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Medication coverage guide

Ezetimibe (Zetia and others)

Generic name: Ezetimibe

What it is used for

A cholesterol-lowering medicine that reduces how much cholesterol the gut absorbs; it is often taken with a statin, or instead of one, to lower LDL cholesterol.

Which part of Medicare may cover it

Part D (tablets taken at home). Part A during a covered inpatient stay. No Part B clinician-administered form in the CMS Part B spending file.

Medicare Advantage

Most Medicare Advantage plans that include drug coverage (MAPD plans) use the same formulary-and-tier system; the plan's own drug list decides coverage and copay — check the plan's formulary.

Medicare Supplement

Medicare Supplement (Medigap) plans sold today do not include prescription drug coverage; drug coverage comes from Part D or an MAPD plan.

Part D formulary figures for 2027

Plans listing this drug
5,495 of 5,495
Listing share
100%
Most common tier
Tier 1
Share of listing plans at that tier
67.72%

Full tier distribution

TierPlans
Tier 13,721
Tier 21,461
Tier 3229
Tier 457
Tier 627

CMS dashboard figures

Program averages from CMS dashboard data — average total spending across Part D (before rebates), NOT a reader's copay.

Ezetimibe

Brand name
Ezetimibe
Generic name
Ezetimibe
Total claims (2024)
8,748,229
Total program spending (2024)
208,731,153.2
Total beneficiaries (2024)
2,411,057
Rank by beneficiaries (2024)
54
Average spending per claim (2024)
23.859818164
Average spending per beneficiary (2024)
86.572467262
Average spending per dosage unit, weighted (2024)
0.3191986617

Zetia

Brand name
Zetia
Generic name
Ezetimibe
Total claims (2024)
7,124
Total program spending (2024)
5,835,522.45
Total beneficiaries (2024)
1,813
Rank by beneficiaries (2024)
1,570
Average spending per claim (2024)
819.13566115
Average spending per beneficiary (2024)
3,218.7106729
Average spending per dosage unit, weighted (2024)
12.442027581

Part B status

No ezetimibe row in the CMS Part B Spending by Drug HCPCS file (RY26, data through 2024) — no J-code basis; coverage path is Part D.

Package notes

Dashboard rank 54 by beneficiaries 2024 (2,411,057). Dashboard rank 53 (empagliflozin / Jardiance) is already gated in Batch 1, and rank 60 (Ondansetron HCl) is the same drug as the gated ondansetron package in Batch 6 — a dashboard salt-name split, handled explicitly here and not re-gated. The resolved set contains ezetimibe-simvastatin and bempedoic acid-ezetimibe combination concepts; the established combination exclusion keeps only the single-ingredient ezetimibe tablet concept.

Company rollup

Every organization below has at least one plan in the supplied plan-coverage file that lists this medication.

