARE SERVICES, INC. H3528 2021 ConnectiCare State of Connecticut 0 ConnectiCare 0 1 CONNECTICARE, INC. H3533 2021 Humana Select Counties in New York 0 www.humana.com 0 1 HUMANA HEALTH COMPANY OF NEW YORK, INC. H3536 2021 Anthem Blue Cross and Blue Shield State of New Hampshire 0 https://shop.anthem.com/medicare Anthem Blue Cross and Blue Shield 0 1 MATTHEW THORNTON HEALTH PLAN, INC. H3554 2021 Arkansas Blue Medicare State of Arkansas 0 http://www.arkansasbluecross.com/medicare Arkansas Blue Medicare Plus 0 1 USABLE PPO INSURANCE COMPANY H3557 2021 Blue Cross & Blue Shield of Rhode Island State of Rhode Island 0 www.bcbsri.com 0 2 BLUE CROSS & BLUE SHIELD OF RHODE ISLAND H3561 2021 Wellcare by Health Net Select counties in California 0 0 1 HEALTH NET COMMUNITY SOLUTIONS, INC. H3563 2021 Gary and Mary West PACE North San Diego County 0 Gary and Mary West PACE 0 2 GARY AND MARY WEST SENIOR SERVICES, INC. H3572 2021 AHF Fulton County, Georgia 0 www.php-ga.org/for-members/drug-benefit PHP 0 2 AHF MCO OF GEORGIA, INC. H3597 2021 Aetna Medicare Aetna Health Inc. (Maine) 0 http://www.aetnamedicare.com/ 0 1 AETNA HEALTH INC. (ME) H3613 2021 McGregor PACE McGregor PACE Cuyahoga County 0 MCGREGOR PACE 0 2 MCGREGOR PACE H3632 2021 Medica Select counties in Iowa and Nebraska 0 medica.com 0 2 MEDICA COMMUNITY HEALTH PLAN H3653 2021 Paramount Elite Medicare Plans Paramount Elite Medicare Plans 0 http://www.paramounthealthcare.com/medicareplans Paramount Elite 0 1 PARAMOUNT CARE, INC. H3655 2021 Anthem Blue Cross and Blue Shield Ohio and Indiana 0 https://shop.anthem.com/medicare Anthem Blue Cross and Blue Shield 0 1 COMMUNITY INSURANCE COMPANY H3660 2021 SummaCare Medicare Advantage Plans Northern Ohio 0 www.summacare.com/medicare SummaCare 0 2 SUMMACARE INC. H3664 2021 PrimeTime Health Plan Northeast Ohio Area 0 www.primetimehealthplan.com PrimeTime Health Plan 0 2 AULTCARE HEALTH INSURING CORPORATION H3668 2021 MediGold Central, SE, SW, and NW Ohio and Central, Eastern, North and Western Iowa 0 www.medigold.com MediGold 0 2 MOUNT CARMEL HEALTH PLAN, INC. H3672 2021 The Health Plan Ohio / West Virginia 0 www.healthplan.org The Health Plan 0 2 THE HEALTH PLAN OF WEST VIRGINIA, INC. H3706 2021 GlobalHealth OKLAHOMA (PARTIAL) 0 www.globalhealth.com GlobalHealth 0 1 GLOBALHEALTH, INC. H3708 2021 American Health Advantage of Oklahoma Central and East Oklahoma 0 ok.amhealthplans.com American Health Advantage of Oklahoma 0 1 OKLAHOMA SUPERIOR SELECT, INC. H3725 2021 Bright Health State of Illinois 0 0 1 BRIGHT HEALTH INSURANCE COMPANY OF ILLINOIS H3727 2021 Communicare Advantage none 0 www.CommuniCare-advantage.com CommuniCare Advantage 0 1 OH CHS SNP INC. H3748 2021 Aetna Medicare Select counties in Washington 0 http://www.aetnamedicare.com/ 0 1 AETNA BETTER HEALTH OF WASHINGTON, INC. H3749 2021 UnitedHealthcare Select Counties in OK 0 0 1 UNITEDHEALTHCARE OF OKLAHOMA, INC. H3755 2021 CommunityCare Senior Health Plan (HMO) Tulsa Metro Area 0 https://www.ccokadvantage.com/2021/shp/pharmacy-and-Rx-info.asp CommunityCare Choice, Inc. 0 2 COMMUNITYCARE GOVERNMENT PROGRAMS, INC. H3777 2021 Experience Health, Inc. Experience Health, Inc. 0 Experience Health, Inc. 0 2 EXPERIENCE HEALTH, INC. H3794 2021 UnitedHealthcare Select Counties in WI 0 0 1 CARE IMPROVEMENT PLUS WISCONSIN INSURANCE COMPANY H3800 2021 Provider Partners Health Plans Urban Illinois 0 pphealthplan.com Provider Partners Illinois Advantage Plan 0 1 PROVIDER PARTNERS HEALTH PLAN OF ILLINOIS H3805 2021 UnitedHealthcare Select Counties in OR, and WA 0 0 1 UNITEDHEALTHCARE OF OREGON, INC. H3809 2021 Providence ElderPlace Portland Multnomah County Oregon 0 Providence ElderPlace 0 2 PROVIDENCE HEALTH & SERVICES - OREGON H3810 2021 AllCare Advantage Counties:Josephine, Douglas*, Jackson 0 www.allcarehealth.com/medicare/allcare-advantage-2019 AllCare HEALTH PLAN 0 1 ALLCARE HEALTH PLAN, INC. H3811 2021 Samaritan Advantage Health Plan Linn, Benton, and Lincoln counties 0 https://medicare.samhealthplans.org Samaritan Advantage Health Plan 0 2 SAMARITAN HEALTH PLANS, INC. H3813 2021 Moda Health Plan, Inc. State of Oregon 0 www.modahealth.com/medicare MODA HEALTH PLAN, INC. 0 1 MODA HEALTH PLAN, INC. H3814 2021 ATRIO Health Plans ATRIO Health Plans 0 www.atriohp.com ATRIO Health Plans 0 1 ATRIO HEALTH PLANS H3815 2021 Alignment Health Plan parts of southern CA and parts of northern CA 0 www.alignmenthealthplan.com Alignment Health Plan 0 1 ALIGNMENT HEALTH PLAN H3817 2021 Regence BlueCross BlueShield of Oregon Select Counties in Oregon/Clark Co, WA 0 www.regence.com/medicare Regence MedAdvantage (PPO) 0 2 REGENCE BLUECROSS BLUESHIELD OF OREGON H3822 2021 Blue Cross and Blue Shield of IL, NM State of Illinois, State of New Mexico 0 0 2 HEALTH CARE SERVICE CORPORATION H3832 2021 HMSA Akamai Advantage State of Hawaii 0 www.hmsa.com/advantage HMSA Akamai Advantage 0 2 HAWAII MEDICAL SERVICE ASSOCIATION H3864 2021 PacificSource Medicare Select counties in Idaho, Montana, Oregon and Washington 0 http://Medicare.PacificSource.com 0 2 PACIFICSOURCE COMMUNITY HEALTH PLANS H3890 2021 Johns Hopkins HealthCare Counties: AA BL BC CR CV HW FR MG SS WH WC WR 0 www.hopkinsmedicare.com 0 1 HOPKINS HEALTH ADVANTAGE, INC. H3907 2021 UPMC for Life Western Pennsylvania 0 https://www.upmchealthplan.com/medicare/documents-and-forms/ UPMC Health Plan 0 1 UPMC HEALTH PLAN, INC. H3908 2021 Mercy LIFE - West Philadelphia Counties: PHL (partial), DelCo (partial) 0 www.trinityhealthpace.org Mercy LIFE - West Philadelphia 0 2 TRINITY HEALTH LIFE PENNSYLVANIA, INC. H3909 2021 Independence Blue Cross Southeastern Pennsylvania Area 0 http://www.ibxmedicare.com 0 2 QCC INSURANCE COMPANY H3916 2021 Highmark Inc. Northern, Western, and Central Pennsylvania 0 Highmark Senior Health Company 0 2 HIGHMARK SENIOR HEALTH COMPANY H3917 2021 Community LIFE Allegheny, Bedford, Fulton, Somerset, Washington, and Westmoreland Counties (Partial) 0 www.commlife.org COMMUNITY LIFE 0 2 PITTSBURGH CARE PARTNERSHIP, INC. H3918 2021 LIFE Pittsburgh NW Allegheny County, Pittsburgh PA 0 LIFEPittsburgh.org LIFE Pittsburgh 0 2 LIVING INDEPENDENCE FOR THE ELDERLY PITTSBURGH INC H3919 2021 Mercy LIFE Counties: PHL (partial), DelCo, Montco (partial) 0 Mercy LIFE 0 2 Mercy LIFE H3923 2021 Capital Blue Cross Central Pennsylvania 0 https://www.capitalbluemedicare.com 0 1 CAPITAL ADVANTAGE INSURANCE COMPANY H3924 2021 Geisinger Gold Central & Northeast Pennsylvania 0 www.geisingergold.com Geisinger Gold 0 1 GEISINGER INDEMNITY INSURANCE COMPANY H3925 2021 Senior LIFE Johnstown, Inc. Cambria Somerset PACE Senior LIFE Johnstown 0 Senior LIFE Johnstown 0 1 PENNSYLVANIA PACE, INC. H3928 2021 Aetna Medicare Parishes within the Metro Areas of New Orleans, Baton Rouge, Shreveport, Bayou, N. Shore and Monroe. 0 http://www.aetnamedicare.com/ Coventry Health Care of Lousiana, Inc. 0 1 AETNA HEALTH INC. (LA) H3931 2021 Aetna Medicare Aetna Health, Inc. (Pennsylvania) 0 http://www.aetnamedicare.com/ 0 1 AETNA HEALTH INC. (PA) H3942 2021 Elderhaus PACE Wilmington, North Carolina Metro Area 0 www.elderhaus.com Elderhaus PACE 0 2 ELDERHAUS INC. H3949 2021 Cigna Select Pennsylvania Counties 0 www.cigna.com/medicare Bravo Health Pennsylvania, Inc. 0 1 BRAVO HEALTH PENNSYLVANIA, INC. H3952 2021 Independence Blue Cross Southeastern Pennsylvania Area 0 http://www.ibxmedicare.com 0 1 KEYSTONE HEALTH PLAN EAST, INC. H3954 2021 Geisinger Gold Central & Northeast Pennsylvania 0 www.geisingergold.com Geisinger Gold 0 2 GEISINGER HEALTH PLAN H3957 2021 Highmark Inc. Western Pennsylvania 0 Highmark Choice Company 0 2 HIGHMARK CHOICE COMPANY H3959 2021 Aetna Medicare Aetna Health Inc. Western and Central Pennsylvania 0 http://www.aetnamedicare.com/ 0 1 AETNA HEALTH INC. (PA) H3962 2021 Capital Blue Cross Central Pennsylvania 0 https://www.capitalbluemedicare.com Keystone Health Plan Central, Inc. 0 1 KEYSTONE HEALTH PLAN CENTRAL, INC. H3975 2021 Wellcare Select counties in KY 0 0 1 WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC H3977 2021 InnovAge Kentucky PACE, LLC Louisville, Kentucky area 0 www.myinnovage.com InnovAge Kentucky PACE, LLC 0 1 INNOVAGE KENTUCKY PACE, LLC H3979 2021 Blue Cross and Blue Shield of Oklahoma State of Oklahoma 0 0 1 GHS HEALTH MAINTENANCE ORGANIZATION, INC. H3991 2021 Cherry Blossom PACE Cherry Blossom PACE 0 www.cherryblossompace.com Cherry Blossom PACE 0 1 CONCERTOHEALTH OF NORTHERN VIRGINIA, LLC H4003 2021 Medicare y Mucho Más Puerto Rico 0 www.mmm-pr.com 0 1 MMM HEALTHCARE, LLC H4004 2021 PMC Medicare Choice Puerto Rico 0 www.mmmpr.com 0 1 MMM HEALTHCARE, LLC H4005 2021 Triple-S Advantage Island of Puerto Rico 0 www.sssadvantage.com TRIPLE-S Advantage, INC. 0 1 TRIPLE S ADVANTAGE, INC. H4007 2021 Humana Island of Puerto Rico 0 www.humana.com 0 1 HUMANA HEALTH PLANS OF PUERTO RICO, INC. H4036 2021 Anthem Blue Cross and Blue Shield Wisconsin - Select Counties 0 https://shop.anthem.com/medicare Anthem Blue Cross and Blue Shield 0 1 ANTHEM INSURANCE COMPANIES, INC. H4053 2021 Prisma Health SeniorCare PACE-Upstate Anderson, Greenville and Pickens Counties 0 0 2 PRISMA HEALTH-UPSTATE H4074 2021 Mercy LIFE of Alabama Mercy LIFE of Alabama 0 0 2 MERCY LIFE OF ALABAMA H4091 2021 Simpra Advantage State of Alabama 0 www.simpra.com Simpra Advantage 0 1 SIMPRA ADVANTAGE, INC. H4093 2021 Provider Partners Health Plans Southeastern and Western Pennsylvania 0 www.pphealthplanpa.com PPHP-PA 0 1 PROVIDER PARTNERS HEALTH PLAN OF PENNSYLVANIA, INC H4094 2021 UnitedHealthcare Select Counties in MD 0 0 1 OPTIMUM CHOICE, INC. H4105 2021 PACE Organization Of Rhode Island PACE Organization of Rhode Island 0 www.pace-ri.org PACE Organization of Rhode Island 0 2 PACE ORGANIZATION OF RHODE ISLAND H4118 2021 Huron Valley PACE Southeast Michigan 0 Huron Valley PACE 0 2 THE WASHTENAW PACE H4140 2021 Doctors HealthCare Plans, Inc. Miami-Dade County Area 0 www.doctorshcp.com Filed for a Federal Trademark and waiting on final approval 0 1 DOCTORS HEALTHCARE PLANS, INC. H4141 2021 Humana Atlanta Metro Area 0 www.humana.com 0 1 HUMANA EMPLOYERS HEALTH PLAN OF GEORGIA, INC. H4142 2021 Cherokee Elder Care Cherokee and surrounding counties 0 