H3916-805-000Local PPO
Highmark Blue Cross Blue Shield or Highmark Blue Shield
Community Blue Medicare PPO MA PA Calendar (PPO) · Pennsylvania
Employer/retiree group
H3916-805-000 — Community Blue Medicare PPO MA PA Calendar (PPO) — Pennsylvania → H3916-806-000Local PPO
Highmark Blue Cross Blue Shield or Highmark Blue Shield
Community Blue Medicare PPO PA MAPD Calendar (PPO) · Pennsylvania
Employer/retiree group
H3916-806-000 — Community Blue Medicare PPO PA MAPD Calendar (PPO) — Pennsylvania → H3916-807-000Local PPO
Highmark Blue Cross Blue Shield or Highmark Blue Shield
Community Blue Medicare PPO MAPD Calendar Perform (PPO) · Pennsylvania
Employer/retiree group
H3916-807-000 — Community Blue Medicare PPO MAPD Calendar Perform (PPO) — Pennsylvania → H3916-808-000Local PPO
Highmark Blue Cross Blue Shield or Highmark Blue Shield
Freedom Blue PPO MAPD ASO CALENDAR (PPO) · Pennsylvania
Employer/retiree group
H3916-808-000 — Freedom Blue PPO MAPD ASO CALENDAR (PPO) — Pennsylvania → H3916-809-000Local PPO
Highmark Blue Cross Blue Shield or Highmark Blue Shield
Community Blue Medicare PPO ASO CALENDAR (PPO) · Pennsylvania
Employer/retiree group
H3916-809-000 — Community Blue Medicare PPO ASO CALENDAR (PPO) — Pennsylvania → H3916-810-000Local PPO
Highmark Blue Cross Blue Shield or Highmark Blue Shield
Community Blue Medicare Plus PPO ASO CALENDAR (PPO) · Pennsylvania
Employer/retiree group
H3916-810-000 — Community Blue Medicare Plus PPO ASO CALENDAR (PPO) — Pennsylvania → H3923-801-000Local PPO
Capital Blue Cross
Capital Blue Cross Group Rx (CY) (PPO) · National
Employer/retiree group
H3923-801-000 — Capital Blue Cross Group Rx (CY) (PPO) — National → H3923-802-000Local PPO
Capital Blue Cross
Capital Blue Cross Group No Rx (CY) (PPO) · National
Employer/retiree group
H3923-802-000 — Capital Blue Cross Group No Rx (CY) (PPO) — National → H3923-817-000Local PPO
Capital Blue Cross
Capital Blue Cross Group Custom Rx (CY) (PPO) · National
Employer/retiree group
H3923-817-000 — Capital Blue Cross Group Custom Rx (CY) (PPO) — National → H3923-818-000Local PPO
Capital Blue Cross
Capital Blue Cross Group Rx Complete (CY) (PPO) · National
Employer/retiree group
H3923-818-000 — Capital Blue Cross Group Rx Complete (CY) (PPO) — National → H3923-819-000Local PPO
Capital Blue Cross
Capital Blue Cross Group Rx Standard (CY) (PPO) · National
Employer/retiree group
H3923-819-000 — Capital Blue Cross Group Rx Standard (CY) (PPO) — National → H3923-820-000Local PPO
Capital Blue Cross
Capital Blue Cross Group Rx (FY) (PPO) · National
Employer/retiree group
H3923-820-000 — Capital Blue Cross Group Rx (FY) (PPO) — National → H3923-832-000Local PPO
Capital Blue Cross
Capital Blue Cross Group No Rx (FY) (PPO) · National
Employer/retiree group
H3923-832-000 — Capital Blue Cross Group No Rx (FY) (PPO) — National → H3928-801-000HMO
Aetna Medicare
Aetna Medicare Plan w/Rx (HMO) · Louisiana
Employer/retiree group
H3928-801-000 — Aetna Medicare Plan w/Rx (HMO) — Louisiana → H3928-803-000HMO
Aetna Medicare
Aetna Medicare Plan (HMO) · Louisiana
Employer/retiree group
H3928-803-000 — Aetna Medicare Plan (HMO) — Louisiana → H3928-805-000HMO
Aetna Medicare