OrganizationPlans listing the drugTier rangeTier distribution
ABSOLUTE TOTAL CARE, INC.1Tier 1Tier 1: 1
AETNA BETTER HEALTH INC. (CT)4Tier 1–2Tier 1: 1 · Tier 2: 3
AETNA BETTER HEALTH INC. (GA)27Tier 1–2Tier 1: 5 · Tier 2: 22
AETNA BETTER HEALTH INC. (NJ)1Tier 2Tier 2: 1
AETNA BETTER HEALTH OF CALIFORNIA INC.8Tier 2Tier 2: 8
AETNA BETTER HEALTH OF MICHIGAN INC.3Tier 2Tier 2: 3
AETNA BETTER HEALTH OF OKLAHOMA INC.1Tier 2Tier 2: 1
AETNA BETTER HEALTH OF TEXAS INC.6Tier 2Tier 2: 6
AETNA BETTER HEALTH OF WASHINGTON, INC.2Tier 1–2Tier 1: 1 · Tier 2: 1
AETNA BETTER HEALTH PREMIER PLAN MMAI INC.1Tier 2Tier 2: 1
AETNA BETTER HEALTH, INC. (LA)16Tier 1–2Tier 1: 1 · Tier 2: 15
AETNA HEALTH AND LIFE INSURANCE COMPANY20Tier 2Tier 2: 20
AETNA HEALTH INC. (CT)6Tier 2Tier 2: 6
AETNA HEALTH INC. (FL)49Tier 1–2Tier 1: 10 · Tier 2: 39
AETNA HEALTH INC. (GA)7Tier 1–2Tier 1: 1 · Tier 2: 6
AETNA HEALTH INC. (LA)1Tier 2Tier 2: 1
AETNA HEALTH INC. (ME)5Tier 2Tier 2: 5
AETNA HEALTH INC. (NJ)5Tier 2Tier 2: 5
AETNA HEALTH INC. (NY)18Tier 1–2Tier 1: 4 · Tier 2: 14
AETNA HEALTH INC. (PA)49Tier 1–2Tier 1: 9 · Tier 2: 40
AETNA HEALTH INC. (TX)29Tier 1–2Tier 1: 10 · Tier 2: 19
AETNA HEALTH OF CALIFORNIA INC.17Tier 1–2Tier 1: 5 · Tier 2: 12
AETNA HEALTH OF IOWA INC.8Tier 1–2Tier 1: 3 · Tier 2: 5
AETNA HEALTH OF MICHIGAN INC.12Tier 1–2Tier 1: 5 · Tier 2: 7
AETNA HEALTH OF OHIO INC.24Tier 1–2Tier 1: 11 · Tier 2: 13
AETNA HEALTH OF UTAH INC.2Tier 2Tier 2: 2
AETNA LIFE INSURANCE COMPANY181Tier 2Tier 2: 181
AIDS HEALTHCARE FOUNDATION1Tier 1Tier 1: 1
ALAMEDA ALLIANCE FOR HEALTH1Tier 1Tier 1: 1
ALIGN SENIOR CARE CALIFORNIA INC.3Tier 1Tier 1: 3
ALIGN SENIOR CARE FLORIDA, INC.2Tier 1Tier 1: 2
ALIGN SENIOR CARE IOWA INSURANCE COMPANY2Tier 1Tier 1: 2
ALIGN SENIOR CARE MI, LLC2Tier 1Tier 1: 2
ALIGNMENT HEALTH ADVANTAGE PLAN INC4Tier 1Tier 1: 4
ALIGNMENT HEALTH ADVANTAGE PLAN INC.5Tier 1Tier 1: 5
ALIGNMENT HEALTH INSURANCE COMPANY OF ARIZONA INC10Tier 1Tier 1: 10
ALIGNMENT HEALTH PLAN37Tier 1Tier 1: 37
ALIGNMENT HEALTH PLAN OF ARIZONA, INC.7Tier 1Tier 1: 7
ALIGNMENT HEALTH PLAN OF NEVADA, INC.4Tier 1Tier 1: 4
ALIGNMENT HEALTH PLAN OF NORTH CAROLINA, INC.10Tier 1Tier 1: 10
ALLCARE HEALTH PLAN, INC.1Tier 1Tier 1: 1
ALLIANCE HEALTH AND LIFE INSURANCE COMPANY5Tier 2Tier 2: 5
ALLINA HEALTH AND AETNA INSURANCE COMPANY7Tier 1–2Tier 1: 2 · Tier 2: 5
ALOHACARE1Tier 2Tier 2: 1
ALTERWOOD ADVANTAGE, INC.6Tier 1Tier 1: 6
AMERICAN HEALTH PLAN OF FL, INC.1Tier 1Tier 1: 1
AMERICAN HEALTH PLAN OF INDIANA INC3Tier 1Tier 1: 3
AMERICAN HEALTH PLAN OF IOWA INC3Tier 1Tier 1: 3
AMERICAN HEALTH PLAN OF MISSOURI, INC.2Tier 1Tier 1: 2
AMERICAN HEALTH PLAN OF MS, INC.1Tier 1Tier 1: 1
AMERICAN HEALTH PLAN OF PENNSYLVANIA INC1Tier 1Tier 1: 1
AMERICAN HEALTH PLAN OF UT, INC.2Tier 1Tier 1: 2
AMERICAN HEALTH PLAN, INC.1Tier 1Tier 1: 1
AMERICAN PROGRESSIVE LIFE & HLTH INS COMPANY OF NY6Tier 1Tier 1: 6
AMERIHEALTH CARITAS FLORIDA, INC.2Tier 2Tier 2: 2
AMERIHEALTH CARITAS LOUISIANA, INC.1Tier 2Tier 2: 1
AMERIHEALTH CARITAS NORTH CAROLINA, INC.1Tier 2Tier 2: 1
AMERIHEALTH HMO, INC1Tier 2Tier 2: 1
AMERIHEALTH INSURANCE COMPANY OF NEW JERSEY1Tier 2Tier 2: 1
AMERIHEALTH MICHIGAN, INC.2Tier 2Tier 2: 2
AMH HEALTH, LLC5Tier 1Tier 1: 5
ANTHEM HEALTH PLANS, INC.6Tier 1Tier 1: 6
ANTHEM HP, LLC.6Tier 1Tier 1: 6
ANTHEM INSURANCE CO. & BCBSMA & BCBSRI & BCBSVT2Tier 1–2Tier 1: 1 · Tier 2: 1
ANTHEM INSURANCE COMPANIES, INC.27Tier 1Tier 1: 27
ARCADIAN HEALTH PLAN, INC.71Tier 1Tier 1: 71
ARIZONA PHYSICIANS IPA, INC.2Tier 1Tier 1: 2
ARKANSAS HEALTH & WELLNESS HEALTH PLAN, INC.4Tier 1Tier 1: 4