eldercare.cherokee.org Cherokee Elder Care 0 2 CHEROKEE NATION COMPREHENSIVE CARE AGENCY H4152 2021 Blue Cross & Blue Shield of Rhode Island State of Rhode Island 0 bcbsri.com 0 2 BLUE CROSS & BLUE SHIELD OF RHODE ISLAND H4172 2021 NHC Advantage Missouri (partial) (Tennessee (partial) 0 www.NHCAdvantage-MO.com NHC Advantage 0 1 NHC ADVANTAGE, LLC H4185 2021 Neighborhood Healthcare PACE Neighborhood Healthcare PACE 0 Neighborhood Healthcare PACE 0 2 NEIGHBORHOOD HEALTHCARE H4198 2021 Integris Health Partners+ (HMO) Select Oklahoma Counties 0 https://www.ccokadvantage.com/2021/AMP/pharmacy-and-Rx-info.asp CommunityCare Choice, Inc. 0 2 COMMUNITYCARE GOVERNMENT PROGRAMS, INC. H4203 2021 Prisma Health SeniorCare PACE Columbia Metro Area 0 Prisma Health SeniorCare PACE 0 2 PRISMA HEALTH-MIDLANDS H4213 2021 Arkansas Blue Medicare State of Arkansas 0 http://www.arkansasbluecross.com ARKANSAS BLUE CROSS AND BLUE SHIELD 0 2 USABLE MUTUAL INSURANCE COMPANY H4227 2021 VISTA Health Plan Inc. Eastern Pennsylvania 0 http://keystonefirstvipchoice.com/ 0 1 VISTA HEALTH PLAN, INC. H4232 2021 American Health Advantage of Utah North/Central Utah 0 American Health Advantage of Utah 0 1 AMERICAN HEALTH PLAN OF UT, INC. H4235 2021 Senior Total Life Care Senior Total Life Care 0 www.seniorTLC.org Senior Total Life Care 0 2 SENIOR TOTAL LIFE CARE, INC. H4256 2021 PACE North Grand Traverse Area 0 0 2 PACE NORTH, INC. H4279 2021 UPMC for Life Complete Care Western Pennsylvania 0 http://www.upmchealthplan.com/snp/learn/plan-benefits/prescription-drug-coverage/ 0 2 UPMC FOR YOU, INC H4304 2021 Advantage U Wasatch Front 0 AdvantageUMedicare.com 0 2 UNIVERSITY OF UTAH HEALTH INSURANCE PLANS H4305 2021 Total Life Healthcare Total Life Healthcare of Northeast Arkansas 0 n/a Total Life Healthcare 0 2 TOTAL LIFE HEALTHCARE H4326 2021 PACE@Home Catawba Valley 0 www.pace-at-home.org PACE@Home 0 2 PACE @ HOME, INC. H4343 2021 Ascension Complete Birmingham & Mobile Alabama 0 0 1 CENTENE VENTURE COMPANY ALABAMA HEALTH PLAN, INC. H4346 2021 Anthem Blue Cross and Blue Shield Parts of Colorado and Nevada 0 https://shop.anthem.com/medicare Anthem Blue Cross and Blue Shield 0 1 HMO COLORADO, INC. H4388 2021 Security Health Plan of Wisconsin, Inc. Wisconsin statewide 0 Secure Saver 0 2 SECURITY HEALTH PLAN OF WISCONSIN, INC. H4393 2021 ArchCare Senior Life New York, Bronx, Richmond and Westchester Counties 0 www.archcareseniorlife.org ArchCare Senior Life 0 2 CATHOLIC MANAGED LONG TERM CARE, INC. H4402 2021 Alexian Brothers Community Services Hamilton County Area 0 None ALEXIAN BROTHERS COMMUNITY SERVICES 0 2 ALEXIAN BROTHERS COMMUNITY SERVICES H4407 2021 Cigna Mississippi 0 www.cigna.com/medicare 0 1 HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. H4461 2021 Humana Memphis, Nashville, and East Tennessee Metro Areas 0 www.humana.com Humana Insurance Company 0 1 CARITEN HEALTH PLAN INC. H4490 2021 American Health Advantage of Missouri Missouri (partial) 0 mo.amhealthplans.com Missouri Medicare Select, LLC 0 1 MISSOURI MEDICARE SELECT, LLC H4497 2021 Medical Mutual of Ohio Medical Mutual of Ohio 0 0 2 MEDICAL MUTUAL OF OHIO H4506 2021 Wellcare Select counties in TX 0 www.TexanPlus.com SelectCare of Texas 0 1 SELECTCARE OF TEXAS, INC. H4513 2021 Cigna Alabama, Tennessee, Texas and Other Select Regions 0 www.cigna.com/medicare 0 1 HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. H4514 2021 UnitedHealthcare Select Counties in TX 0 0 1 UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C. H4517 2021 The Basics at Jan Werner Potter, TX and Randall, TX Counties 0 THE BASICS AT JAN WERNER 0 2 AMARILLO MULTISVC CTR FR THE AGING INC H4518 2021 Bienvivir Senior Health Services Southwest Texas 0 www.bienvivir.org Bienvivir Senior Health Services 0 2 BIENVIVIR SENIOR HEALTH SERVICES H4523 2021 Aetna Medicare Aetna Health Inc. (Texas) 0 http://www.aetnamedicare.com/ 0 1 AETNA HEALTH INC. (TX) H4527 2021 UnitedHealthcare Select Counties in TX 0 0 1 PHYSICIANS HEALTH CHOICE OF TEXAS, LLC H4544 2021 Peoples Health State of LA 0 0 1 PEOPLES HEALTH, INC. H4556 2021 Consolidated Assoc Of Railroad Employees Hc Consolidated Assoc Of Railroad Employees Hc 0 0 2 CONSOLIDATED ASSOC OF RAILROAD EMPLOYEES HC H4590 2021 UnitedHealthcare Select Counties in TX 0 0 1 UNITEDHEALTHCARE BENEFITS OF TEXAS, INC. H4604 2021 UnitedHealthcare Select Counties in ID, and UT 0 0 1 UNITEDHEALTHCARE OF UTAH, INC. H4605 2021 Regence BlueCross BlueShield of Utah Davis/Salt Lake/Utah/Weber 0 www.regence.com/medicare Regence MedAdvantage (PPO) 0 2 REGENCE BLUECROSS BLUESHIELD OF UTAH H4623 2021 Humana Multi-state 0 www.humana.com 0 1 HUMANA REGIONAL HEALTH PLAN, INC. H4624 2021 Zing Health Select Counties in Illinois, Indiana and Michigan 0 myzinghealth.com Zing Health 0 1 ZING HEALTH OF MICHIGAN, INC. H4652 2021 Union Pacific Railroad Employes Health Systems Union Pacific Railroad Employes Health Systems 0 Iron Road Healthcare 0 2 UNION PACIFIC RAILROAD EMPLOYES HEALTH SYSTEMS H4675 2021 Braven Health Eastern New Jersey 0 Braven Health 0 1 HEALTHIER NEW JERSEY INSURANCE COMPANY H4676 2021 Troy Medicare Charlotte Region 0 www.performrx.com Troy Medicare 0 1 TROY HEALTH, INC. H4699 2021 Wellcare Select counties in RI 0 0 1 WELLCARE HEALTH PLANS OF RHODE ISLAND, INC. H4709 2021 Bright Health State of Florida 0 0 1 BRIGHT HEALTH INSURANCE COMPANY OF FLORIDA H4711 2021 Aetna Medicare Select counties in Colorado and Nevada 0 http://www.aetnamedicare.com/ 0 1 COVENTRY HEALTH CARE OF NEBRASKA, INC. H4714 2021 PACE of the Southern Piedmont PACE of the Southern Piedmont 0 https://pacesp.com/ PACE of the Southern Piedmont, Inc. 0 2 PACE OF THE SOUTHERN PIEDMONT, INC. H4754 2021 PacificSource Medicare Select counties in Oregon and Idaho 0 http://Medicare.PacificSource.com 0 2 PACIFICSOURCE COMMUNITY HEALTH PLANS H4829 2021 UnitedHealthcare Select Counties in CA 0 0 1 UHC OF CALIFORNIA H4835 2021 Aetna Medicare Select counties in Arizona 0 http://www.aetnamedicare.com/ 0 1 AETNA BETTER HEALTH OF OKLAHOMA INC. H4847 2021 Wellcare SELECT COUNTIES IN SC 0 www.WellCare.com/medicare 0 1 WELLCARE OF SOUTH CAROLINA, INC. H4853 2021 Bright Health Phoenix Metro Area 0 0 1 BRIGHT HEALTH COMPANY OF ARIZONA H4868 2021 Wellcare Select Counties in New York 0 http://www.TodaysOptionsNY.com Today's Options 0 1 WELLCARE OF NEW YORK, INC. H4875 2021 Priority Health Medicare Select Michigan Lower Peninsula Counties 0 www.priorityhealth.com Priority Health 0 2 PRIORITY HEALTH H4882 2021 HealthPartners Select Counties in Metro and Central Minnesota and NE Wisconsin 0 healthpartners.com/medicare HealthPartners 0 2 HEALTHPARTNERS, INC. H4906 2021 C and O Employees' Hospital Association C and O Employees' Hospital Association 0 0 2 C AND O EMPLOYEES' HOSPITAL ASSOCIATION H4909 2021 Anthem Blue Cross and Blue Shield Select Counties in Virginia and Missouri 0 https://shop.anthem.com/medicare Anthem Blue Cross Blue Shield 0 1 ANTHEM INSURANCE COMPANIES, INC. H4922 2021 AgeWell New York AgeWell New York Metro Area 0 http://www.agewellnewyork.com/ AgeWell New York 0 1 AGEWELL NEW YORK, LLC H4931 2021 Banner Medicare Advantage Dual AZ: Cochise, Gila, Graham, Greenlee, La Paz, Maricopa, Pima, Pinal, Santa Cruz, Yuma 0 https://www.banneruca.com/plan-information/pharmacy-and-part-d-coverage Banner - University Care Advantage 0 2 BANNER - UNIVERSITY CARE ADVANTAGE H4937 2021 Blue Shield of California Alameda County 0 www.blueshieldca.com/medicare BLUE SHIELD OF CALIFORNIA 0 2 CALIFORNIA PHYSICIANS' SERVICE H4961 2021 Alignment Health Plan Parts of Northern California 0 www.alignmenthealthplan.com Alignment Health Plan 0 1 ALIGNMENT HEALTH PLAN H4982 2021 Aetna Medicare Select counties in California 0 http://www.aetnamedicare.com/ 0 1 AETNA BETTER HEALTH OF CALIFORNIA INC. H4999 2021 LIFE Northwestern Pennsylvania Northwestern Pennsylvania 0 www.carekinesis.com LIFE Northwestern Pennsylvania 0 2 THE LUTHERAN HOME FOR THE AGED H5007 2021 Providence Health System Greater Metropolitan Seattle 0 Providence ElderPlace - Seattle 0 2 PROVIDENCE HEALTH SYSTEM H5008 2021 UnitedHealthcare Select Counties in LA, MS, and WA 0 0 1 UNITEDHEALTHCARE INSURANCE COMPANY H5009 2021 Regence BlueShield Select Counties in Washington 0 www.regence.com/medicare Regence MedAdvantage (PPO) 0 2 REGENCE BLUESHIELD H5010 2021 Asuris Northwest Health Spokane County 0 www.asuris.com/medicare Asuris TruAdvantage (PPO) 0 2 ASURIS NORTHWEST HEALTH H5015 2021 Texas Independence Health Plan Select Texas counties 0 www.txindependencehealthplan.com Texas Independence Health Plan 0 1 TEXAS INDEPENDENCE HEALTH PLAN, INC. H5037 2021 Mountain Empire PACE Lee, Scott, Wise Counties and Norton City 0 www.meoc.org Mountain Empire PACE 0 2 MOUNTAIN EMPIRE OLDER CITIZENS, INC. H5042 2021 CDPHP Medicare Advantage Capital Region of New York 0 CDPHP Universal Benefits, Inc. 0 2 CDPHP UNIVERSAL BENEFITS, INC. H5050 2021 Kaiser Permanente Greater Puget Sound Area & Spokane County 0 www.kp.org/wa/medicare Kaiser Foundation Health Plan of Washington 0 2 KAISER FOUNDATION HEALTH PLAN OF WASHINGTON H5085 2021 Community PACE at Home, Inc, Community PACE at Home, Inc, 0 Community PACE at Home, Inc. 0 1 COMMUNITY PACE AT HOME, INC H5087 2021 Wellcare Select counties in CA 0 www.wellcare.com/medicare WellCare 0 1 WELLCARE OF CALIFORNIA, INC. H5106 2021 Highmark Inc. State of West Virginia 0 Highmark Senior Solutions Company 0 2 HIGHMARK SENIOR SOLUTIONS COMPANY H5117 2021 Wellcare by Allwell Select counties in LA 0 0 1 LOUISIANA HEALTHCARE CONNECTIONS, INC. H5124 2021 Franciscan Senior Health & Wellness Franciscan Alliance, Inc. 0 Franciscan Senior Health & Wellness 0 2 FRANCISCAN ACO, INC. H5126 2021 Oscar Oscar 0 0 1 OSCAR INSURANCE COMPANY H5140 2021 Blue Cross Blue Shield of Arizona Central and Southern Arizona 0 0 2 BLUE CROSS AND BLUE SHIELD ARIZONA, INC. H5141 2021 Clover Health Select Counties in NJ, TX, GA, PA, MS, TN, AZ, AR, SC 0 www.caremark.com Clover Health 0 1 CLOVER INSURANCE COMPANY H5167 2021 Rocky Mountain PACE Colorado Springs Metro Area 0 www.rmhcare.org Rocky Mountain PACE 0 2 ROCKY MOUNTAIN HEALTH CARE SERVICES H5172 2021 Community Health Group