Aetna Medicare Plan (HMO) · Louisiana
Employer/retiree group
H3928-805-000 — Aetna Medicare Plan (HMO) — Louisiana → H3931-197-000HMO
Aetna Medicare
Aetna Medicare Signature (HMO) · Spokane County
H3931-197-000 — Aetna Medicare Signature (HMO) — Spokane County → H3931-801-000HMO
Aetna Medicare
Aetna Medicare Plan (HMO) · Pennsylvania
Employer/retiree group
H3931-801-000 — Aetna Medicare Plan (HMO) — Pennsylvania → H3931-804-000HMO
Aetna Medicare
Aetna Medicare Plan w/Rx (HMO) · Pennsylvania
Employer/retiree group
H3931-804-000 — Aetna Medicare Plan w/Rx (HMO) — Pennsylvania → H3931-808-000HMO
Aetna Medicare
Aetna Medicare Plan (HMO) · Pennsylvania
Employer/retiree group
H3931-808-000 — Aetna Medicare Plan (HMO) — Pennsylvania → H3959-804-000HMO
Aetna Medicare
Aetna Medicare Plan w/Rx (HMO) · Pennsylvania
Employer/retiree group
H3959-804-000 — Aetna Medicare Plan w/Rx (HMO) — Pennsylvania → H3962-801-000HMO
Capital Blue Cross
Capital Blue Cross Group Rx (CY) (HMO) · National
Employer/retiree group
H3962-801-000 — Capital Blue Cross Group Rx (CY) (HMO) — National → H3962-802-000HMO
Capital Blue Cross
Capital Blue Cross Group No Rx (CY) (HMO) · National
Employer/retiree group
H3962-802-000 — Capital Blue Cross Group No Rx (CY) (HMO) — National → H3962-813-000HMO
Capital Blue Cross
Capital Blue Cross Group Custom Rx (CY) (HMO) · National
Employer/retiree group
H3962-813-000 — Capital Blue Cross Group Custom Rx (CY) (HMO) — National → H3962-817-000HMO
Capital Blue Cross
Capital Blue Cross Group Rx (FY) (HMO) · National
Employer/retiree group
H3962-817-000 — Capital Blue Cross Group Rx (FY) (HMO) — National → H3962-828-000HMO
Capital Blue Cross
Capital Blue Cross Group No Rx (FY) (HMO) · National
Employer/retiree group
H3962-828-000 — Capital Blue Cross Group No Rx (FY) (HMO) — National → H4005-801-000Local PPO
Triple-S Advantage
Óptimo (PPO) · Puerto Rico
Employer/retiree group
H4005-801-000 — Óptimo (PPO) — Puerto Rico → H4005-802-000Local PPO
Triple-S Advantage
Óptimo Plus A (PPO) · Puerto Rico
Employer/retiree group
H4005-802-000 — Óptimo Plus A (PPO) — Puerto Rico → H4005-804-000Local PPO
Triple-S Advantage
Óptimo Plus B (PPO) · Puerto Rico
Employer/retiree group
H4005-804-000 — Óptimo Plus B (PPO) — Puerto Rico → H4026-001-000HMO
SCAN Health Plan
SCAN Classic WA (HMO) · Pierce, Thurston and Spokane Counties
H4026-001-000 — SCAN Classic WA (HMO) — Pierce, Thurston and Spokane Counties → H4026-801-000HMO
SCAN Health Plan
SCAN Retiree Group (HMO) · Pierce, Thurston, and Spokane counties
Employer/retiree group
H4026-801-000 — SCAN Retiree Group (HMO) — Pierce, Thurston, and Spokane counties → H4026-802-000HMO
SCAN Health Plan
SCAN Retiree Group (HMO) · Pierce, Thurston, and Spokane counties
Employer/retiree group
H4026-802-000 — SCAN Retiree Group (HMO) — Pierce, Thurston, and Spokane counties → H4026-803-000HMO
SCAN Health Plan
SCAN Retiree Group (HMO) · Pierce, Thurston, and Spokane counties
Employer/retiree group
H4026-803-000 — SCAN Retiree Group (HMO) — Pierce, Thurston, and Spokane counties → H4026-804-000HMO
SCAN Health Plan
SCAN Retiree Group (HMO) · Pierce, Thurston, and Spokane counties
Employer/retiree group