ARKANSAS SUPERIOR SELECT, INC.2Tier 1Tier 1: 2
ASPIRE HEALTH PLAN4Tier 2Tier 2: 4
ASTIVA HEALTH, INC.8Tier 2Tier 2: 8
ATRIO HEALTH PLANS11Tier 1Tier 1: 11
AULTCARE HEALTH INSURING CORPORATION3Tier 2Tier 2: 3
AmeriHealth Caritas VIP Next, Inc.2Tier 2Tier 2: 2
Anthem HP, LLC5Tier 1Tier 1: 5
BANNER - UNIVERSITY CARE ADVANTAGE2Tier 1Tier 1: 2
BANNER HEALTH PLAN, INC.1Tier 2Tier 2: 1
BAYCARE SELECT HEALTH PLANS, INC.2Tier 1Tier 1: 2
BCBS OF MASSACHUSETTS HMO BLUE, INC.7Tier 1Tier 1: 7
BCBS OF ALABAMA & UTIC INSURANCE COMPANY2Tier 2Tier 2: 2
BCBS OF MICHIGAN MUTUAL INSURANCE COMPANY26Tier 3Tier 3: 26
BCBSM, Inc.9Tier 2Tier 2: 9
BESHP, INC.2Tier 2Tier 2: 2
BLUE CARE NETWORK OF MICHIGAN15Tier 3Tier 3: 15
BLUE CROSS & BLUE SHIELD OF RHODE ISLAND5Tier 2Tier 2: 5
BLUE CROSS AND BLUE SHIELD OF ALABAMA3Tier 2Tier 2: 3
BLUE CROSS AND BLUE SHIELD OF FLORIDA, INC.14Tier 2Tier 2: 14
BLUE CROSS AND BLUE SHIELD OF KANSAS3Tier 2Tier 2: 3
BLUE CROSS AND BLUE SHIELD OF NORTH CAROLINA14Tier 2Tier 2: 14
BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF GEORGIA4Tier 1Tier 1: 4
BLUE CROSS OF CALIFORNIA18Tier 1Tier 1: 18
BLUE CROSS OF CALIFORNIA PARTNERSHIP PLAN, INC.18Tier 1Tier 1: 18
BLUE CROSS OF IDAHO HEALTH SERVICE, INC.6Tier 2Tier 2: 6
BLUECROSS AND BLUESHIELD OF SOUTH CAROLINA6Tier 2Tier 2: 6
BLUECROSS BLUESHIELD KANSAS SOLUTIONS, INC.3Tier 2Tier 2: 3
BLUECROSS BLUESHIELD OF TENNESSEE, INC.19Tier 1Tier 1: 19
BRAVO HEALTH MID-ATLANTIC, INC.5Tier 1–3Tier 1: 4 · Tier 3: 1
BRAVO HEALTH PENNSYLVANIA, INC.31Tier 1–3Tier 1: 26 · Tier 3: 5
BUCKEYE COMMUNITY HEALTH PLAN, INC.4Tier 1Tier 1: 4
Baylor Scott & White Insurance Company3Tier 2Tier 2: 3
Bridgeway Health Solutions of Arizona, Inc.2Tier 1Tier 1: 2
CALIFORNIA PHYSICIANS' SERVICE20Tier 2–3Tier 2: 19 · Tier 3: 1
CAPITAL ADVANTAGE INSURANCE COMPANY24Tier 2Tier 2: 24
CAPITAL DISTRICT PHYSICIANS' HEALTH PLAN, INC.3Tier 1Tier 1: 3
CAPITAL HEALTH PLAN4Tier 2Tier 2: 4
CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO.204Tier 1Tier 1: 204
CARE N' CARE INSURANCE COMPANY OF NORTH CAROLINA4Tier 2Tier 2: 4
CAREFIRST ADVANTAGE DSNP, INC.1Tier 1Tier 1: 1
CAREFIRST ADVANTAGE PPO, INC.4Tier 1Tier 1: 4
CAREPLUS HEALTH PLANS, INC.37Tier 1Tier 1: 37
CARESOURCE OHIO, INC.1Tier 1Tier 1: 1
CARITEN HEALTH PLAN INC.51Tier 1Tier 1: 51
CELTIC INSURANCE COMPANY3Tier 1Tier 1: 3
CHA HMO, INC.47Tier 1Tier 1: 47
CHAMPION HEALTH PLAN OF CALIFORNIA INC10Tier 1Tier 1: 10
CHAMPION HEALTH PLAN OF NEVADA, INC.6Tier 1Tier 1: 6
CHINESE COMMUNITY HEALTH PLAN4Tier 1Tier 1: 4
CLEVER CARE OF GOLDEN STATE, INC.6Tier 1Tier 1: 6
CLOVER HMO OF NEW JERSEY INC.2Tier 2Tier 2: 2
CLOVER INSURANCE COMPANY11Tier 2Tier 2: 11
COMMONWEALTH CARE ALLIANCE, INC.2Tier 1Tier 1: 2
COMMUNITY CARE HEALTH PLAN OF LOUISIANA, INC.2Tier 1Tier 1: 2
COMMUNITY CARE HEALTH PLAN, INC.1Tier 1Tier 1: 1
COMMUNITY FIRST HEALTH PLANS, INC.3Tier 1Tier 1: 3
COMMUNITY HEALTH CHOICE TEXAS, INC.5Tier 1Tier 1: 5
COMMUNITY HEALTH GROUP2Tier 1Tier 1: 2
COMMUNITY HEALTH PLAN OF WASHINGTON2Tier 2Tier 2: 2
COMMUNITY INSURANCE COMPANY10Tier 1Tier 1: 10
COMMUNITYCARE GOVERNMENT PROGRAMS, INC.4Tier 1Tier 1: 4
COMPCARE HEALTH SERVICES INSURANCE CORPORATION16Tier 1Tier 1: 16
CONTRA COSTA COUNTY MEDICAL SERVICE DBA CONTRA COSTA HEALTH1Tier 1Tier 1: 1
COORDINATED CARE CORPORATION3Tier 1Tier 1: 3
COORDINATED CARE OF WASHINGTON, INC.2Tier 1Tier 1: 2
COVENTRY HEALTH AND LIFE INSURANCE COMPANY27Tier 2Tier 2: 27
COVENTRY HEALTH CARE OF ILLINOIS, INC.14Tier 1–2Tier 1: 1 · Tier 2: 13
COVENTRY HEALTH CARE OF KANSAS, INC.9Tier 2Tier 2: 9