Community Health Group 0 http://www.chgsd.com/ COMMUNITY HEALTH GROUP 0 2 COMMUNITY HEALTH GROUP H5178 2021 Humana South Carolina counties 0 www.humana.com 0 1 HUMANA HEALTH PLAN, INC. H5190 2021 Wellcare by Allwell Select Counties in Florida 0 0 1 SUNSHINE STATE HEALTH PLAN, INC. H5199 2021 Wellcare Select Counties in FL 0 www.WellCare.com/medicare N/A 0 1 WELLCARE HEALTH INSURANCE OF ARIZONA, INC. H5209 2021 My Choice Wisconsin Health Plan Southern, Central and Northeastern Wisconsin 0 www.mychoicewi.org My Choice Wisconsin Health Plan Inc. 0 2 My Choice Wisconsin Health Plan, Inc. H5211 2021 Security Health Plan of Wisconsin, Inc. Central, South Central, Northern, Western and Eastern Wisconsin 0 www.securityhealth.org/medicareadvantage Security Health Plan 0 2 SECURITY HEALTH PLAN OF WISCONSIN, INC. H5212 2021 Community Care Milwaukee County, Waukesha County, Racine County, Kenosha County 0 www.CommunityCareInc.org Community Care 0 2 COMMUNITY CARE, INC. H5213 2021 InnovAge New Mexico PACE Albuquerque Metro Area 0 www.myinnovage.com InnovAge New Mexico PACE 0 1 TOTAL COMMUNITY CARE, L.L.C. H5215 2021 Network Health Medicare Advantage Plans East Central Wisconsin 0 www.NetworkHealthMedicare.com Network Health Medicare Advantage Plans 0 1 NETWORK HEALTH INSURANCE CORPORATION H5216 2021 Humana Multi-state 0 www.humana.com 0 1 HUMANA INSURANCE COMPANY H5232 2021 Paramount Elite Medicare Plans Paramount Elite Medicare Plans 0 http://www.paramounthealthcare.com/medicareplans Paramount Elite 0 1 PARAMOUNT CARE, INC. H5253 2021 UnitedHealthcare Select Counties in AZ, IA, IL, KY, NC, OH, TN, VA, and WI 0 0 1 UNITEDHEALTHCARE OF WISCONSIN, INC. H5256 2021 Medical Associates Clinic Health Plan of Wisconsin Southwest Wisconsin 0 0 2 MEDICAL ASSOCIATES CLINIC HEALTH PLAN H5262 2021 Quartz Medicare Advantage Southern Wisconsin, Northcentral Illinois, and Northeastern Iowa 0 0 2 QUARTZ HEALTH PLAN CORPORATION H5264 2021 Dean Health Plan, Inc. South Central Wisconsin 0 Dean Health Plan, Inc. 0 1 DEAN HEALTH PLAN, INC. H5273 2021 CarePartners of Connecticut Connecticut 0 www.carepartnersct.com 0 2 CAREPARTNERS OF CONNECTICUT, INC. H5280 2021 Molina Healthcare of Ohio Ohio 0 www.molinamedicare.com 0 1 MOLINA HEALTHCARE OF OHIO, INC. H5294 2021 Wellcare by Allwell Select counties in TX 0 0 1 SUPERIOR HEALTH PLAN, INC. H5296 2021 Alignment Health Plan Piedmont Region 0 www.alignmenthealthplan.com Alignment Health Plan 0 1 ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC. H5302 2021 Aetna Medicare Georgia 0 http://www.aetnamedicare.com/ Coventry Health Care of Georgia, Inc. 0 1 AETNA HEALTH INC. (GA) H5322 2021 UnitedHealthcare Select Counties in FL, GA, KS, NJ, OH, OK, TX, and VA 0 0 1 CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO. H5325 2021 Aetna Medicare Select counties in Kansas and Missouri 0 http://www.aetnamedicare.com/ 0 1 COVENTRY HEALTH CARE OF KANSAS, INC. H5337 2021 Aetna Better Health of Ohio (HMO SNP) Akron Metro Area, Youngstown Metro Area, Toledo Metro Area 0 Aetna Better Health of Ohio 0 1 AETNA HEALTH OF OHIO INC. (OH) H5355 2021 IEHP DualChoice Riverside and San Bernardino Counties 0 www.iehp.org IEHP DualChoice 0 2 IEHP HEALTH ACCESS H5373 2021 ProMedica Medicare Plan ProMedica Medicare Plan - Northeast Indiana 0 http://promedicahealthplan.com/medicare ProMedica Medicare Plans 0 1 PARAMOUNT CARE OF INDIANA, INC. H5374 2021 Longevity Health Plan North Carolina(Partial) 0 Longevity Health Plan 0 1 LONGEVITY HEALTH PLAN OF NORTH CAROLINA, INC. H5377 2021 Humana Multi-state 0 www.humana.com 0 1 HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC. H5386 2021 Sharp Health Plan San Diego County 0 http://www.sharpmedicareadvantage.com Sharp Health Plan 0 2 SHARP HEALTH PLAN H5398 2021 Ascension Complete Butler, Harvey and Sedgwick Counties 0 0 1 CENTENE VENTURE COMPANY KANSAS H5403 2021 On Lok PACE San Francisco Bay Area 0 www.onlok.org/PACE On Lok PACE 0 2 ON LOK SENIOR HEALTH SERVICES H5405 2021 Center For Elders' Independence Alameda and Contra Costa Counties 0 www.cei.elders.org Center for Elders' Independence 0 2 CENTER FOR ELDERS INDEPENDENCE H5406 2021 Sutter SeniorCare PACE Sacramento, California 0 sutterseniorcare.org dba Sutter SeniorCare PACE 0 2 SUTTER VALLEY HOSPITALS H5410 2021 Cigna Partial Miami-Dade Area, South Florida and Santa Rosa and Escambia counties 0 www.cigna.com/medicare 0 1 HEALTHSPRING OF FLORIDA, INC. H5420 2021 UnitedHealthcare Select Counties in FL 0 0 1 MEDICA HEALTHCARE PLANS, INC. H5422 2021 Anthem Blue Cross and Blue Shield GA Selected Counties 0 https://shop.bcbsga.com/medicare Anthem Blue Cross and Blue Shield 0 1 BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA H5425 2021 SCAN Health Plan SCAN - California 0 https://www.scanhealthplan.com/ SCAN Health Plan 0 2 SCAN HEALTH PLAN H5427 2021 Freedom Health, Inc. Select Counties in Florida 0 www.freedomhealth.com Freedom Health 0 1 FREEDOM HEALTH, INC. H5430 2021 WellCare Select Counties in Arizona 0 https://www.care1st.com/az/medicare ONECare 0 1 ONECARE BY CARE1ST HEALTH PLAN OF ARIZONA INC. H5431 2021 HealthSun Health Plans, Inc. County Of Miami-Dade, Broward County and Palm Beach County 0 www.healthsun.com HealthSun Health Plans, Inc. 0 1 HEALTHSUN HEALTH PLANS, INC. H5433 2021 OneCare Orange County, California 0 https://www.caloptima.org/en/ForMembers/OneCare/Pharmacy.aspx CalOptima 0 2 ORANGE COUNTY HEALTH AUTHORITY H5434 2021 Florida Blue Central area (11 counties), South area (5 counties) and NW area (2 counties) 0 www.floridablue.com/medicare Florida Blue 0 1 BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC. H5435 2021 UnitedHealthcare Select Counties in KS, KY, MO, MT, NE, OK, and WY 0 0 1 UNITEDHEALTHCARE INSURANCE COMPANY H5439 2021 Wellcare by Health Net Northern and Southern Oregon 0 0 1 HEALTH NET LIFE INSURANCE COMPANY H5447 2021 Community First Health Plans Bexar County Service Delivery Area 0 https://communityfirstmedicare.com/ COMMUNITY FIRST HEALTH PLANS 0 2 COMMUNITY FIRST HEALTH PLANS, INC. H5454 2021 Clear Spring Health Metro Chicago, Rockford and Metro St. Louis 0 0 1 CLEAR SPRING HEALTH OF ILLINOIS, INC. H5471 2021 Simply Healthcare Plans, Inc. Simply Healthcare Plans, Inc 0 http://www.simplyhealthcareplans.com Simply Healthcare Plans, Inc. 0 1 SIMPLY HEALTHCARE PLANS, INC. H5475 2021 Wellcare Select Counties In MI/OH 0 0 1 MERIDIAN HEALTH PLAN OF MICHIGAN, INC. H5493 2021 Saint Francis LIFE County of New Castle, Delaware 0 Saint Francis LIFE 0 2 LIFE AT ST. FRANCIS HEALTHCARE, INC. H5496 2021 Imperial Health Plan of California, Inc. Northern, Central and Southern California 0 www.imperialhealthplan.com 0 1 IMPERIAL HEALTH PLAN OF CALIFORNIA, INC. H5521 2021 Aetna Medicare Aetna Health Inc. (Suburban Philadelphia) 0 http://www.aetnamedicare.com/ 0 1 AETNA LIFE INSURANCE COMPANY H5522 2021 Aetna Medicare Aetna Health Inc. Western and Central Pennsylvania 0 http://www.aetnamedicare.com/ 0 1 HEALTHASSURANCE PENNSYLVANIA, INC. H5525 2021 Humana Multi-state 0 www.humana.com/ 0 1 HUMANA BENEFIT PLAN OF ILLINOIS, INC. H5526 2021 Highmark Blue Cross Blue Shield of Western New York and Highmark Blue Shield of Northeastern New York Western and Northeastern New York 0 www.bcbswny.com BlueCross BlueShield of Western New York/BlueShield of Northeastern New York 0 2 Highmark Western and Northeastern New York Inc. H5528 2021 EmblemHealth Medicare PPO State of New York 0 www.emblemhealth.com 0 2 EmblemHealth, Inc. H5533 2021 UPMC for Life Western Pennsylvania 0 https://www.upmchealthplan.com/medicare/documents-and-forms/ UPMC Health Plan 0 1 UPMC HEALTH NETWORK, INC. H5549 2021 VNSNY CHOICE Medicare NYC Metro Area, Nassau, Suffolk, Westchester 0 http://www.vnsnychoice.org/ 0 2 VNS CHOICE H5576 2021 Vantage Health Plan Louisiana 0 www.VantageMedicare.com 0 1 VANTAGE HEALTH PLAN, INC. H5577 2021 MCS Classicare Puerto Rico 0 www.mcsclassicare.com MCS Classicare 0 1 MCS ADVANTAGE, INC. H5580 2021 Mercy Care Advantage Mercy Care Advantage 0 www.MercyCareAdvantage.com/members/mca/part-d Mercy Care Advantage 0 2 MERCY CARE H5587 2021 Health Choice Arizona Arizona (Apache, Coconino, Gila, Maricopa, Mohave, Navajo, Pinal, Yavapai Counties) 0 https://www.healthchoicepathway.com/members/prescription-drug-information/ Health Choice Pathway 0 1 HEALTH CHOICE ARIZONA, INC. H5590 2021 Wellcare by Allwell Central and Southern Arizona 0 Arizona Complete Health Medicare Advantage 0 1 Bridgeway Health Solutions of Arizona, Inc. H5591 2021 Martin's Point Generations Advantage Martin's Point Generations Advantage 0 Martin's Point Generations Advantage 0 2 MARTIN'S POINT GENERATIONS ADVANTAGE, INC. H5593 2021 Aetna Medicare Select counties in Iowa 0 http://www.aetnamedicare.com/ 0 1 AETNA HEALTH OF IOWA INC. H5594 2021 Optimum HealthCare, Inc. Select Counties in Florida 0 www.youroptimumhealthcare.com OPTIMUM HEALTHCARE, INC. 0 1 OPTIMUM HEALTHCARE, INC. H5599 2021 Wellcare by Fidelis Care New York Counties 0 0 2 NEW YORK QUALITY HEALTHCARE CORPORATION H5608 2021 Denver Health Medical Plan, Inc. Denver Metro Area 0 http://denverhealthmedicalplan.org 0 2 DENVER HEALTH MEDICAL PLAN, INC. H5610 2021 Care Resources West Michigan 0 www.careresources.org Care Resources 0 2 CARE RESOURCES H5613 2021 MVP HEALTH CARE Vermont 0 SmartFund 0 2 MVP HEALTH PLAN, INC. H5619 2021 Humana Multi-state 0 www.humana.com 0 1 ARCADIAN HEALTH PLAN, INC. H5628 2021 Molina Healthcare of Utah & Idaho Idaho and Utah Counties 0 www.molinahealthcare.com/medicare 0 1 MOLINA HEALTHCARE OF UTAH, INC. H5629 2021 St. Paul's PACE San Diego Metro Area, San Diego East County, San Diego South County 0 St. Paul's PACE 0 2 COMMUNITY ELDERCARE OF SAN DIEGO H5644 2021 Network Health Medicare Advantage Plans Southeast Wisconsin 0 www.NetworkHealthMedicare.com Network Health Medicare Advantage Plans 0 1 NETWORK HEALTH INSURANCE CORPORATION H5649 2021 Central Health Medicare Plan Los Angeles, Orange, Riverside, San Bernardino, & Ventura Counties 0 http://www.centralhealthplan.com Central Health Medicare Plan 0 1 CENTRAL HEALTH PLAN OF CALIFORNIA, INC. H5652 2021 UnitedHealthcare Select Counties in CO, FL, KS, MD, MA, MI, NJ, NC, PA, TX, and