H4026-804-000 — SCAN Retiree Group (HMO) — Pierce, Thurston, and Spokane counties → H4036-801-000Local PPO
Anthem Blue Cross and Blue Shield
Anthem Medicare Preferred (PPO) · National
Employer/retiree group
H4036-801-000 — Anthem Medicare Preferred (PPO) — National → H4036-802-000Local PPO
Anthem Blue Cross and Blue Shield
Anthem Medicare Preferred (PPO) · National
Employer/retiree group
H4036-802-000 — Anthem Medicare Preferred (PPO) — National → H4036-805-000Local PPO
Anthem Blue Cross and Blue Shield
Anthem Medicare Preferred (PPO) · National
Employer/retiree group
H4036-805-000 — Anthem Medicare Preferred (PPO) — National → H4036-806-000Local PPO
Anthem Blue Cross and Blue Shield
Anthem Medicare Preferred (PPO) · National
Employer/retiree group
H4036-806-000 — Anthem Medicare Preferred (PPO) — National → H4036-807-000Local PPO
Anthem Blue Cross and Blue Shield
Anthem Medicare Preferred (PPO) · National
Employer/retiree group
H4036-807-000 — Anthem Medicare Preferred (PPO) — National → H4036-809-000Local PPO
Anthem Blue Cross and Blue Shield
Anthem Medicare Preferred (PPO) · National
Employer/retiree group
H4036-809-000 — Anthem Medicare Preferred (PPO) — National → H4036-810-000Local PPO
Anthem Blue Cross and Blue Shield
Anthem Medicare Preferred (PPO) · National
Employer/retiree group
H4036-810-000 — Anthem Medicare Preferred (PPO) — National → H4036-812-000Local PPO
Anthem Blue Cross and Blue Shield
Anthem Medicare Preferred (PPO) · National
Employer/retiree group
H4036-812-000 — Anthem Medicare Preferred (PPO) — National → H4036-813-000Local PPO
Anthem Blue Cross and Blue Shield
Anthem Medicare Preferred (PPO) · National
Employer/retiree group
H4036-813-000 — Anthem Medicare Preferred (PPO) — National → H4036-814-000Local PPO
Anthem Blue Cross and Blue Shield
Anthem Medicare Preferred (PPO) · National
Employer/retiree group
H4036-814-000 — Anthem Medicare Preferred (PPO) — National → H4036-819-000Local PPO
Anthem Blue Cross and Blue Shield
Anthem Medicare Preferred (PPO) · National
Employer/retiree group
H4036-819-000 — Anthem Medicare Preferred (PPO) — National → H4036-820-000Local PPO
Anthem Blue Cross and Blue Shield
Anthem Medicare Preferred (PPO) · National
Employer/retiree group
H4036-820-000 — Anthem Medicare Preferred (PPO) — National → H4036-821-000Local PPO
Anthem Blue Cross and Blue Shield
Anthem Medicare Preferred (PPO) · National
Employer/retiree group
H4036-821-000 — Anthem Medicare Preferred (PPO) — National → H4036-822-000Local PPO
Anthem Blue Cross and Blue Shield
Anthem Medicare Preferred (PPO) · National
Employer/retiree group
H4036-822-000 — Anthem Medicare Preferred (PPO) — National → H4036-823-000Local PPO
Anthem Blue Cross and Blue Shield
Anthem Medicare Preferred (PPO) · National (MA)
Employer/retiree group
H4036-823-000 — Anthem Medicare Preferred (PPO) — National (MA) → H4036-824-000Local PPO
Anthem Blue Cross and Blue Shield
Anthem Medicare Preferred (PPO) · National (MA)
Employer/retiree group
H4036-824-000 — Anthem Medicare Preferred (PPO) — National (MA) → H4036-825-000Local PPO
Anthem Blue Cross and Blue Shield
Anthem Medicare Preferred (PPO) · National (MA)
Employer/retiree group