COVENTRY HEALTH CARE OF MISSOURI, INC.35Tier 1–2Tier 1: 6 · Tier 2: 29
COVENTRY HEALTH CARE OF NEBRASKA, INC.3Tier 2Tier 2: 3
COVENTRY HEALTH CARE OF VIRGINIA, INC.1Tier 2Tier 2: 1
COVENTRY HEALTH CARE OF WEST VIRGINIA, INC.6Tier 2Tier 2: 6
COX HEALTH SYSTEMS HMO INC3Tier 1Tier 1: 3
California Physicians' Service2Tier 2Tier 2: 2
DEAN HEALTH PLAN, INC.4Tier 6Tier 6: 4
DENVER HEALTH MEDICAL PLAN, INC.2Tier 1Tier 1: 2
DEVOTED HEALTH PLAN OF OREGON1Tier 1Tier 1: 1
DEVOTED HEALTH INSURANCE COMPANY5Tier 1Tier 1: 5
DEVOTED HEALTH INSURANCE COMPANY OF ALABAMA INC12Tier 1Tier 1: 12
DEVOTED HEALTH INSURANCE COMPANY OF ARIZONA, INC.4Tier 1Tier 1: 4
DEVOTED HEALTH INSURANCE COMPANY OF ARKANSAS INC10Tier 1Tier 1: 10
DEVOTED HEALTH INSURANCE COMPANY OF COLORADO INC4Tier 1Tier 1: 4
DEVOTED HEALTH INSURANCE COMPANY OF CONNECTICUT12Tier 1Tier 1: 12
DEVOTED HEALTH INSURANCE COMPANY OF DELAWARE5Tier 1Tier 1: 5
DEVOTED HEALTH INSURANCE COMPANY OF GEORGIA INC16Tier 1Tier 1: 16
DEVOTED HEALTH INSURANCE COMPANY OF HAWAII INC9Tier 1Tier 1: 9
DEVOTED HEALTH INSURANCE COMPANY OF INDIANA23Tier 1Tier 1: 23
DEVOTED HEALTH INSURANCE COMPANY OF KANSAS11Tier 1Tier 1: 11
DEVOTED HEALTH INSURANCE COMPANY OF KENTUCKY INC10Tier 1Tier 1: 10
DEVOTED HEALTH INSURANCE COMPANY OF LOUISIANA23Tier 1Tier 1: 23
DEVOTED HEALTH INSURANCE COMPANY OF MICHIGAN12Tier 1Tier 1: 12
DEVOTED HEALTH INSURANCE COMPANY OF MISSISSIPPI10Tier 1Tier 1: 10
DEVOTED HEALTH INSURANCE COMPANY OF MISSOURI4Tier 1Tier 1: 4
DEVOTED HEALTH INSURANCE COMPANY OF NEBRASKA8Tier 1Tier 1: 8
DEVOTED HEALTH INSURANCE COMPANY OF NEW HAMPSHIRE6Tier 1Tier 1: 6
DEVOTED HEALTH INSURANCE COMPANY OF NEW JERSEY6Tier 1Tier 1: 6
DEVOTED HEALTH INSURANCE COMPANY OF NEW YORK23Tier 1Tier 1: 23
DEVOTED HEALTH INSURANCE COMPANY OF OKLAHOMA12Tier 1Tier 1: 12
DEVOTED HEALTH INSURANCE COMPANY OF PENNSYLVANIA INC5Tier 1Tier 1: 5
DEVOTED HEALTH INSURANCE COMPANY OF SOUTH CAROLINA INC43Tier 1Tier 1: 43
DEVOTED HEALTH INSURANCE COMPANY OF TENNESSEE INC7Tier 1Tier 1: 7
DEVOTED HEALTH INSURANCE COMPANY OF TEXAS1Tier 1Tier 1: 1
DEVOTED HEALTH INSURANCE COMPANY OF UTAH, INC.7Tier 1Tier 1: 7
DEVOTED HEALTH INSURANCE COMPANY OF WASHINGTON4Tier 1Tier 1: 4
DEVOTED HEALTH PLAN OF ALABAMA INC6Tier 1Tier 1: 6
DEVOTED HEALTH PLAN OF ARIZONA, INC.12Tier 1Tier 1: 12
DEVOTED HEALTH PLAN OF COLORADO INC17Tier 1Tier 1: 17
DEVOTED HEALTH PLAN OF FLORIDA, INC.100Tier 1Tier 1: 100
DEVOTED HEALTH PLAN OF HAWAII, INC.9Tier 1Tier 1: 9
DEVOTED HEALTH PLAN OF ILLINOIS, INC.6Tier 1Tier 1: 6
DEVOTED HEALTH PLAN OF MISSOURI INC27Tier 1Tier 1: 27
DEVOTED HEALTH PLAN OF NEW MEXICO, INC.11Tier 1Tier 1: 11
DEVOTED HEALTH PLAN OF NORTH CAROLINA INC36Tier 1Tier 1: 36
DEVOTED HEALTH PLAN OF OHIO INC2Tier 1Tier 1: 2
DEVOTED HEALTH PLAN OF OHIO, INC.20Tier 1Tier 1: 20
DEVOTED HEALTH PLAN OF OREGON INC22Tier 1Tier 1: 22
DEVOTED HEALTH PLAN OF PENNSYLVANIA INC30Tier 1Tier 1: 30
DEVOTED HEALTH PLAN OF SOUTH CAROLINA INC1Tier 1Tier 1: 1
DEVOTED HEALTH PLAN OF TENNESSEE INC9Tier 1Tier 1: 9
DEVOTED HEALTH PLAN OF TEXAS, INC.75Tier 1Tier 1: 75
DEVOTED HEALTH PLAN OF VIRGINIA INC16Tier 1Tier 1: 16
DEVOTED HEALTH PLAN OF WASHINGTON, INC.18Tier 1Tier 1: 18
DIGNITY CARE CORPORATION2Tier 1Tier 1: 2
DOCTORS HEALTHCARE PLANS, INC.9Tier 2Tier 2: 9
Devoted Health Insurance Company of Illinois, Inc.2Tier 1Tier 1: 2
Devoted of Illinois, Inc.16Tier 1Tier 1: 16
EL PASO FIRST HEALTH PLANS, INC.4Tier 1Tier 1: 4
ELDERPLAN, INC.4Tier 1Tier 1: 4
ELDERSERVE HEALTH, INC.2Tier 1Tier 1: 2
ELITE HEALTH PLAN, INC.2Tier 1Tier 1: 2
EMPHESYS INSURANCE COMPANY111Tier 1Tier 1: 111