VA 0 0 1 SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. H5656 2021 WellCare Select counties in TX 0 www.Universal-American-Medicare.com TexasFirst Health Plans 0 1 SELECTCARE HEALTH PLANS, INC. H5703 2021 South Country Health Alliance Select Counties in Minnesota 0 https://www.mnscha.org 0 2 SOUTH COUNTRY HEALTH ALLIANCE H5742 2021 FirstCare Advantage FirstCare Advantage 0 www.firstcare.com FirstCare Health Plans 0 1 SHA, L.L.C H5746 2021 Amerigroup Community Care of New Mexico Central New Mexico 0 www.myamerigroup.com/medicare AMERIGROUP Community Care of New Mexico, Inc. 0 1 AMERIGROUP COMMUNITY CARE OF NEW MEXICO, INC. H5774 2021 Triple S Advantage Commonwealth of Puerto Rico 0 www.sssadvantage.com Triple-S Advantage, Inc. 0 1 TRIPLE S ADVANTAGE, INC. H5779 2021 Wellcare Select Counties In Illinois 0 0 1 MERIDIAN HEALTH PLAN OF ILLINOIS, INC. H5793 2021 Aetna Medicare CT, MA, NH and RI 0 http://www.aetnamedicare.com/ Aetna Health of Connecticut 0 1 AETNA HEALTH INC. (CT) H5810 2021 Molina Healthcare of California Southern California 0 www.molinahealthcare.com/medicare 0 1 MOLINA HEALTHCARE OF CALIFORNIA H5822 2021 Midland Care PACE Counties: DG, JA, JF, OS, PT, SN, WB, LY, MS, NM.AT.DP.BR. 0 Midland Care PACE 0 2 MIDLAND CARE CONNECTION H5823 2021 Molina Healthcare of Washington, Inc. Western and Eastern Washington 0 www.molinahealthcare.com/medicare 0 1 MOLINA HEALTHCARE OF WASHINGTON, INC. H5826 2021 Community Health Plan of WA Medicare Advantage Eastern and Western Washington State 0 www.medicare.chpw.org Community Health Plan of WA Medicare Advantage 0 2 COMMUNITY HEALTH PLAN OF WASHINGTON H5828 2021 AMERIGROUP Community Care Select counties in Tennessee 0 AMERIGROUP Community Care 0 1 AMERIGROUP TENNESSEE, INC. H5841 2021 Bright Health State of Colorado 0 0 1 BRIGHT HEALTH INSURANCE COMPANY H5843 2021 Banner Medicare Advantage Prime South-Central South-Western Arizona 0 https://www.bannerhealth.com/ Banner Medicare Advantage Prime 0 2 BANNER HEALTH PLAN, INC. H5852 2021 AHF Los Angeles County, California 0 www.php-ca.org/for-members/drug-benefit/ PHP 0 2 AIDS HEALTHCARE FOUNDATION H5854 2021 Anthem Blue Cross and Blue Shield State of Connecticut 0 https://shop.anthem.com/medicare Anthem Blue Cross and Blue Shield 0 1 ANTHEM HEALTH PLANS, INC. H5859 2021 CareOregon Advantage Portland Metro Area, Southern Oregon, Northwest 0 www.careoregonadvantage.org CareOregon Advantage 0 2 HEALTH PLAN OF CAREOREGON, INC. H5883 2021 Blue Care Network BCN Advantage 0 www.bcbsm.com/medicare 0 2 BLUE CARE NETWORK OF MICHIGAN H5902 2021 Senior LIFE Altoona, Inc. Ebensburg Blair Indiana LIFE Center 0 Senior LIFE Altoona 0 1 SENIOR LIFE ALTOONA, INC. H5926 2021 Molina Healthcare of Michigan West and East Michigan 0 www.molinahealthcare.com/medicare 0 1 MOLINA HEALTHCARE OF MICHIGAN, INC. H5928 2021 Blue Shield of California Southern California and portions of Central and Northern California 0 www.blueshieldca.com/medicare Blue Shield of California Promise Health Plan 0 2 California Physicians' Service H5932 2021 Gateway Health Medicare Assured Pennsylvania Counties 0 www.MedicareAssured.com 0 2 GATEWAY HEALTH PLAN, INC. H5934 2021 Hope PACE Lee, Charlotte and Collier Counties, Florida 0 hopehcs.org/pace Hope PACE 0 2 HOPE HOSPICE AND COMMUNITY SERVICES, INC. H5937 2021 UCare State of Minnesota 0 www.ucare.org 0 2 UCARE MINNESOTA H5938 2021 Capital Health Plan Capital Health Plan 0 www.capitalhealth.com/Medicare 0 2 CAPITAL HEALTH PLAN H5943 2021 VillageHealth VillageHealth - Southern California 0 http://www.villagehealthca.com VillageHealth 0 2 SCAN HEALTH PLAN H5945 2021 Prominence Health Plan Prominence Health Plan 0 www.prominencemedicare.com Prominence Health Plan 0 1 PROMINENCE HEALTHFIRST H5959 2021 Blue Cross Blue Shield of Minnesota State of Minnesota 0 www.bluecrossmn.com Blue Cross Blue Shield of Minnesota 0 2 BLUE CROSS AND BLUE SHIELD OF MINNESOTA H5965 2021 Wellcare Select counties in WA 0 www.WellCare.com/medicare 0 1 WELLCARE HEALTH INSURANCE COMPANY OF WASHINGTON H5969 2021 AlohaCare State of Hawaii 0 http://www.AlohaCare.org AlohaCare 0 2 ALOHACARE H5970 2021 Humana Select New York Metro Areas 0 www.humana.com 0 1 HUMANA INSURANCE COMPANY OF NEW YORK H5978 2021 Senior LIFE Lehigh Valley, Inc. Lehigh and Northampton counties in Pennsylvania 0 Senior LIFE 0 1 SENIOR LIFE LEHIGH VALLEY, INC. H5989 2021 Healthfirst Medicare Plan New York City and Long Island 0 https://healthfirst.org/medicare-long-term-care-plans Healthfirst Medicare Plan 0 2 HEALTHFIRST HEALTH PLAN, INC. H5991 2021 EmblemHealth Medicare HMO New York City, Long Island, Hudson Valley, Capital Region 0 emblemhealth.com/medicare 0 2 HEALTH INSURANCE PLAN OF GREATER NEW YORK H5992 2021 Senior Whole Health of New York Senior Whole Health of New York 0 www.seniorwholehealth.com Senior Whole Health of New York 0 1 SENIOR WHOLE HEALTH OF NEW YORK, INC. H5995 2021 ATRIO Health Plans Marion and Polk Counties 0 www.atriohp.com ATRIO Health Plans 0 1 ATRIO HEALTH PLANS H6053 2021 Santa Fe Employes Hospital Assn. - Coast Lines State of California 0 SANTA FE EMPLOYES HOSPITAL ASSN - COAST LINES 0 2 SANTE FE EMPLOYEES HOSPITAL ASSOCIATION H6059 2021 PACE OF THE TRIAD PACE OF THE TRIAD 0 https://www.pacetriad.org/ PACE OF THE TRIAD 0 2 PACE OF GUILFORD AND ROCKINGHAM COUNTIES, INC. H6067 2021 CareFirst BlueCross BlueShield Medicare Advantage CareFirst BlueCross BlueShield Medicare Advantage Maryland 0 CareFirst BlueCross BlueShield Medicare Advantage 0 1 CAREFIRST ADVANTAGE, INC. H6078 2021 Region 6 Rx Corp PPO National 0 0 1 Group Retiree Health Solutions, Inc. H6079 2021 InnovAge California PACE San Bernardino Metro Area 0 www.totallongtermcare.org InnovAge California PACE - Inland Empire 0 1 TOTAL LONGTERM CARE, INC. H6080 2021 Meridian Greater Chicago Area 0 0 1 MERIDIAN HEALTH PLAN OF ILLINOIS, INC. H6121 2021 Bright Health State of Illinois 0 0 1 BRIGHT HEALTH INSURANCE COMPANY OF ILLINOIS H6140 2021 Wabash Mem. Hospital Wabash Mem. Hospital 0 0 2 WABASH MEMORIAL HOSPITAL ASSOCIATION H6142 2021 Union Health Service, Inc. Union Health Service, Inc 0 0 2 UNION HEALTH SERVICES, INC. H6154 2021 Medica Greater Minneapolis/St. Paul Metro Area 0 www.medica.com Medica Advantage Solution 0 2 MEDICA HEALTH PLANS H6158 2021 Arkansas Blue Medicare State of Arkansas 0 http://www.arkansasbluecross.com/medicare Arkansas Blue Medicare 0 1 USABLE HMO, INC. H6188 2021 LIFE Armstrong LIFE Armstrong 0 LIFE Armstrong County 0 2 VIECARE ARMSTRONG, LLC H6202 2021 NextBlue of North Dakota Central-East North Dakota 0 0 1 NEXTBLUE OF NORTH DAKOTA INSURANCE COMPANY H6229 2021 Anthem Blue Cross Cal MediConnect Los Angeles and Santa Clara County 0 0 1 BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC. H6231 2021 PACE Baton Rouge PACE - East and West Baton Rouge Parishes 0 www.carekinesis.com PACE Baton Rouge 0 2 FRANCISCAN PACE, INC. H6237 2021 Regence BlueCross BlueShield of Oregon Portland Metro Area and Clark County, WA 0 www.regence.com/medicare Regence BlueAdvantage HMO 0 2 REGENCE BLUECROSS BLUESHIELD OF OREGON H6306 2021 FirstMedicare Direct FirstCarolinaCare Insurance Company - North Carolina 0 www.firstmedicare.com FirstMedicare Direct 0 2 FIRSTCAROLINACARE INSURANCE COMPANY H6316 2021 Healthy Blue Select counties in MO 0 https://shop.anthem.com/medicare 0 1 MISSOURI CARE, INCORPORATED H6328 2021 Care N' Care Insurance Company Dallas/Fort Worth Metro Area 0 www.cnchealthplan.com 0 1 CARE N' CARE INSURANCE COMPANY, INC. H6334 2021 NY Hotel Trades Council and Hotel Assn. of NYC NY Hotel Trades Council and Hotel Assn. of NYC 0 0 2 NY HOTEL TRADES COUNCIL & HOTEL ASSOCIATION OF NYC H6342 2021 Complete Health with PACE Central Arkansas 0 Complete Health with PACE 0 2 COMPLETE HEALTH WITH PACE H6345 2021 PruittHealth Premier North Carolina (partial) and South Carolina (partial) 0 www.pruitthealthpremier.com PruittHealth Premier 0 1 PRUITTHEALTH PREMIER NORTH CAROLINA, LLC H6348 2021 Wellcare by Allwell Central, Northern, Southwest & Northwest Indiana 0 0 1 COORDINATED CARE CORPORATION H6351 2021 Liberty Medicare Advantage North Carolina (partial) 0 www.libertyadvantageplan.com Liberty Advantage 0 1 LIBERTY ADVANTAGE, LLC H6371 2021 Lutheran Senior LIFE Lutheran Senior LIFE Hudson County 0 Lutheran Senior LIFE at Jersey City 0 2 LUTHERAN SENIOR HEALTHCARE, INC. H6379 2021 Clear Spring Health Metro Denver, Boulder, Ft. Collins, Colorado Springs and Pueblo 0 0 1 CLEAR SPRING HEALTH (CO), INC. H6396 2021 CareSource CareSource 0 http:\\caresource.com Caresource 0 2 CARESOURCE OHIO, INC. H6399 2021 Aetna Better Health of New Jersey Select Counties in New Jersey 0 https://www.aetnabetterhealth.com/new-jersey-hmosnp/pharmacy-prescription-drug-benefits.html Aetna Better Health of New Jersey 0 1 AETNA BETTER HEALTH INC. (NJ) H6425 2021 PACE of the Ozarks Northwest Arkansas 0 PACE of the Ozarks 0 2 WASHINGTON REGIONAL MEDICORP H6439 2021 WellCare Select counties in Arizona 0 www.WellCare.com/medicare 0 1 WELLCARE HEALTH PLANS OF ARIZONA, INC. H6446 2021 Wellcare by Allwell Select counties in Northern and Southern Nevada 0 0 1 SILVERSUMMIT HEALTHPLAN, INC. H6453 2021 Blue Cross and Blue Shield of Louisiana HMO State of Louisiana 0 HMO Louisiana, Inc. 0 1 HMO LOUISIANA, INC. H6502 2021 Blue Medicare Advantage Kansas City Area 0 0 1 MISSOURI VALLEY LIFE AND HEALTH INSURANCE COMPANY H6526 2021 UnitedHealthcare Select Counties in NM 0 0 1 UNITEDHEALTHCARE OF NEW MEXICO, INC. H6528 2021 UnitedHealthcare Select Counties in AL, AR, GA, and WY 0 0 1 CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO. H6529 2021 MyTruAdvantage Select counties in Indiana 0 Caremark.com SIHO Insurance Services 0 1 SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC. H6550 2021 Wellcare by Allwell Kansas City & Wichita Metro Areas 0 0 1 SUNFLOWER STATE HEALTH PLAN, INC. H6551 2021 LIFE St. Mary LIFE St. Mary 0 LIFE St. Mary 0 2 LIFE ST. MARY H6594 2021 Wellcare Select counties in VT 0 0 1 WELLCARE HEALTH PLANS OF VERMONT, INC. H6595 2021 UnitedHealthcare Select Counties in KY 0 0 1 UNITEDHEALTHCARE OF KENTUCKY, LTD. H6596 2021 Fallon Health Weinberg-PACE Erie