H4036-825-000 — Anthem Medicare Preferred (PPO) — National (MA) → H4036-826-000Local PPO
Anthem Blue Cross and Blue Shield
Anthem Medicare Preferred (PPO) · National (MA)
Employer/retiree group
H4036-826-000 — Anthem Medicare Preferred (PPO) — National (MA) → H4036-827-000Local PPO
Anthem Blue Cross and Blue Shield
Anthem Medicare Preferred (PPO) · National (MD)
Employer/retiree group
H4036-827-000 — Anthem Medicare Preferred (PPO) — National (MD) → H4036-828-000Local PPO
Anthem Blue Cross and Blue Shield
Anthem Medicare Preferred (PPO) · National (MD)
Employer/retiree group
H4036-828-000 — Anthem Medicare Preferred (PPO) — National (MD) → H4036-829-000Local PPO
Anthem Blue Cross and Blue Shield
Anthem Medicare Preferred (PPO) · National (MD)
Employer/retiree group
H4036-829-000 — Anthem Medicare Preferred (PPO) — National (MD) → H4036-830-000Local PPO
Anthem Blue Cross and Blue Shield
Anthem Medicare Preferred (PPO) · National (MD)
Employer/retiree group
H4036-830-000 — Anthem Medicare Preferred (PPO) — National (MD) → H4213-801-000PFFS
Arkansas Blue Medicare
BlueMedicare Preferred Group CY (PFFS) · Employer Group Plan
Employer/retiree group
H4213-801-000 — BlueMedicare Preferred Group CY (PFFS) — Employer Group Plan → H4213-802-000PFFS
Arkansas Blue Medicare
BlueMedicare Preferred Group NCY (PFFS) · Employer Group Plan
Employer/retiree group
H4213-802-000 — BlueMedicare Preferred Group NCY (PFFS) — Employer Group Plan → H4213-803-000PFFS
Arkansas Blue Medicare
BlueMedicare Value Group CY (PFFS) · Employer Group Plan
Employer/retiree group
H4213-803-000 — BlueMedicare Value Group CY (PFFS) — Employer Group Plan → H4213-804-000PFFS
Arkansas Blue Medicare
BlueMedicare Value Group NCY (PFFS) · Employer Group Plan
Employer/retiree group
H4213-804-000 — BlueMedicare Value Group NCY (PFFS) — Employer Group Plan → H4407-033-000HMO
HealthSpring
HealthSpring Preferred (HMO) · Spokane
H4407-033-000 — HealthSpring Preferred (HMO) — Spokane → H4497-801-000Local PPO
Medical Mutual of Ohio
MedMutual Advantage EGWP (Calendar Year) (PPO) · Ohio Regions
Employer/retiree group
H4497-801-000 — MedMutual Advantage EGWP (Calendar Year) (PPO) — Ohio Regions → H4497-802-000Local PPO
Medical Mutual of Ohio
MedMutual Advantage EGWP (Non-Calendar Year) (PPO) · Ohio Regions
Employer/retiree group
H4497-802-000 — MedMutual Advantage EGWP (Non-Calendar Year) (PPO) — Ohio Regions → H4497-803-000Local PPO
Medical Mutual of Ohio
MedMutual Advantage EGWP (MA-Only) (PPO) · Ohio Regions
Employer/retiree group
H4497-803-000 — MedMutual Advantage EGWP (MA-Only) (PPO) — Ohio Regions → H4513-821-000HMO
HealthSpring
HealthSpring Preferred (HMO) · Nationwide
Employer/retiree group
H4513-821-000 — HealthSpring Preferred (HMO) — Nationwide → H4523-801-000HMO
Aetna Medicare
Aetna Medicare Plan (HMO) · Texas
Employer/retiree group
H4523-801-000 — Aetna Medicare Plan (HMO) — Texas → H4523-802-000HMO
Aetna Medicare
Aetna Medicare Plan w/Rx (HMO) · Texas
Employer/retiree group
H4523-802-000 — Aetna Medicare Plan w/Rx (HMO) — Texas → H4523-805-000HMO
Aetna Medicare
Aetna Medicare Plan (HMO) · Texas
Employer/retiree group
H4523-805-000 — Aetna Medicare Plan (HMO) — Texas → H4605-801-000Local PPO