ESSENCE HEALTHCARE PPO, INC.7Tier 2Tier 2: 7
ESSENCE HEALTHCARE, INC.7Tier 2Tier 2: 7
ETERNALHEALTH OF ARIZONA INC3Tier 2Tier 2: 3
ETERNALHEALTH, INC.3Tier 2Tier 2: 3
EXCELLUS HEALTH PLAN COMMUNITY CARE LLC4Tier 1Tier 1: 4
EXCELLUS HEALTH PLAN, INC.14Tier 1Tier 1: 14
FALLON COMMUNITY HEALTH PLAN12Tier 1–2Tier 1: 2 · Tier 2: 10
FIRST HEALTH LIFE & HEALTH INSURANCE COMPANY1Tier 2Tier 2: 1
FLORIDA BLUE MEDICARE, INC.20Tier 2Tier 2: 20
FREEDOM HEALTH, INC.24Tier 1Tier 1: 24
GATEWAY HEALTH PLAN, INC.4Tier 4Tier 4: 4
GEISINGER HEALTH PLAN9Tier 1Tier 1: 9
GEISINGER INDEMNITY INSURANCE COMPANY4Tier 1Tier 1: 4
GEORGIA ASSURANCE, INC.2Tier 1Tier 1: 2
GLOBALHEALTH, INC.6Tier 1Tier 1: 6
GOLD KIDNEY OF ARIZONA6Tier 1Tier 1: 6
GOLD KIDNEY OF FLORIDA INC9Tier 1Tier 1: 9
GOOD SAMARITAN INSURANCE PLAN OF NEBRASKA, INC.2Tier 2Tier 2: 2
GROUP HEALTH COOPERATIVE OF EAU CLAIRE2Tier 2Tier 2: 2
HAMASPIK, INC.2Tier 1Tier 1: 2
HAP CARESOURCE1Tier 2Tier 2: 1
HARMONY HEALTH PLAN, INC.14Tier 1Tier 1: 14
HAWAII MEDICAL SERVICE ASSOCIATION4Tier 1Tier 1: 4
HAWAII MEDICAL SERVICE ASSOCIATION (HMSA)2Tier 1Tier 1: 2
HEALTH ALLIANCE PLAN OF MICHIGAN7Tier 2Tier 2: 7
HEALTH CARE SERVICE CORPORATION5Tier 2Tier 2: 5
HEALTH CHOICE ARIZONA, INC.1Tier 1Tier 1: 1
HEALTH FIRST HEALTH PLANS6Tier 2Tier 2: 6
HEALTH INSURANCE PLAN OF GREATER NEW YORK9Tier 2Tier 2: 9
HEALTH NET COMMUNITY SOLUTIONS, INC.4Tier 1Tier 1: 4
HEALTH NET HEALTH PLAN OF OREGON, INC.2Tier 1Tier 1: 2
HEALTH NET LIFE INSURANCE COMPANY4Tier 1Tier 1: 4
HEALTH NET OF ARIZONA, INC.5Tier 1Tier 1: 5
HEALTH NET OF CALIFORNIA, INC.8Tier 1Tier 1: 8
HEALTH NEW ENGLAND, INC.6Tier 2Tier 2: 6
HEALTH PARTNERS PLANS, INC.7Tier 2Tier 2: 7
HEALTH PLAN OF CAREOREGON, INC.1Tier 1Tier 1: 1
HEALTHFIRST HEALTH PLAN, INC.7Tier 1Tier 1: 7
HEALTHFIRST INSURANCE COMPANY, INC.1Tier 1Tier 1: 1
HEALTHKEEPERS, INC.22Tier 1Tier 1: 22
HEALTHPARTNERS INSURANCE COMPANY2Tier 2Tier 2: 2
HEALTHPARTNERS, INC.5Tier 2Tier 2: 5
HEALTHSPRING HEALTHCARE OF COLORADO, INC.5Tier 1Tier 1: 5
HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC.135Tier 1–3Tier 1: 109 · Tier 3: 26
HEALTHSPRING OF FLORIDA, INC.10Tier 1–3Tier 1: 3 · Tier 3: 7
HEALTHSUN HEALTH PLANS, INC.11Tier 2Tier 2: 11
HEALTHY ARKANSAS, INC.3Tier 2Tier 2: 3
HEALTHY MISSISSIPPI, INC.3Tier 2Tier 2: 3
HIGHMARK BCBSD INC.3Tier 2Tier 2: 3
HIGHMARK BCBSD, INC.2Tier 4Tier 4: 2
HIGHMARK CHOICE COMPANY31Tier 2Tier 2: 31
HIGHMARK HEALTH OPTIONS WEST VIRGINIA INC.1Tier 4Tier 4: 1
HIGHMARK SENIOR HEALTH COMPANY38Tier 2Tier 2: 38
HIGHMARK SENIOR SOLUTIONS COMPANY8Tier 2Tier 2: 8
HMO COLORADO, INC.11Tier 1Tier 1: 11
HMO LOUISIANA, INC.9Tier 2Tier 2: 9
HMO Minnesota1Tier 2Tier 2: 1
HOME STATE HEALTH PLAN, INC.3Tier 1Tier 1: 3
HOPKINS HEALTH ADVANTAGE, INC.6Tier 1Tier 1: 6
HORIZON HEALTHCARE OF NEW JERSEY, INC.2Tier 1–2Tier 1: 1 · Tier 2: 1
HORIZON INSURANCE COMPANY2Tier 2Tier 2: 2
HPMP OF FLORIDA, INC.5Tier 2Tier 2: 5
HUMANA BENEFIT PLAN OF ILLINOIS, INC.33Tier 1Tier 1: 33
HUMANA BENEFIT PLAN OF SOUTH CAROLINA, INC.1Tier 1Tier 1: 1
HUMANA EMPLOYERS HEALTH PLAN OF GEORGIA, INC.7Tier 1Tier 1: 7
HUMANA HEALTH BENEFIT PLAN OF LOUISIANA, INC.23Tier 1Tier 1: 23
HUMANA HEALTH COMPANY OF NEW YORK, INC.5Tier 1Tier 1: 5
HUMANA HEALTH INSURANCE COMPANY OF FLORIDA, INC.6Tier 1Tier 1: 6
HUMANA HEALTH PLAN OF CALIFORNIA, INC.2Tier 1Tier 1: 2
HUMANA HEALTH PLAN OF OHIO, INC.4Tier 1Tier 1: 4
HUMANA HEALTH PLAN OF TEXAS, INC.1Tier 1Tier 1: 1
HUMANA HEALTH PLAN, INC.3Tier 1Tier 1: 3
HUMANA INSURANCE COMPANY221Tier 1Tier 1: 221
HUMANA INSURANCE COMPANY OF KENTUCKY3Tier 1Tier 1: 3