County 0 fallonweinberg.com Fallon Health Weinberg 0 2 FALLON HEALTH WEINBERG, INC. H6622 2021 Humana Multi-state 0 www.humana.com 0 1 HUMANA WI HEALTH ORGANIZATION INSURANCE CORP H6652 2021 American Health Advantage of Florida Central/East Florida 0 American Health Advantage of Florida 0 1 AMERICAN HEALTH PLAN OF FL, INC. H6672 2021 Clear Spring Health Georgia Counties 0 0 1 EON HEALTH, INC. (GA) H6706 2021 UnitedHealthcare Select Counties in CO 0 0 1 UNITEDHEALTHCARE OF COLORADO, INC. H6713 2021 Wellcare Select counties in IL 0 0 1 WELLCARE OF ILLINOIS, INC. H6723 2021 Medical Mutual of Ohio Medical Mutual of Ohio 0 0 2 MEDICAL MUTUAL OF OHIO H6743 2021 ATRIO Health Plans ATRIO Health Plans 0 www.atriohp.com ATRIO Health Plans 0 1 ATRIO HEALTH PLANS H6750 2021 Harvard Pilgrim Health Care of New England, Inc. Harvard Pilgrim Health Care of New England, Inc. 0 www.harvardpilgrim.org/medicare HARVARD PILGRIM HEALTH CARE OF NEW ENGLAND, INC. 0 2 HARVARD PILGRIM HEALTH CARE OF NEW ENGLAND, INC. H6776 2021 RiverSpring Health Plans Bronx, Kings, Nassau, New York, Queens, Richmond, Westchester 0 RiverSpringhealthplans.org RiverSpring Health Plans 0 2 ELDERSERVE HEALTH, INC. H6787 2021 Senior Community Care of Michigan Lansing and surrounding 3 County area 0 Senior Community Care of Michigan 0 2 VOANS SENIOR COMMUNITY CARE OF MICHIGAN, INC. H6815 2021 Wellcare by Health Net Northern and Southern Oregon 0 0 1 HEALTH NET HEALTH PLAN OF OREGON H6830 2021 Ascension Complete Butler, Harvey and Sedgwick Counties 0 0 1 CENTENE VENTURE COMPANY KANSAS H6832 2021 Align Senior Care Michigan Partial 0 Align Senior Care 0 1 ALIGN SENIOR CARE MI, LLC H6846 2021 CarePartners PACE CarePartners PACE 0 www.Missionhealth.org CarePartners PACE 0 1 CAREPARTNERS REHABILITATION HOSPITAL, LLLP H6870 2021 Superior HealthPlan Bexar, Dallas, Hidalgo Counties 0 0 1 SUPERIOR HEALTH PLAN, INC. H6874 2021 Aspirus Health Plan Wisconsin Area 0 www.ucare.org Aspirus Health Plan 0 1 ASPIRUS HEALTH PLAN, INC. H6887 2021 Inspira Health Network LIFE Inspira Health Network LIFE 0 Inspira Health Network LIFE, Inc, 0 2 INSPIRA HEALTH NETWORK LIFE, INC. H6891 2021 American Health Advantage of Texas Texas 0 American Health Advantage of Texas 0 1 AMERICAN HEALTH PLAN OF TX, INC. H6898 2021 Vermont Blue Advantage State of Vermont 0 0 1 VERMONT BLUE ADVANTAGE, INC. H6910 2021 MediGold Greater Boise Area 0 www.medigold.com MediGold 0 2 MOUNT CARMEL HEALTH PLAN OF IDAHO, INC. H6936 2021 Blue Cross Blue Shield of Arizona Central and Southern Arizona 0 0 2 BLUE CROSS & BLUE SHIELD OF ARIZONA, INC. H6941 2021 LIFE PACE, INC. TULSA COUNTY 0 LIFE PACE 0 2 LIFE PACE H6959 2021 KeyCare Advantage Maryland (partial) 0 KeyCare Advantage 0 1 ISNP VENTURES, LLC H6975 2021 Wellcare Select counties in AL 0 www.WellCare.com/medicare 0 1 WELLCARE OF ALABAMA, INC. H6988 2021 Centers Plan for Healthy Living NYC Metro Area, Rockland, Erie, Niagara Counties 0 www.centersplan.com CPHL 0 1 CENTERS PLAN FOR HEALTHY LIVING, LLC H7003 2021 Immanuel Pathways Omaha Omaha Metro and Surrounding Areas 0 Immanuel Pathways-PACE NE 0 2 PACE NEBRASKA H7006 2021 ATRIO Health Plans Oregon, Nevada, Tennessee, and Louisiana 0 www.atriohp.com ATRIO Health Plans 0 1 ATRIO HEALTH PLANS H7020 2021 Cigna South Carolina 0 www.cigna.com/medicare 0 1 CIGNA HEALTHCARE OF SOUTH CAROLINA, INC. H7063 2021 Blue Cross and Blue Shield of Kansas Northeast and South Central Kansas 0 https://www.primetherapeutics.com 0 2 BLUECROSS BLUESHIELD KANSAS SOLUTIONS, INC. H7076 2021 CareSource CareSource Indiana, Inc. 0 http:\\caresource.com CareSource 0 2 CARESOURCE INDIANA, INC. H7114 2021 Valir PACE Foundation Oklahoma City Metro Valir PACE Foundation 0 www.valir.com 0 2 VALIR PACE FOUNDATION H7115 2021 Memorial Hermann Health Plan Greater Houston, including Fort Bend, Harris and Montgomery Counties 0 https://healthplan.memorialhermann.org/medicare-advantage 0 1 MEMORIAL HERMANN HEALTH PLAN H7119 2021 Provider Partners Health Plans Central, Southern and Northeastern Ohio 0 pphealthplan.com PPHP-OH 0 1 PROVIDER PARTNERS HEALTH PLAN OF OHIO H7123 2021 UPMC for Life Complete Care Eastern Pennsylvania 0 http://www.upmchealthplan.com/snp/learn/plan-benefits/prescription-drug-coverage/ 0 2 UPMC HEALTH COVERAGE, INC. H7149 2021 Aetna Medicare Partial State of Nebraska 0 http://www.aetnamedicare.com/ 0 1 AETNA HEALTH INC. (PA) H7163 2021 Vantage Health Plan Western Mississippi 0 www.VantageMedicare.com Vantage Health Plan of Mississippi, Inc. 0 1 VANTAGE HEALTH PLAN OF MISSISSIPPI, INC. H7165 2021 Blue Cross Blue Shield of South Carolina State of South Carolina 0 www.scbluesmedadvantage.com/marx20 Blue Cross and Blue Shield of SC 0 1 BLUECROSS AND BLUESHIELD OF SOUTH CAROLINA H7172 2021 Aetna Better Health of Ohio, MyCare Ohio Ohio 0 0 1 AETNA BETTER HEALTH INC. (OH) H7173 2021 Wellcare by Allwell Metro Atlanta, North and Central Regions 0 0 1 PEACH STATE HEALTH PLAN, INC. H7175 2021 Wellcare Select counties in NC 0 www.WellCare.com/medicare 0 1 WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC. H7195 2021 Northland PACE Senior Care Services Central & South Western North Dakota 0 http://northlandpace.com/ Northland PACE Senior Care Services 0 2 NORTHLAND PACE PROGRAM H7220 2021 Indiana University Health Plans State of Indiana - Indianapolis Metro and Surrounding Counties 0 www.iuhealthplansmedicare.org IU Health Plans 0 2 INDIANA UNIVERSITY HEALTH PLANS NFP, INC. H7245 2021 Premera Blue Cross Medicare Advantage Various Counties in Eastern and Western WA 0 www.premera.com/ma 0 2 PREMERA BLUE CROSS H7262 2021 TRU PACE Boulder and Southwest Weld Counties 0 0 2 TRU COMMUNITY CARE H7273 2021 Banner Medicare Advantage Plus South-Central South-Western Arizona 0 https://www.bannerhealth.com/ Banner Medicare Advantage Plus 0 1 BANNER HEALTH INSURANCE GROUP H7284 2021 Humana Multi-state 0 www.humana.com 0 1 HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC. H7301 2021 Aetna Medicare Central and Northern Illinois 0 http://www.aetnamedicare.com/ 0 1 COVENTRY HEALTH CARE OF ILLINOIS, INC. H7322 2021 Oscar Oscar 0 0 1 OSCAR HEALTH PLAN OF NEW YORK, INC. H7323 2021 Wellcare Select counties in TX 0 www.WellCare.com/medicare 0 1 WELLCARE NATIONAL HEALTH INSURANCE COMPANY H7326 2021 Wellcare Select counties in SC 0 www.WellCare.com/medicare 0 1 WELLCARE OF SOUTH CAROLINA, INC. H7330 2021 Zing Health Chicago Metro Area 0 myzinghealth.com Zing Health 0 1 ZING HEALTH, INC. H7366 2021 ConcertoHealth PACE of Los Angeles Los Angeles area 0 0 1 CONCERTOHEALTH PACE OF LOS ANGELES, LLC H7399 2021 Ascension Complete Cook, DuPage, Kane and Will Counties 0 0 1 CENTENE VENTURE COMPANY ILLINOIS H7404 2021 UnitedHealthcare Select Counties in MN, NV, ND, and UT 0 0 1 PACIFICARE LIFE ASSURANCE COMPANY H7409 2021 Bright Health State of South Carolina 0 0 1 BRIGHT HEALTH COMPANY OF SOUTH CAROLINA, INC. H7419 2021 Tufts Health Plan Commonwealth of Massachusetts 0 0 2 TUFTS HEALTH PUBLIC PLANS, INC. H7445 2021 UnitedHealthcare State of DE 0 0 1 UNITEDHEALTHCARE OF ILLINOIS, INC. H7464 2021 UnitedHealthcare Select Counties in VA 0 0 1 UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC. H7469 2021 PACE Partners of Northeast Florida PACE Partners of Northeast Florida 0 PACE Place and The PACE Place 0 2 PACE PARTNERS OF NORTHEAST FLORIDA, INC. H7501 2021 CalOptima PACE Orange County, California 0 CalOptima 0 3 ORANGE COUNTY HEALTH AUTHORITY H7511 2021 Great Plains Medicare Advantage Nebraska (partial) 0 www.greatplainsmedicareadvantage.com Great Plains Medicare Advantage 0 1 GOOD SAMARITAN INSURANCE PLAN OF NEBRASKA, INC. H7518 2021 Wellcare Select counties in MO 0 www.WellCare.com/medicare 0 1 WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC H7522 2021 Medicare y Mucho Más Puerto Rico 0 www.mmm-pr.com 0 1 MMM HEALTHCARE, LLC H7557 2021 Longevity Health Plan Michigan (partial) 0 Longevity Health Plan 0 1 LONGEVITY HEALTH PLAN OF MICHIGAN, INC. H7559 2021 Magellan Complete Care Virginia 0 Magellan Complete Care of Virginia, LLC 0 1 MAGELLAN COMPLETE CARE OF VIRGINIA, LLC. H7594 2021 Brandman Health Plan Los Angeles Area 0 www.Brandmanhealth.com 0 2 BRANDMAN HEALTH PLAN H7598 2021 Group Health Cooperative of Eau Claire Group Health Cooperative of Eau Claire 0 0 2 GROUP HEALTH COOPERATIVE OF EAU CLAIRE H7607 2021 Clever Care Health Plan Southern California 0 0 1 CLEVER CARE OF GOLDEN STATE, INC. H7617 2021 Humana South Carolina counties 0 www.humana.com 0 1 EMPHESYS INSURANCE COMPANY H7619 2021 AtlantiCare LIFE Connection New Jersey Counties of Atlantic and Cape May 0 AtlantiCare LIFE Connection 0 2 ATLANTICARE HEALTH SERVICES, INC. H7621 2021 Humana Multi-state 0 www.humana.com 0 1 HUMANA HEALTH PLAN OF CALIFORNIA, INC. H7646 2021 PHP Medicare Central and Southwest Michigan 0 PHP Medicare 0 2 PHP MEDICARE H7660 2021 LIFE Beaver and Lawrence Counties Beaver and Lawrence Counties 0 LIFE Beaver and Lawrence Counties 0 2 VIECARE BEAVER, LLC H7678 2021 Molina Healthcare of Texas, Inc. West, North and South Texas 0 www.molinahealthcare.com/medicare 0 1 MOLINA HEALTHCARE OF TEXAS, INC. H7680 2021 Prominence Health Plan Prominence Health Plan 0 www.prominencemedicare.com Prominence Health Plan 0 1 PROMINENCE HEALTHFIRST OF TEXAS H7728 2021 Anthem Blue Cross and Blue Shield Select Counties in Georgia,Kentucky and New Hampshire 0 https://shop.anthem.com/medicare Anthem Blue Cross and Blue Shield 0 1 ANTHEM HEALTH PLANS OF NEW HAMPSHIRE, INC. H7779 2021 American Health Advantage of Tennessee Tennessee 0 American Health Advantage of Tennessee 0 1 AMERICAN HEALTH PLAN, INC. H7787 2021 Cigna North Texas 0 www.cigna.com/medicare 0 1 HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. H7831 2021 New Horizons Living Serving St. Louis City and St. Louis county areas 0 0 2 PRIME ACQUISITIONS, LLC D.B.A. NEW HORIZONS LIVING H7833 2021 UnitedHealthcare Harris County, Texas 0 0 1 UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C. H7844 2021 Molina Healthcare of Michigan West and NE Michigan 0 www.molinamedicare.com 0 1 MOLINA HEALTHCARE OF MICHIGAN, INC. H7849 2021 Cigna Multiple States 0 www.cigna.com/medicare CIGNA HEALTH AND LIFE INSURANCE