Regence BlueCross BlueShield of Utah
Regence MedAdvantage (PPO) · Nationwide except territories
Employer/retiree group
H4605-801-000 — Regence MedAdvantage (PPO) — Nationwide except territories → H4605-802-000Local PPO
Regence BlueCross BlueShield of Utah
Regence MedAdvantage + Rx (PPO) · Nationwide except territories
Employer/retiree group
H4605-802-000 — Regence MedAdvantage + Rx (PPO) — Nationwide except territories → H4711-801-000HMO
Aetna Medicare
Aetna Medicare Plan (HMO) · Colorado and Nevada
Employer/retiree group
H4711-801-000 — Aetna Medicare Plan (HMO) — Colorado and Nevada → H4835-801-000HMO
Aetna Medicare
Aetna Medicare Plan (HMO) · Arizona
Employer/retiree group
H4835-801-000 — Aetna Medicare Plan (HMO) — Arizona → H4875-803-000Local PPO
Priority Health Medicare
PriorityMedicare PPO EG Non-Calendar Year (PPO) · National
Employer/retiree group
H4875-803-000 — PriorityMedicare PPO EG Non-Calendar Year (PPO) — National → H4875-804-000Local PPO
Priority Health Medicare
PriorityMedicare PPO EG Calendar Year (PPO) · National
Employer/retiree group
H4875-804-000 — PriorityMedicare PPO EG Calendar Year (PPO) — National → H4875-805-000Local PPO
Priority Health Medicare
PriorityMedicare PPO No RX EGWP Calendar (PPO) · National
Employer/retiree group
H4875-805-000 — PriorityMedicare PPO No RX EGWP Calendar (PPO) — National → H4875-806-000Local PPO
Priority Health Medicare
PriorityMedicare PPO No RX EGWP Non-Calendar (PPO) · National
Employer/retiree group
H4875-806-000 — PriorityMedicare PPO No RX EGWP Non-Calendar (PPO) — National → H4875-807-000Local PPO
Priority Health Medicare
PriorityMedicare EG Calendar Year $50 Part B PPO (PPO) · United States and its territories
Employer/retiree group
H4875-807-000 — PriorityMedicare EG Calendar Year $50 Part B PPO (PPO) — United States and its territories → H4875-810-000Local PPO
Priority Health Medicare
PriorityMedicare EG Calendar Year $125 Buy Back (PPO) · United States and its territories
Employer/retiree group
H4875-810-000 — PriorityMedicare EG Calendar Year $125 Buy Back (PPO) — United States and its territories → H4882-801-000Local PPO
HealthPartners
HealthPartners Group MAPD CY (PPO) · All States Excluding Cost Counties
Employer/retiree group
H4882-801-000 — HealthPartners Group MAPD CY (PPO) — All States Excluding Cost Counties → H4882-803-000Local PPO
HealthPartners
HealthPartners Group MA Only (PPO) · All States Excluding Cost Counties
Employer/retiree group
H4882-803-000 — HealthPartners Group MA Only (PPO) — All States Excluding Cost Counties → H4882-804-000Local PPO
HealthPartners
HealthPartners Group II MAPD CY (PPO) · All States Excluding Cost Counties
Employer/retiree group
H4882-804-000 — HealthPartners Group II MAPD CY (PPO) — All States Excluding Cost Counties → H4882-805-000Local PPO
HealthPartners
HealthPartners Group II MA Only (PPO) · All States Excluding Cost Counties
Employer/retiree group
H4882-805-000 — HealthPartners Group II MA Only (PPO) — All States Excluding Cost Counties → H4882-806-000Local PPO
HealthPartners
HealthPartners Group III MAPD CY (PPO) · All States Excluding Cost Counties
Employer/retiree group