HUMANA INSURANCE COMPANY OF NEW YORK2Tier 1Tier 1: 2
HUMANA MEDICAL PLAN OF MICHIGAN, INC.4Tier 1Tier 1: 4
HUMANA MEDICAL PLAN OF PENNSYLVANIA, INC.2Tier 1Tier 1: 2
HUMANA MEDICAL PLAN OF UTAH, INC.2Tier 1Tier 1: 2
HUMANA MEDICAL PLAN, INC.84Tier 1Tier 1: 84
HUMANA REGIONAL HEALTH PLAN, INC.2Tier 1Tier 1: 2
HUMANA WI HEALTH ORGANIZATION INSURANCE CORP58Tier 1Tier 1: 58
HUMANADENTAL INSURANCE COMPANY1Tier 1Tier 1: 1
HealthKeepers, Inc.4Tier 1Tier 1: 4
Healthy Mississippi, Inc.1Tier 2Tier 2: 1
Highmark Western and Northeastern New York Inc.11Tier 2Tier 2: 11
Humana Insurance Co. & Humana Insurance Co. of NY102Tier 2–3Tier 2: 68 · Tier 3: 34
IMPERIAL COUNTY LOCAL HEALTH AUTHORITY1Tier 1Tier 1: 1
IMPERIAL HEALTH PLAN OF CALIFORNIA, INC.3Tier 2Tier 2: 3
INDEPENDENT CARE HEALTH PLAN1Tier 1Tier 1: 1
INDEPENDENT HEALTH ASSOCIATION, INC.5Tier 2Tier 2: 5
INDEPENDENT HEALTH BENEFITS CORPORATION1Tier 2Tier 2: 1
ISNP VENTURES, LLC2Tier 1Tier 1: 2
ITASCA MEDICAL CARE1Tier 1Tier 1: 1
Inland Empire Health Plan1Tier 1Tier 1: 1
JOHNS HOPKINS HEALTH PLAN OF VIRGINIA, INC.1Tier 1Tier 1: 1
KAISER FDTN HLTH PLAN OF THE MID-ATLANTIC STATES19Tier 1Tier 1: 19
KAISER FOUNDATION HEALTH PLAN OF NEVADA3Tier 1Tier 1: 3
KAISER FOUNDATION HEALTH PLAN OF WASHINGTON13Tier 1Tier 1: 13
KAISER FOUNDATION HP OF CO11Tier 1Tier 1: 11
KAISER FOUNDATION HP OF GA, INC.8Tier 1Tier 1: 8
KAISER FOUNDATION HP OF THE N W4Tier 1Tier 1: 4
KAISER FOUNDATION HP, INC.54Tier 1Tier 1: 54
KANSAS SUPERIOR SELECT, INC.2Tier 1Tier 1: 2
KERN HEALTH SYSTEMS1Tier 1Tier 1: 1
KEYSTONE HEALTH PLAN CENTRAL, INC.11Tier 2Tier 2: 11
KEYSTONE HEALTH PLAN EAST, INC.9Tier 2Tier 2: 9
KS PLAN ADMINISTRATORS, LLC2Tier 2Tier 2: 2
LAGNIAPPE ADVANTAGE INSURANCE COMPANY1Tier 1Tier 1: 1
LEON HEALTH, INC.4Tier 1Tier 1: 4
LIBERTY ADVANTAGE, LLC3Tier 1Tier 1: 3
LIFEWORKS ADVANTAGE, LLC2Tier 1Tier 1: 2
LOCAL INITIATIVE HEALTH AUTHORITY FOR LA COUNTY1Tier 2Tier 2: 1
LONGEVITY HEALTH PLAN OF COLORADO, INC.1Tier 1Tier 1: 1
LONGEVITY HEALTH PLAN OF FLORIDA, INC.1Tier 1Tier 1: 1
LONGEVITY HEALTH PLAN OF ILLINOIS, INC.1Tier 1Tier 1: 1
LONGEVITY HEALTH PLAN OF MICHIGAN, INC.1Tier 1Tier 1: 1
LONGEVITY HEALTH PLAN OF NEW JERSEY INSURANCE COMP2Tier 1Tier 1: 2
LONGEVITY HEALTH PLAN OF NEW YORK, INC.1Tier 1Tier 1: 1
LONGEVITY HEALTH PLAN OF NORTH CAROLINA, INC.1Tier 1Tier 1: 1
LOUISIANA HEALTH SERVICE & INDEMNITY COMPANY3Tier 2Tier 2: 3
MANAGED HEALTH SERVICES INSURANCE CORP.3Tier 1Tier 1: 3
MARQUIS ADVANTAGE, INC.3Tier 1Tier 1: 3
MARTIN'S POINT GENERATIONS ADVANTAGE, INC.8Tier 1Tier 1: 8
MASS GENERAL BRIGHAM HEALTH PLAN, INC2Tier 1Tier 1: 2
MCLAREN HEALTH PLAN, INC.3Tier 1Tier 1: 3
MCS ADVANTAGE, INC.20Tier 2Tier 2: 20
MEDCARE PARTNERS HEALTH PLAN OF TEXAS, LLC3Tier 1Tier 1: 3
MEDCO CONTAINMENT LIFE & MEDCO CONTAINMENT NY & HEALTH CARE40Tier 2–3Tier 2: 35 · Tier 3: 5
MEDICA HEALTH PLANS23Tier 6Tier 6: 23
MEDICA INSURANCE COMPANY4Tier 2Tier 2: 4
MEDICAL MUTUAL OF OHIO16Tier 2Tier 2: 16
MEDISUN, INC.5Tier 2Tier 2: 5
MERCY CARE3Tier 1Tier 1: 3
MERIDIAN HEALTH PLAN OF ILLINOIS, INC.4Tier 1Tier 1: 4
MERIDIAN HEALTH PLAN OF MICHIGAN, INC.6Tier 1Tier 1: 6
METROPLUS HEALTH PLAN, INC.3Tier 1Tier 1: 3
MISSOURI CARE, INCORPORATED2Tier 1Tier 1: 2
MMM HEALTHCARE, LLC24Tier 2Tier 2: 24
MOLINA HEALTHCARE OF ARIZONA, INC.1Tier 1Tier 1: 1
MOLINA HEALTHCARE OF CALIFORNIA4Tier 1Tier 1: 4
MOLINA HEALTHCARE OF ILLINOIS, INC.1Tier 1Tier 1: 1
MOLINA HEALTHCARE OF IOWA, INC.2Tier 1Tier 1: 2
MOLINA HEALTHCARE OF KENTUCKY, INC.3Tier 1Tier 1: 3
MOLINA HEALTHCARE OF MICHIGAN, INC.3Tier 1Tier 1: 3