COMPANY 0 1 CIGNA HEALTH AND LIFE INSURANCE COMPANY H7853 2021 Bright Health State of Colorado 0 0 1 BRIGHT HEALTH INSURANCE COMPANY H7855 2021 Brandman Centers for Senior Care Brandman Centers for Senior Care 0 Brandman Centers for Senior Care 0 2 BRANDMAN CENTERS FOR SENIOR CARE, INC. H7885 2021 Health Plan of San Mateo San Mateo County 0 http://www.hpsm.org Health Plan of San Mateo 0 2 SAN MATEO HEALTH COMMISSION H7890 2021 Santa Clara Family Health Plan Cal MediConnect Plan Santa Clara County 0 www.scfhp.com/healthcareplans/calmediconnect dba Santa Clara Family Health Plan 0 2 SANTA CLARA COUNTY HEALTH AUTHORITY H7917 2021 BlueCross BlueShield of Tennessee State of Tennessee 0 bcbstmedicare.com BLUECROSS BLUESHIELD OF TENNESSEE 0 2 BLUECROSS BLUESHIELD OF TENNESSEE, INC. H7925 2021 Ascension Complete Central, Southeast and Southwest Indiana Counties 0 0 1 CENTENE VENTURE COMPANY INDIANA, INC. H7971 2021 Horizon Blue Cross Blue Shield of New Jersey State of New Jersey 0 https://medicare.horizonblue.com/ Horizon Blue Cross Blue Shield of New Jersey 0 1 HORIZON INSURANCE COMPANY H7993 2021 Devoted Health Greater Houston 0 www.Devoted.com Devoted Health 0 1 DEVOTED HEALTH PLAN OF TEXAS, INC. H8003 2021 Blue Cross Blue Shield of South Carolina State of South Carolina 0 www.scbluesmedadvantage.com/marx20 Blue Cross and Blue Shield of SC 0 1 BLUECROSS AND BLUESHIELD OF SOUTH CAROLINA H8010 2021 Clover Health Select Counties in New Jersey and Texas 0 www.caremark.com Clover Health 0 1 CLOVER HMO OF NEW JERSEY, INC. H8016 2021 OneCare Connect Orange County, California 0 https://www.caloptima.org/en/ForMembers/OneCareConnect/Pharmacy.aspx CalOptima 0 2 ORANGE COUNTY HEALTH AUTHORITY H8019 2021 WellFirst Health St. Louis Metro Area 0 wellfirstbenefits.com 0 2 SSM HEALTH PLAN H8026 2021 Aetna Better Health Premier Plan Southern Michigan Area 0 Aetna Better Health Premier Plan 0 1 AETNA BETTER HEALTH OF MICHIGAN INC. H8046 2021 Molina Healthcare of Illinois Central Illinois 0 www.molinamedicare.com 0 1 MOLINA HEALTHCARE OF ILLINOIS, INC. H8064 2021 FirstMedicare Direct FirstCarolinaCare Insurance Company- Sandhills, North Carolina 0 FirstMedicare Direct 0 2 FIRSTCAROLINACARE INSURANCE COMPANY H8067 2021 Provider Partners Health Plans Western & Central Maryland 0 www.pphealthplan.com Provider Partners Maryland Advantage Plan 0 1 PROVIDER PARTNERS HEALTH PLAN, INC. H8082 2021 WelbeHealth Sierra PACE Parts of Stanislaus and San Joaquin Counties California 0 WelbeHealth Sierra PACE 0 1 STOCKTON PACE H8087 2021 Humana Multi-state 0 www.humana.com 0 1 HUMANADENTAL INSURANCE COMPANY H8093 2021 Georgia Health Advantage Georgia 0 Georgia Health Advantage 0 1 GEORGIA ASSURANCE, INC. H8096 2021 Centra PACE Centra PACE - Lynchburg, Farmville, & Gretna Virginia 0 www.centrahealth.com Centra PACE 0 2 CENTRA HEALTH, INC. H8125 2021 UnitedHealthcare Select Counties in OH, and OK 0 0 1 UnitedHealthcare Insurance Company of America H8130 2021 Molina Healthcare of Florida Panhandle, NE Florida, Tampa and Central Florida Areas 0 www.molinahealthcare.com/medicare 0 1 MOLINA HEALTHCARE OF FLORIDA, INC. H8133 2021 Blue Cross and Blue Shield of Texas State of Texas 0 0 1 GHS INSURANCE COMPANY H8142 2021 Baylor Scott & White Health Plan Central Texas 0 www.swhp.org SeniorCare Advantage HMO 0 2 SCOTT AND WHITE HEALTH PLAN H8145 2021 Humana Humana 0 www.humana.com N/A 0 1 HUMANA INSURANCE COMPANY H8173 2021 Devoted Health Phoenix 0 www.Devoted.com Devoted Health 0 1 DEVOTED HEALTH PLAN OF ARIZONA, INC. H8176 2021 Molina Healthcare of South Carolina South Carolina Counties 0 www.molinahealthcare.com/medicare 0 1 MOLINA HEALTHCARE OF SOUTH CAROLINA,INC H8181 2021 Blue Cross and Blue Shield of Nebraska Omaha/Lincoln Metro Area and Central Nebraska 0 0 2 SAPPHIRE EDGE, INC. H8189 2021 Wellcare by Allwell 35 counties in Eastern and Central Wisconsin 0 0 1 MANAGED HEALTH SERVICES, WISCONSIN H8197 2021 Molina Healthcare of Texas West, North and South Texas 0 www.molinamedicare.com 0 1 MOLINA HEALTHCARE OF TEXAS, INC. H8211 2021 UnitedHealthcare Select Counties in MT, and WV 0 0 1 MAMSI LIFE AND HEALTH INSURANCE COMPANY H8213 2021 FIRST CHOICE VIP CARE PLUS SOUTH CAROLINA 0 www.firstchoicevipcareplus.com 0 1 SELECT HEALTH OF SOUTH CAROLINA, INC. H8225 2021 Ascension Complete Jacksonville & Pensacola Area 0 0 1 CENTENE VENTURE COMPANY FLORIDA H8258 2021 L.A. Care Cal MediConnect Plan L.A. Care Health Plan 0 http://www.calmediconnectla.org 0 2 LOCAL INITIATIVE HEALTH AUTHORITY FOR L.A. COUNTY H8280 2021 Bright Health State of Alabama 0 0 1 BRIGHT HEALTH INSURANCE COMPANY OF ALABAMA, INC. H8293 2021 Clear Spring Health Central, Southern and Shenandoah Valley Virginia 0 0 1 CLEAR SPRING HEALTH (VA), INC. H8298 2021 Horizon Blue Cross Blue Shield of New Jersey Select New Jersey Counties 0 https://medicare.horizonblue.com/ 0 1 HORIZON HEALTHCARE OF NEW JERSEY, INC. H8332 2021 Aetna Medicare Select Counties In Texas 0 http://www.aetnamedicare.com/ 0 1 AETNA BETTER HEALTH OF KANSAS, INC. H8343 2021 Amerigroup Insurance Company New Jersey, Tennessee and Select counties in Texas and New Mexico 0 0 1 AMERIGROUP INSURANCE COMPANY H8364 2021 Bright Health State of Alabama 0 0 1 BRIGHT HEALTH INSURANCE COMPANY OF ALABAMA, INC. H8379 2021 Priority Health Medicare Lower Peninsula Michigan Counties 0 www.priorityhealth.com Priority Health 0 2 PRIORITY HEALTH CHOICE, INC. H8390 2021 CareSource CareSource Georgia Co. 0 http:\\caresource.com CareSource 0 2 CARESOURCE GEORGIA CO. H8423 2021 Cigna CarePlan MMP Texas 0 www.mycignahealthspring.com 0 1 HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. H8424 2021 SIOUXLAND PACE, INC. Woodbury, Monona, Plymouth, Cherokee County area 0 Siouxland PACE 0 2 SIOUXLAND PACE, INC. H8432 2021 Empire BlueCross BlueShield Select Counties in Maine and New York 0 https://shop.anthem.com/medicare Anthem Blue Cross and Blue Shield 0 1 EMPIRE HEALTHCHOICE HMO, INC. H8452 2021 CareSource MyCare Ohio Northeast, Northeast Central, East Central Ohio 0 Caresource 0 2 CARESOURCE H8457 2021 Longevity Health Plan New York (partial) 0 www.longevityhealthplan.com Longevity Health Plan 0 1 LONGEVITY HEALTH PLAN OF NEW YORK, INC. H8492 2021 Dignity Health Plan Select Louisiana Counties 0 Dignity Care Corporation 0 1 DIGNITY CARE CORPORATION H8547 2021 Blue Cross and Blue Shield of Illinois State of Illinois 0 0 1 ILLINOIS BLUE CROSS BLUE SHIELD INSURANCE COMPANY H8552 2021 Anthem Blue Cross Life and Health Insurance Co. State of California 0 https://shop.anthem.com/medicare/ca Anthem Blue Cross 0 1 ANTHEM BLUE CROSS LIFE AND HEALTH INS COMPANY H8553 2021 Wellcare Select counties in AZ 0 0 1 WELLCARE HEALTH INSURANCE OF THE SOUTHWEST, INC. H8554 2021 Blue Cross and Blue Shield of Texas Rio Grande Valley, and Bexar and El Paso Counties 0 0 1 GHS INSURANCE COMPANY H8578 2021 Health New England Medicare Advantage Plans Western Massachusetts 0 www.hne.com/medicare 0 2 HEALTH NEW ENGLAND, INC. H8597 2021 Aetna Medicare Bexar, Tarrant, Johnson and Guadeloupe counties 0 Aetna Better Health of Texas and Aetna Better Health 0 1 AETNA BETTER HEALTH OF TEXAS INC. H8604 2021 The Health Plan Eastern Ohio & West Virginia 0 www.healthplan.org 0 1 THP INSURANCE COMPANY H8614 2021 Milford Wellness Village PACE Southern Delaware 0 Milford Wellness Village PACE 0 1 MILFORD WELLNESS VILLAGE PACE H8634 2021 Blue Cross and Blue Shield of IL, NM State of Illinois, State of New Mexico 0 0 2 HEALTH CARE SERVICE CORPORATION H8649 2021 Aetna Medicare Utah 0 http://www.aetnamedicare.com/ Altius Health Plans Inc. 0 1 AETNA HEALTH OF UTAH INC H8655 2021 InnovAge Virginia PACE - Richmond and Peninsula InnovAge Virginia PACE - Richmond (greater Richmond area) and Peninsula (greater Newport News area 0 http://myinnovage.com InnovAge Virginia PACE - Richmond & InnovAge Virginia PACE - Peninsula 0 1 INNOVAGE VIRGINIA PACE II, LLC H8677 2021 Molina Healthcare of California Southern California 0 www.molinamedicare.com 0 1 MOLINA HEALTHCARE OF CALIFORNIA H8711 2021 Wellcare Select counties in NJ 0 0 1 WELLCARE HEALTH INSURANCE COMPANY OF NEW JERSEY H8748 2021 UnitedHealthcare Select Counties in GA, and SC 0 0 1 UNITEDHEALTHCARE INSURANCE COMPANY H8764 2021 Aspire Health County of Monterey 0 www.aspirehealthplan.org Aspire Health Plan 0 2 ASPIRE HEALTH PLAN H8768 2021 UnitedHealthcare Select Counties in IL, IA, KS, KY, MS, MO, NJ, OH, and OK 0 0 1 UNITEDHEALTHCARE INSURANCE CO. OF THE RIVER VALLEY H8769 2021 Ascension Living PACE of Michigan Ascension Living PACE of Michigan 0 Ascension Living PACE of Michigan 0 2 Center for Gerontology H8777 2021 Complete Senior Care Complete Senior Care 0 CompleteSeniorCare 0 2 COMPLETE SENIOR CARE, INC. H8783 2021 UCare Northern Minnesota and Northwestern Wisconsin 0 0 2 UCARE HEALTH, INC. H8786 2021 Amerigroup STAR+PLUS MMP Harris County/Tarrant County/El Paso County/Bexar County 0 Amerigroup 0 1 AMERIGROUP TEXAS, INC. H8797 2021 Perennial Advantage Ohio (partial) 0 Perennial Advantage 0 1 PERENNIAL ADVANTAGE OF OHIO, INC. H8800 2021 Total Senior Care, Inc. Total Senior Care, Inc. 0 0 2 TOTAL SENIOR CARE, INC. H8845 2021 Magellan Complete Care Arizona-Central 0 Magellan Complete Care of Arizona, Inc 0 1 MAGELLAN COMPLETE CARE OF ARIZONA, INC. H8849 2021 Amerigroup Select counties in Texas 0 0 1 AMERIGROUP INSURANCE COMPANY H8854 2021 CareFirst BlueCross BlueShield Medicare Advantage Dual Prime Select Maryland Counties 0 http://www.ummedicareadvantage.org CareFirst BlueCross BlueShield Medicare Advantage 0 1 CareFirst Advantage DSNP, Inc. H8889 2021 Medica Select counties in the State of Minnesota 0 medica.com Medica Advantage Solution 0 2 MEDICA HEALTH PLANS H8908 2021 Humana Detroit Metro Area 0 www.humana.com 0 1 HUMANA MEDICAL PLAN OF MICHIGAN, INC. H8961 2021 Oscar Oscar 0 0 1 OSCAR MANAGED CARE OF SOUTH FLORIDA, INC H8967 2021 Great Plains Medicare Advantage North Dakota (partial) 0 www.greatplainsmedicareadvantage.com Great Plains Medicare Advantage 0 1 GOOD SAMARITAN INSURANCE PLAN OF NORTH DAKOTA, LLC H9001 2021 Fallon Health Massachusetts except Dukes and Nantucket counties 0 www.fallonhealth.org Fallon Health 0 2 