H4882-806-000 — HealthPartners Group III MAPD CY (PPO) — All States Excluding Cost Counties → H4909-804-000Local PPO
Anthem Blue Cross and Blue Shield
Anthem Medicare Preferred (PPO) · National
Employer/retiree group
H4909-804-000 — Anthem Medicare Preferred (PPO) — National → H4909-805-000Local PPO
Anthem Blue Cross and Blue Shield
Anthem Medicare Preferred (PPO) · National
Employer/retiree group
H4909-805-000 — Anthem Medicare Preferred (PPO) — National → H4909-810-000Local PPO
Anthem Blue Cross and Blue Shield
Anthem Medicare Preferred (PPO) · National
Employer/retiree group
H4909-810-000 — Anthem Medicare Preferred (PPO) — National → H4909-811-000Local PPO
Anthem Blue Cross and Blue Shield
Anthem Medicare Preferred (PPO) · National
Employer/retiree group
H4909-811-000 — Anthem Medicare Preferred (PPO) — National → H4909-812-000Local PPO
Anthem Blue Cross and Blue Shield
Anthem Medicare Preferred (PPO) · National
Employer/retiree group
H4909-812-000 — Anthem Medicare Preferred (PPO) — National → H4909-814-000Local PPO
Anthem Blue Cross and Blue Shield
Anthem Medicare Preferred (PPO) · National
Employer/retiree group
H4909-814-000 — Anthem Medicare Preferred (PPO) — National → H4909-815-000Local PPO
Anthem Blue Cross and Blue Shield
Anthem Medicare Preferred (PPO) · National
Employer/retiree group
H4909-815-000 — Anthem Medicare Preferred (PPO) — National → H4909-817-000Local PPO
Anthem Blue Cross and Blue Shield
Anthem Medicare Preferred (PPO) · National
Employer/retiree group
H4909-817-000 — Anthem Medicare Preferred (PPO) — National → H4909-818-000Local PPO
Anthem Blue Cross and Blue Shield
Anthem Medicare Preferred (PPO) · National
Employer/retiree group
H4909-818-000 — Anthem Medicare Preferred (PPO) — National → H4937-801-000Local PPO
Blue Shield of California
Blue Shield Medicare (PPO) · GMAPD PPO
Employer/retiree group
H4937-801-000 — Blue Shield Medicare (PPO) — GMAPD PPO → H4937-802-000Local PPO
Blue Shield of California
Blue Shield Medicare (PPO) · GMAPD PPO
Employer/retiree group
H4937-802-000 — Blue Shield Medicare (PPO) — GMAPD PPO → H4937-803-000Local PPO
Blue Shield of California
Blue Shield Medicare without Rx (PPO) · GMA-only PPO
Employer/retiree group
H4937-803-000 — Blue Shield Medicare without Rx (PPO) — GMA-only PPO → H4937-804-000Local PPO
Blue Shield of California
Blue Shield Medicare without Rx (PPO) · GMA-only PPO
Employer/retiree group
H4937-804-000 — Blue Shield Medicare without Rx (PPO) — GMA-only PPO → H4937-805-000Local PPO
Blue Shield of California
CCPOA Medical Plan Medicare (PPO) · GMAPD PPO for CCPOA Only
Employer/retiree group
H4937-805-000 — CCPOA Medical Plan Medicare (PPO) — GMAPD PPO for CCPOA Only → H4937-806-000Local PPO
Blue Shield of California
Blue Shield Medicare (PPO) · GMAPD PPO Part B Only
Employer/retiree group
H4937-806-000 — Blue Shield Medicare (PPO) — GMAPD PPO Part B Only → H4937-807-000Local PPO
Blue Shield of California
Blue Shield Medicare (PPO) · GMAPD PPO Part B Only
Employer/retiree group
H4937-807-000 — Blue Shield Medicare (PPO) — GMAPD PPO Part B Only → H4937-808-000Local PPO
Blue Shield of California
Blue Shield Medicare (PPO) · GMAPD PPO
Employer/retiree group
H4937-808-000 — Blue Shield Medicare (PPO) — GMAPD PPO →