MOLINA HEALTHCARE OF NEBRASKA, INC.2Tier 1Tier 1: 2
MOLINA HEALTHCARE OF NEW MEXICO, INC.1Tier 1Tier 1: 1
MOLINA HEALTHCARE OF OHIO, INC.2Tier 1Tier 1: 2
MOLINA HEALTHCARE OF SOUTH CAROLINA,INC2Tier 1Tier 1: 2
MOLINA HEALTHCARE OF TEXAS, INC.7Tier 1Tier 1: 7
MOLINA HEALTHCARE OF UTAH, INC.3Tier 1Tier 1: 3
MOLINA HEALTHCARE OF WASHINGTON, INC.3Tier 1Tier 1: 3
MOUNT CARMEL HEALTH INSURANCE COMPANY1Tier 1Tier 1: 1
MOUNT CARMEL HEALTH PLAN OF NEW YORK, INC.2Tier 1Tier 1: 2
MOUNT CARMEL HEALTH PLAN, INC.9Tier 1Tier 1: 9
MULTICARE HEALTH PLAN2Tier 1Tier 1: 2
MVP HEALTH PLAN, INC.8Tier 1Tier 1: 8
Mass General Brigham Health Plan, Inc.3Tier 2Tier 2: 3
Molina Healthcare of Wisconsin, Inc.4Tier 1Tier 1: 4
NATIVE ADVANTAGE, INC.1Tier 1Tier 1: 1
NEBRASKA TOTAL CARE, INC.3Tier 1Tier 1: 3
NEIGHBORHOOD HEALTH PLAN OF RHODE ISLAND2Tier 1Tier 1: 2
NETWORK HEALTH INSURANCE CORPORATION7Tier 1Tier 1: 7
NEW CENTURY HEALTH PLAN, INC.2Tier 1Tier 1: 2
NEW YORK QUALITY HEALTHCARE CORPORATION7Tier 1Tier 1: 7
NHC ADVANTAGE, LLC2Tier 1Tier 1: 2
OH CHS SNP INC.4Tier 1Tier 1: 4
OKLAHOMA SUPERIOR SELECT, INC.1Tier 1Tier 1: 1
OPTIMUM HEALTHCARE, INC.13Tier 1Tier 1: 13
ORANGE COUNTY HEALTH AUTHORITY1Tier 1Tier 1: 1
OXFORD HEALTH PLANS (NJ), INC.5Tier 1Tier 1: 5
PACIFICSOURCE COMMUNITY HEALTH PLANS5Tier 1Tier 1: 5
PARTNERS INSURANCE COMPANY INC2Tier 2Tier 2: 2
PARTNERS INSURANCE COMPANY OF NEW JERSEY INC1Tier 2Tier 2: 1
PEAK HEALTH INSURANCE CORPORATION9Tier 1Tier 1: 9
PENNSYLVANIA HEALTH & WELLNESS, INC.3Tier 1Tier 1: 3
PEOPLES HEALTH, INC.18Tier 1Tier 1: 18
PERENNIAL ADVANTAGE OF COLORADO, INC.6Tier 1Tier 1: 6
PERENNIAL ADVANTAGE OF OHIO, INC.3Tier 1Tier 1: 3
PHYSICIANS HEALTH CHOICE OF TEXAS, LLC23Tier 1Tier 1: 23
PREFERRED CARE PARTNERS, INC.32Tier 1Tier 1: 32
PRESBYTERIAN HEALTH PLAN3Tier 2Tier 2: 3
PRIMEWEST RURAL MN HEALTH CARE ACCESS INITIATIVE2Tier 1Tier 1: 2
PRIORITY HEALTH35Tier 2Tier 2: 35
PRIORITY HEALTH CHOICE, INC.5Tier 2Tier 2: 5
PROCARE ADVANTAGE, LLC3Tier 1Tier 1: 3
PROMINENCE HEALTHFIRST10Tier 2Tier 2: 10
PROMINENCE HEALTHFIRST OF FLORIDA INC6Tier 2Tier 2: 6
PROMINENCE HEALTHFIRST OF TEXAS13Tier 2Tier 2: 13
PROVIDER PARTNERS HEALTH PLAN OF ILLINOIS1Tier 1Tier 1: 1
PROVIDER PARTNERS HEALTH PLAN OF INDIANA3Tier 1Tier 1: 3
PROVIDER PARTNERS HEALTH PLAN OF MISSOURI, INC.3Tier 1Tier 1: 3
PROVIDER PARTNERS HEALTH PLAN OF NORTH CAROLINA3Tier 1Tier 1: 3
PROVIDER PARTNERS HEALTH PLAN OF PENNSYLVANIA, INC3Tier 1Tier 1: 3
PROVIDER PARTNERS HEALTH PLAN OF TEXAS, INC.1Tier 1Tier 1: 1
PRUITTHEALTH PREMIER NORTH CAROLINA, LLC3Tier 1Tier 1: 3
PRUITTHEALTH PREMIER, INC.3Tier 1Tier 1: 3
Preferred Care Network, Inc.3Tier 1Tier 1: 3
QCC INSURANCE COMPANY3Tier 2Tier 2: 3
QUARTZ HEALTH PLAN CORPORATION10Tier 2Tier 2: 10
QUARTZ HEALTH PLAN MN CORPORATION4Tier 2Tier 2: 4
RANGE HEALTH, INC.4Tier 2Tier 2: 4
REGENCE BLUECROSS BLUESHIELD OF OREGON9Tier 2Tier 2: 9
REGENCE BLUECROSS BLUESHIELD OF UTAH2Tier 2Tier 2: 2
REGENCE BLUESHIELD2Tier 2Tier 2: 2
SAMARITAN HEALTH PLANS, INC.1Tier 2Tier 2: 1
SAN FRANCISCO HEALTH AUTHORITY DBA SAN FRANCISCO HEALTH PLAN1Tier 1Tier 1: 1
SAN JOAQUIN COUNTY HEALTH COMMISSION1Tier 1Tier 1: 1
SAN MATEO HEALTH COMMISSION1Tier 1Tier 1: 1
SANFORD HEALTH PLAN4Tier 2Tier 2: 4
SANFORD HEALTH PLAN OF MINNESOTA2Tier 2Tier 2: 2
SANTA BARBARA SAN LUIS OBISPO REGIONAL HEALTH AUTHORITY DBA1Tier 1Tier 1: 1
SANTA CLARA COUNTY HEALTH AUTHORITY1Tier 1Tier 1: 1
SANTA CRUZ MONTEREY MERCED SAN BENITO MARIPOSA MANAGED MEDIC1Tier 1Tier 1: 1
SAPPHIRE EDGE, INC.3Tier 2Tier 2: 3
SCAN DESERT HEALTH PLAN, INC.8Tier 2Tier 2: 8