FALLON COMMUNITY HEALTH PLAN H9003 2021 Kaiser Permanente Portland-Vancouver Metro, Salem OR, Longview WA 0 kp.org 0 2 KAISER FOUNDATION HP OF THE N W H9042 2021 MyTruAdvantage Select counties in Indiana 0 Caremark.com SIHO Insurance Services 0 1 SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC. H9047 2021 Providence Medicare Advantage Plans Portland Metro, Willamette Valley, Central Oregon & Seattle Area 0 0 2 PROVIDENCE HEALTH ASSURANCE H9052 2021 Sunrise PACE Region VII Area Agency on Aging 0 Sunrise PACE 0 2 REGION VII AREA AGENCY ON AGING H9065 2021 AMH Health Select Counties in Maine 0 Anthem Blue Cross and Blue Shield 0 1 AMH HEALTH, LLC H9066 2021 Nascentia Health Plus Upstate New York 0 0 2 VISITING NURSE ASSOCIATION OF CENTRAL NEW YORK H9068 2021 ALBRIGHT CARE SERVICES ALBRIGHT CARE SERVICES 0 Albright LIFE 0 2 ALBRIGHT CARE SERVICES H9070 2021 Humana Select counties in OK 0 www.humana.com 0 1 COMPBENEFITS INSURANCE COMPANY H9082 2021 Molina Healthcare of New Mexico, Inc. Northwest and Southern New Mexico Areas 0 www.molinahealthcare.com/medicare 0 1 MOLINA HEALTHCARE OF NEW MEXICO, INC. H9095 2021 Longevity Health Plan Oklahoma (partial) 0 Longevity Health Plan 0 1 LONGEVITY HEALTH PLAN OF OKLAHOMA, INC. H9096 2021 Dean Advantage, Prevea360 Medicare Advantage South Central, Northeastern and Western WI 0 www.deancare.com 0 1 DEAN HEALTH PLAN, INC. H9104 2021 SCAN Health Plan SCAN - Southern California 0 https://www.scanhealthplan.com/ SCAN Health Plan 0 2 SCAN HEALTH PLAN H9121 2021 PACE KC PACE KC 0 PACE KC 0 2 PACE KC, LLC H9147 2021 Blue Cross and Blue Shield of North Carolina Select counties in North Carolina 0 Healthy Blue + Medicare (HMO D-SNP) 0 2 BLUE CROSS AND BLUE SHIELD OF NC SENIOR HEALTH H9153 2021 West Virginia Senior Advantage West Virginia (partial) 0 www.WVSeniorAdvantage.com West Virginia Senior Advantage 0 1 WEST VIRGINIA SENIOR ADVANTAGE, INC. H9185 2021 Great Lakes PACE Great Lakes Bay Region: Saginaw, Midland, Bay, Tuscola, Shiawassee and Arenac Counties 0 Great Lakes PACE 0 2 A&D CHARITABLE FOUNDATION, INC. H9191 2021 Provider Partners Health Plans select Missouri counties 0 pphealthplan.com Provider Partners Missouri Advantage Plan 0 1 PROVIDER PARTNERS HEALTH PLAN OF MISSOURI, INC. H9207 2021 Health Partners Medicare Southeastern PA,Lehigh Capital PA,Carbon County,PA 0 www.healthpartnersplans.com 0 2 HEALTH PARTNERS PLANS, INC. H9219 2021 AMH Health select counties in Maine 0 0 1 AMH HEALTH PLANS OF MAINE, INC. H9258 2021 Wellcare Select counties in RI 0 0 1 WELLCARE HEALTH PLANS OF RHODE ISLAND, INC. H9266 2021 Piedmont Health SeniorCare Piedmont Region of North Carolina 0 www.piedmonthealth.org Piedmont Health SeniorCare 0 2 PIEDMONT HEALTH SERVICES, INC. H9276 2021 Allwell Select Counties in Florida 0 0 1 SUNSHINE HEALTH COMMUNITY SOLUTIONS, INC. H9302 2021 Premera Blue Cross Medicare Advantage Various Counties in Eastern and Western WA 0 www.premera.com/ma 0 2 PREMERA BLUE CROSS H9323 2021 Beacon of LIFE County of Monmouth 0 Beacon of LIFE 0 1 ACUTE CARE HEALTH SYSTEM, LLC H9335 2021 Wellcare Select counties in MO 0 0 1 WELLCARE HEALTH PLANS OF MISSOURI, INC. H9364 2021 Wellcare Select counties in Maine 0 www.WellCare.com/medicare 0 1 WELLCARE OF MAINE, INC. H9387 2021 Wellcare by Allwell Eastern Kansas Counties 0 0 1 SUNFLOWER STATE HEALTH PLAN, INC. H9403 2021 Clear Spring Health South Carolina Counties 0 0 1 EON HEALTH, INC. (SC) H9408 2021 Vibra Health Plan Southcentral and Northeast Pennsylvania 0 https://www.vibrahealthplan.com/ Vibra Health Plan, Inc. 0 1 VIBRA HEALTH PLAN, INC. H9411 2021 Asian Heritage Healthcare Central and Southern Los Angeles County 0 NA Asian Heritage Healthcare 0 1 1818 WESTERN, LLC H9412 2021 Geisinger Gold Monmouth and Ocean Counties, New Jersey 0 www.geisingergold.com Geisinger Gold 0 1 GEISINGER QUALITY OPTIONS, INC. H9428 2021 Wellcare Select counties in TN 0 www.wellcare.com/medicare WellCare 0 1 WELLCARE HEALTH INSURANCE OF TENNESSEE, INC. H9431 2021 Aetna Medicare Select counties in ND, ID, NH, NM, OR and RI 0 http://www.aetnamedicare.com/ 0 1 FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY H9438 2021 Bluestem PACE Central Kansas Counties Dickinson, Ellsworth, Harvey, Lincoln, Marion, McPherson, Ottawa, Reno, Rice 0 Bluestem PACE 0 2 BLUESTEM PACE, INC. H9455 2021 Health Choice Generations Utah Davis, Weber, Tooele, Utah, Salt Lake 0 https://www.stewardhcgenerations.org/ut/members/prescription-drug-information/ Health Choice Generations Utah 0 1 HEALTH CHOICE UTAH, INC. H9460 2021 Cigna St. Louis 0 www.cigna.com/medicare 0 1 CIGNA HEALTHCARE OF ST LOUIS, INC. H9487 2021 Michigan Complete Health Wayne and Macomb Counties 0 http://mmp.michigancompletehealth.com 0 1 MICHIGAN COMPLETE HEALTH, INC. H9489 2021 Vermont Blue Advantage State of Vermont 0 0 1 VERMONT BLUE ADVANTAGE, INC. H9516 2021 Bright Health New York City & Long Island 0 0 1 BRIGHT HEALTH INSURANCE COMPANY OF NEW YORK H9525 2021 Anthem Blue Cross and Blue Shield Select Counties in the States of Wisconsin or Kentucky 0 https://shop.anthem.com/medicare Anthem Blue Cross and Blue Shield 0 1 COMPCARE HEALTH SERVICES INSURANCE CORPORATION H9572 2021 Blue Cross Blue Shield of Michigan State of Michigan. 0 www.bcbsm.com/medicare Blue Cross Blue Shield of Michigan 0 2 BCBS OF MICHIGAN MUTUAL INSURANCE COMPANY H9576 2021 NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND STATE OF RHODE ISLAND 0 www.nhpri.org/INTEGRITY NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND 0 2 NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND H9585 2021 BMC HealthNet Plan Senior Care Options BMC HealthNet Plan Senior Care Options 0 www.seniorsgetmore.org/ Boston Medical Center HealthNet Plan 0 2 BOSTON MEDICAL CENTER HEALTH PLAN, INC. H9589 2021 Clear Spring Health Georgia Counties 0 0 1 EON HEALTH, INC. (GA) H9590 2021 Longevity Health Illinois (partial) 0 www.longevityhealthplan.com Longevity Health Plan 0 1 LONGEVITY HEALTH PLAN OF ILLINOIS, INC. H9592 2021 Innovative Integrated Health Inc. Fresno, Kern, Madera, and Tulare Counties 0 Fresno PACE, Bakersfield PACE 0 1 INNOVATIVE INTEGRATED HEALTH, INC. H9615 2021 MVP HEALTH CARE New York: Capital District, Mid-Hudson and Central New York 0 www.mvphealthcare.com GoldAnywhere 0 2 MVP HEALTH PLAN, INC. H9616 2021 San Diego PACE San Diego County 0 http://www.syhc.org/services/senior-services/san-diego-pace/ San Diego PACE 0 2 CENTRO DE SALUD DE LA COMUNIDAD DE SAN YSIDRO H9630 2021 Wellcare by Allwell Select counties in AR 0 0 1 ARKANSAS HEALTH AND WELLNESS HEALTH PLAN, INC H9649 2021 HopeWest PACE HopeWest PACE 0 https://www.hopewestco.org/ HopeWest PACE 0 2 HOPEWEST H9662 2021 Cigna California 0 www.cigna.com/medicare CIGNA HEALTHCARE OF CALIFORNIA, INC. 0 1 CIGNA HEALTHCARE OF CALIFORNIA, INC. H9686 2021 Alignment Health Plan Clark County, Nevada 0 www.alignmenthealthplan.com Alignment Health Plan 0 1 ALIGNMENT HEALTH PLAN OF NEVADA, INC. H9699 2021 Health Advantage Northwest, West Central, and Central Counties in Arkansas 0 http://www.arkansasbluecross.com Health Advantage 0 2 HMO PARTNERS, INC. H9706 2021 Blue Cross and Blue Shield of Texas State of Texas 0 0 1 HCSC INSURANCE SERVICES COMPANY H9712 2021 HAP Empowered MI Health Link HAP Empowered MI Health Link 0 hap.org/emp/hap-empowered/mi-health-link HAP Empowered Mi Health Link 0 1 HAP EMPOWERED HEALTH PLAN, INC. H9725 2021 Cigna North Carolina 0 www.cigna.com/medicare 0 1 CIGNA HEALTHCARE OF NORTH CAROLINA, INC. H9730 2021 Wellcare Select counties in KY 0 www.wellcare.com/medicare WCG 0 1 WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC H9808 2021 CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA Piedmont Triad 0 Healthteamadvantage.com 0 1 CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA H9811 2021 Wellcare by Allwell Select counties in MS 0 0 1 MAGNOLIA HEALTH PLAN, INC. H9826 2021 Community Health Choice Southeast Texas 0 https://www.communityhealthchoice.org/ 0 2 COMMUNITY HEALTH CHOICE TEXAS, INC. H9830 2021 InnovAge Pennsylvania LIFE InnovAge Pennsylvania LIFE (greater Philadelphia area) 0 http://myinnovage.com InnovAge Pennsylvania LIFE - Germantown, Roosevelt, Allegheny, St. Bart's 0 1 INNOVAGE PENNSYLVANIA LIFE, LLC H9834 2021 Quartz Medicare Advantage Southeastern Minnesota 0 0 2 QUARTZ HEALTH PLAN MN CORPORATION H9842 2021 Saint Joseph PACE All St Joseph County and portions of Elkhart and Marshall Counties, Indiana 0 Saint Joseph PACE 0 2 SAINT JOSEPH PACE H9861 2021 Reliance Medicare Advantage Reliance Medicare Advantage 0 0 1 RELIANCE HMO, INC. H9869 2021 Partners Health Plan Bx,Kngs,NY,Queens,Rich,Nass,Suff,West,Rock Counties 0 0 2 PARTNERS HEALTH PLAN, INC. H9870 2021 Passport Advantage Passport Advantage 0 0 2 Justify Holdings, Inc. H9877 2021 Virginia Premier State of Virginia 0 www.virginiapremier.com 0 2 VIRGINIA PREMIER HEALTH PLAN, INC. H9878 2021 Bright Health State of Ohio 0 0 1 BRIGHT HEALTH INSURANCE COMPANY OF OHIO, INC. H9909 2021 American Health Advantage of MS Mississippi 0 American Health Advantage of Mississippi 0 1 AMERICAN HEALTH PLAN OF MS, INC. H9917 2021 Align Senior Care Florida (partial) 0 Align Senior Care 0 1 ALIGN SENIOR CARE FLORIDA, INC. H9942 2021 Longevity Health Plan New Jersey Select Counties 0 Longevity Health Plan 0 1 LONGEVITY HEALTH PLAN OF NEW JERSEY INSURANCE COMP H9952 2021 Medica Greater Minneapolis/St. Paul Metro Area 0 www.medica.com Medica AccessAbility Solution Enhanced 0 2 MEDICA HEALTH PLANS H9955 2021 Molina Healthcare of Ohio Ohio 0 www.molinahealthcare.com/medicare 0 1 MOLINA HEALTHCARE OF OHIO, INC. H9998 2021 Silver Star Lubbock County 0 www.silverstarlubbock.org Silver Star 0 2 LUBBOCK REGIONAL MENTAL HEALTH MENTAL RETARDATION R0110 2021 Humana Humana Regional PPO 1 www.humana.com 0 1 HUMANA INSURANCE COMPANY R0759 2021 UnitedHealthcare State of FL 1 0 1 UNITEDHEALTHCARE INSURANCE COMPANY R0802 2021 Martin's Point Generations Advantage Martin's Point Generations Advantage 1 Martin's Point Generations Advantage 0 2 MARTIN'S POINT GENERATIONS ADVANTAGE, INC. R0865 2021 Humana Humana Regional PPO 1 www.humana.com 0 1 HUMANA INSURANCE COMPANY R0923 2021 Humana Humana Regional PPO 1 www.humana.com 0 1 HUMANA INSURANCE COMPANY R1390 2021 Humana Humana Regional PPO 1 www.humana.com 0 1 HUMANA INSURANCE COMPANY R1532 2021 Humana Humana Regional PPO 1 www.humana.com 0 1 HUMANA INSURANCE COMPANY R1548 2021 UnitedHealthcare States of NC, and VA 1 0 1 UNITEDHEALTHCARE INSURANCE CO. OF THE RIVER VALLEY R2604 2021 UnitedHealthcare States of GA, and SC 1 0 1 UNITEDHEALTHCARE INSURANCE COMPANY R3175 2021 UnitedHealthcare State of HI 1 0 1 UNITEDHEALTHCARE INSURANCE COMPANY R3332 2021 Florida Blue State of Florida 1 www.BlueMedicareFL.com Florida Blue 0 1 BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC. R3392 2021 Humana Humana Regional PPO 1 www.humana.com 0 1 HUMANA INSURANCE COMPANY R3444 2021 UnitedHealthcare States of AR, and MO 1 0 1 CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO. R3887 2021 Humana Humana Regional PPO 1 www.humana.com 0 1 HUMANA INSURANCE COMPANY R4182 2021 Humana Humana Regional PPO 1 www.humana.com 0 1 HUMANA INSURANCE COMPANY R4487 2021 Anthem Blue Cross and Blue Shield States of Indiana and Kentucky 1 https://shop.anthem.com/medicare Anthem Blue Cross and Blue Shield 0 1 ANTHEM INSURANCE COMPANIES, INC. R4845 2021 Humana Humana Regional PPO 1 www.humana.com 0 1 HUMANA INSURANCE COMPANY R5329 2021 UnitedHealthcare States of ME, and NH 1 0 1 SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. R5342 2021 UnitedHealthcare State of NY 1 0 1 UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK R5361 2021 Humana Humana Regional PPO 1 www.humana.com 0 1 HUMANA INSURANCE COMPANY R5495 2021 Humana Humana Regional PPO 1 www.humana.com 0 1 HUMANA INSURANCE COMPANY R5826 2021 Humana Humana Regional PPO 1 www.humana.com 0 1 HUMANA INSURANCE COMPANY R5941 2021 Anthem Blue Cross and Blue Shield State of Ohio 1 https://shop.anthem.com/medicare Anthem Blue Cross and Blue Shield 0 1 ANTHEM INSURANCE COMPANIES, INC. R6694 2021 Aetna Medicare Aetna Health Inc. (NJ/OH) 1 http://www.aetnamedicare.com/ 0 1 AETNA LIFE INSURANCE COMPANY R6801 2021 UnitedHealthcare State of TX 1 0 1 CARE IMPROVEMENT PLUS OF TEXAS INSURANCE COMPANY R7220 2021 Humana Humana Regional PPO 1 www.humana.com 0 1 HUMANA INSURANCE COMPANY R7315 2021 Humana Humana Regional PPO 1 www.humana.com 0 1 HUMANA INSURANCE COMPANY R7444 2021 UnitedHealthcare States of CT, MA, RI, and VT 1 0 1 UNITEDHEALTHCARE INSURANCE COMPANY S0586 2021 MVP Health Care National Employer Group 1 Preferred Gold Prescription Plan 0 2 MVP HEALTH PLAN, INC. S0655 2021 Tufts Health Plan States of Massachusetts and Nationwide 1 Tufts Health Plan Medicare Preferred 0 1 TUFTS INSURANCE COMPANY S1030 2021 BlueRx (PDP) State of Alabama & State of Tennessee 1 0 2 BCBS OF ALABAMA & UTIC INSURANCE COMPANY S1140 2021 Highmark Blue Cross Blue Shield of Western New York and Highmark Blue Shield of Northeastern New York Western New York and Northeastern New York 1 0 2 Highmark Western and Northeastern New York Inc. S1822 2021 HealthPartners Nationwide 1 HealthPartners 0 2 HEALTHPARTNERS, INC. S1894 2021 CommunityCare Prescription Drug Plan (PDP) State of Oklahoma 1 CommunityCare Choice, Inc. 0 2 COMMUNITYCARE GOVERNMENT PROGRAMS, INC. S2465 2021 Optima Medicare State of Virginia 1 Optima Medicare 0 2 OPTIMA HEALTH PLAN S2468 2021 Blue Shield of California State of California 1 www.blueshieldca.com/medicare BLUE SHIELD OF CALIFORNIA 0 2 CALIFORNIA PHYSICIANS' SERVICE S2668 2021 Farm Bureau Health Plans States of Alabama and Tennessee 1 Farm Bureau Health Plans 0 1 MEMBERS HEALTH INSURANCE COMPANY S2874 2021 Humana Puerto Rico - Island Wide 1 www.humana.com 0 1 HUMANA INSURANCE OF PUERTO RICO, INC. S2893 2021 Blue MedicareRx Connecticut, Massachusetts, Rhode Island and Vermont 1 Blue MedicareRx 0 3 ANTHEM INSURANCE CO. & BCBSMA & BCBSRI & BCBSVT S3285 2021 MG Insurance Company MG Insurance Company - National 1 0 1 MG INSURANCE COMPANY S3375 2021 BlueCross BlueShield: Empire, Excellus, WNY & NENY New York 1 Empire BlueCross BlueShield 0 1 EMPIRE HEALTHCHOICE ASSURANCE, INC. S3389 2021 UPMC Health Plan States of Pennsylvania and West Virginia 1 UPMC Health Benefits, Inc 0 1 UPMC HEALTH BENEFITS, INC. S3521 2021 Excellus Health Plan, Inc State of New York 1 0 2 EXCELLUS HEALTH PLAN, INC. S3875 2021 Granite Alliance Granite Alliance National 1 Granite Alliance 0 1 GRANITE ALLIANCE INSURANCE COMPANY S3994 2021 HMSAs Medicare Rx Plan State of Hawaii 1 HMSA's Medicare Rx Plan 0 2 HAWAII MEDICAL SERVICE ASSOCIATION (HMSA) S4219 2021 Health Alliance Medicare Prescription Plan State of Illinois 1 Health Alliance Medical Plans 0 1 HEALTH ALLIANCE MEDICAL PLANS S4501 2021 Pharmacy Benefit Dimensions PDP All Regions 1 INDEPENDENT HEALTH BENEFITS CORPORATION 0 2 INDEPENDENT HEALTH BENEFITS CORPORATION S4802 2021 Wellcare Multi-region 1 1 1 WELLCARE PRESCRIPTION INSURANCE, INC. S5450 2021 BlueScripts Nationwide 1 0 1 SECURITYCARE OF TENNESSEE, INC. S5540 2021 Blue Cross and Blue Shield of North Carolina State of North Carolina 1 Blue Medicare Rx 0 2 BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA S5552 2021 Humana Humana PDP NY 1 www.humana.com 1 1 HUMANA INSURANCE COMPANY OF NEW YORK S5584 2021 Blue Cross Blue Shield of Michigan State of Michigan 1 Blue Cross Blue Shield of Michigan 0 2 BCBS OF MICHIGAN MUTUAL INSURANCE COMPANY S5588 2021 Paramount Prescription Drug Plan Paramount Prescription Drug Plan (Ohio) 1 http://www.paramounthealthcare.com/medicareplans Paramount Insurance Company 0 1 PARAMOUNT INSURANCE COMPANY S5593 2021 Highmark Inc. States of Pennsylvania and West Virginia 1 0 1 HM HEALTH INSURANCE COMPANY S5596 2021 Anthem / Anthem or Blue KC in Missouri CA, CO, GA, IN, KY, ME, MO, NV, NH, OH, VA, WI 1 Anthem Blue Cross and Blue Shield 0 1 ANTHEM INSURANCE COMPANIES, INC. S5601 2021 Aetna Medicare SilverScript Insurance Company 1 http://www.aetnamedicare.com/ 1 1 SILVERSCRIPT INSURANCE COMPANY S5609 2021 Asuris Northwest Health Region of Oregon and Washington 1 Asuris Medicare Script (PDP) 0 2 ASURIS NORTHWEST HEALTH S5617 2021 Cigna National Prescription Drug Plan 1 Cigna-HealthSpring Rx 1 1 CIGNA HEALTH AND LIFE INSURANCE COMPANY S5660 2021 Express Scripts Medicare National (All States except New York State) 1 www.Express-ScriptsMedicare.com 1 1 MEDCO CONTAINMENT LIFE AND MEDCO CONTAINMENT NY S5715 2021 Blue Cross and Blue Shield of IL, NM, OK, TX State of Illinois, State of New Mexico, State of Oklahoma, State of Texas 1 0 1 HCSC INSURANCE SERVICES COMPANY S5726 2021 Blue Cross and Blue Shield of Kansas or Blue KC Kansas 1 Blue Cross Blue Shield of Kansas 0 2 BLUE CROSS AND BLUE SHIELD OF KANSAS S5743 2021 MedicareBlue Rx States of IA, MN, MT, NE, ND, SD, WY 1 Blue Cross Blue Shield Northern Plains Alliance 0 2 WELLMARK IA & SD, & BCBS MN, MT, NE, ND,& WY S5753 2021 WPS Health Insurance State of Wisconsin 1 www.wpsmedicaredrugs.com WPS Health Insurance 0 2 WISCONSIN PHYSICIANS SERVICE INSURANCE CORPORATION S5768 2021 WellCare Multi-region 1 1 1 WELLCARE PRESCRIPTION INSURANCE, INC. S5795 2021 Arkansas Blue Medicare State of Arkansas 1 Arkansas Blue Cross and Blue Shield 0 2 USABLE MUTUAL INSURANCE COMPANY S5805 2021 UnitedHealthcare Nationwide, and Select US Territories 1 1 1 UNITEDHEALTHCARE INSURANCE COMPANY OF NEW YORK S5810 2021 WellCare Multi-region 1 1 1 WELLCARE PRESCRIPTION INSURANCE, INC. S5820 2021 UnitedHealthcare Nationwide, and Select US Territories 1 1 1 UNITEDHEALTHCARE INSURANCE COMPANY S5857 2021 Priority Health Medicare State of Michigan 1 Priority Medicare Rx. 0 1 PRIORITY HEALTH INSURANCE COMPANY S5877 2021 EMI Health State of Utah 1 0 2 EDUCATORS MUTUAL INSURANCE ASSOCIATION S5884 2021 Humana Humana Prescription Drug Plan 1 www.humana.com 1 1 HUMANA INSURANCE COMPANY S5904 2021 Florida Blue State of Florida 1 Florida Blue 0 1 BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC. S5916 2021 Regence BlueShield of Idaho and Regence BC BS Utah Region for Utah and Idaho 1 Regence Medicare Script (PDP) 0 2 REGENCE BLUESHIELD OF IDAHO AND REGENCE BC BS UTAH S5921 2021 UnitedHealthcare Nationwide, and Select US Territories 1 1 1 UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY S5953 2021 Blue Cross Blue Shield of South Carolina State of South Carolina 1 Blue Cross and Blue Shield of SC 0 1 BLUECROSS AND BLUESHIELD OF SOUTH CAROLINA S5960 2021 UniCare Nationwide 1 UniCare 0 1 UNICARE LIFE & HEALTH INSURANCE COMPANY S5966 2021 EmblemHealth Medicare PDP State of New York 1 GHI (Group Health Incorporated) 0 2 EmblemHealth, Inc S5975 2021 Moda Health Plan, Inc. States of Oregon and Washington 1 MODA HEALTH PLAN, INC. 0 1 MODA HEALTH PLAN, INC. S5983 2021 Express Scripts Medicare State of New York 1 www.Express-ScriptsMedicare.com 1 1 MEDCO CONTAINMENT INSURANCE COMPANY OF NEW YORK S5993 2021 Horizon Blue Cross Blue Shield of New Jersey State of New Jersey 1 Horizon Blue Cross Blue Shield of New Jersey 0 1 HORIZON INSURANCE COMPANY S6506 2021 Blue Cross Blue Shield of Arizona State of Arizona 1 0 2 BLUE CROSS AND BLUE SHIELD ARIZONA, INC. S6875 2021 Independence Blue Cross National 1 0 2 QCC INSURANCE COMPANY S6946 2021 Clear Spring Health 44 states and DC 1 Clear Spring Health Insurance Company 0 1 CLEAR SPRING HEALTH INSURANCE COMPANY S7126 2021 Mutual of Omaha Rx National (All States except New York State) 1 Mutual of Omaha Rx 0 1 OMAHA HEALTH INSURANCE COMPANY S7694 2021 Elixir Insurance Elixir Insurance 1 Elixir Insurance 1 1 ELIXIR INSURANCE COMPANY S8067 2021 Avalon Insurance Company Region 6 1 Avalon Insurance Company 0 1 AVALON INSURANCE COMPANY S8182 2021 Amerigroup AZ, TX 1 0 1 AMERIGROUP INSURANCE COMPANY S8677 2021 Providence Health Assurance Employer Group Only PDP All Regions 1 0 2 PROVIDENCE HEALTH ASSURANCE S8841 2021 Optum Insurance of Ohio, Inc. Optum Insurance of Ohio, Inc. 1 0 1 OPTUM INSURANCE OF OHIO, INC. S9325 2021 Exemplar Health Exemplar Health 1 https://exemplar-health.com Exemplar Health 0 1 PRESIDENTIAL LIFE INSURANCE COMPANY S9701 2021 Navitus MedicareRx Nationwide 1 Dean Health Plan, Inc. 0 1 DEAN HEALTH INSURANCE, INC. X0001 2021 Medicare's Limited Income NET Program Medicare's Limited Income NET Program 0 1 1 LIMITED INCOME NET PROGRAM