SCAN HEALTH PLAN66Tier 2Tier 2: 66
SCAN HEALTH PLAN (OR)2Tier 2Tier 2: 2
SCAN HEALTH PLAN (WA)1Tier 2Tier 2: 1
SCAN HEALTH PLAN NEVADA, INC.4Tier 2Tier 2: 4
SCAN HEALTH PLAN TEXAS, INC.4Tier 2Tier 2: 4
SCOTT AND WHITE HEALTH PLAN4Tier 2Tier 2: 4
SECUR INC4Tier 1Tier 1: 4
SECURITY HEALTH PLAN OF WISCONSIN, INC.4Tier 2Tier 2: 4
SELECT HEALTH OF SOUTH CAROLINA, INC.1Tier 2Tier 2: 1
SELECTCARE OF TEXAS, INC.1Tier 1Tier 1: 1
SELECTHEALTH, INC.10Tier 1Tier 1: 10
SENIOR WHOLE HEALTH OF NEW YORK, INC.2Tier 1Tier 1: 2
SENIOR WHOLE HEALTH, LLC3Tier 1Tier 1: 3
SENTARA HEALTH PLANS2Tier 2Tier 2: 2
SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC.81Tier 1Tier 1: 81
SIGNATURE ADVANTAGE, LLC2Tier 1Tier 1: 2
SILVERSCRIPT INSURANCE COMPANY35Tier 2–4Tier 2: 15 · Tier 4: 20
SIMPLY HEALTHCARE PLANS, INC.3Tier 2Tier 2: 3
SIMPRA ADVANTAGE, INC.3Tier 1Tier 1: 3
SOLIS HEALTH PLANS, INC.19Tier 2Tier 2: 19
SOUTH COUNTRY HEALTH ALLIANCE2Tier 2Tier 2: 2
SOUTHEASTERN INDIANA HEALTH ORGANIZATION, INC.3Tier 1Tier 1: 3
ST. LUKE'S HEALTH PLAN, INC.3Tier 2Tier 2: 3
SUMMACARE INC.5Tier 1Tier 1: 5
SUNFLOWER STATE HEALTH PLAN, INC.3Tier 1Tier 1: 3
SUPERIOR HEALTHPLAN, INC.12Tier 1Tier 1: 12
Sunshine State Health Plan, Inc.20Tier 1Tier 1: 20
TEXAS INDEPENDENCE HEALTH PLAN, INC.2Tier 1Tier 1: 2
THE HEALTH PLAN OF WEST VIRGINIA, INC.3Tier 2Tier 2: 3
THP INSURANCE COMPANY3Tier 2Tier 2: 3
TRILLIUM COMMUNITY HEALTH PLAN, INC.1Tier 1Tier 1: 1
TRINITY HEALTH PLAN OF MICHIGAN INC3Tier 1Tier 1: 3
TRIPLE S ADVANTAGE, INC.17Tier 1–2Tier 1: 9 · Tier 2: 8
TROY HEALTH, INC.2Tier 1Tier 1: 2
TSG GUARD, INC.1Tier 1Tier 1: 1
TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION21Tier 1–2Tier 1: 2 · Tier 2: 19
TUFTS HEALTH PUBLIC PLANS, INC.2Tier 1Tier 1: 2
UHC OF CALIFORNIA39Tier 1Tier 1: 39
ULTIMATE HEALTH PLANS, INC.16Tier 2Tier 2: 16
UNITEDHEALTHCARE COMMUNITY PLAN OF TEXAS, L.L.C.14Tier 1Tier 1: 14
UNITEDHEALTHCARE COMMUNITY PLAN, INC.7Tier 1Tier 1: 7
UNITEDHEALTHCARE INS. CO. & UHC INS. CO. OF NY73Tier 3Tier 3: 73
UNITEDHEALTHCARE INSURANCE COMPANY18Tier 1Tier 1: 18
UNITEDHEALTHCARE OF FLORIDA, INC.3Tier 1Tier 1: 3
UNITEDHEALTHCARE OF NEW ENGLAND, INC.5Tier 1Tier 1: 5
UNITEDHEALTHCARE OF NEW YORK, INC.19Tier 1Tier 1: 19
UNITEDHEALTHCARE OF THE MID-ATLANTIC, INC.8Tier 1Tier 1: 8
UNITEDHEALTHCARE OF THE MIDLANDS, INC.49Tier 1Tier 1: 49
UNITEDHEALTHCARE OF THE ROCKIES, INC.21Tier 1Tier 1: 21
UNITEDHEALTHCARE OF WISCONSIN, INC.149Tier 1Tier 1: 149
UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC.7Tier 1Tier 1: 7
UPMC FOR YOU, INC4Tier 4Tier 4: 4
UPMC HEALTH COVERAGE, INC.1Tier 4Tier 4: 1
UPMC HEALTH NETWORK, INC.8Tier 4Tier 4: 8
UPMC HEALTH PLAN, INC.17Tier 4Tier 4: 17
UPPER PENINSULA HEALTH PLAN, LLC1Tier 2Tier 2: 1
USABLE HMO, INC.2Tier 1Tier 1: 2
USABLE MUTUAL INSURANCE COMPANY3Tier 1–2Tier 1: 2 · Tier 2: 1
UnitedHealthcare Benefits of Texas, Inc.66Tier 1Tier 1: 66
UnitedHealthcare of New England, Inc.2Tier 1Tier 1: 2
VERDA HEALTH PLAN OF ARIZONA, INC.2Tier 1Tier 1: 2
VERDA HEALTH PLAN OF TEXAS INC4Tier 1Tier 1: 4
VILLAGE SENIOR SERVICES CORPORATION3Tier 1Tier 1: 3
VISTA HEALTH PLAN, INC.2Tier 2Tier 2: 2
VIVA HEALTH, INC.8Tier 1Tier 1: 8
VNA HOMECARE OPTIONS, LLC3Tier 1Tier 1: 3
VNS CHOICE3Tier 1Tier 1: 3
VOLUNTEER STATE HEALTH PLAN3Tier 1Tier 1: 3
Ventura County Medi-Cal Managed Care Commission1Tier 2Tier 2: 1
WELLCARE HEALTH INSURANCE COMPANY OF KENTUCKY, INC7Tier 1Tier 1: 7
WELLCARE HEALTH INSURANCE OF ARIZONA, INC.10Tier 1Tier 1: 10
WELLCARE HEALTH INSURANCE OF CONNECTICUT, INC.4Tier 1Tier 1: 4
WELLCARE HEALTH INSURANCE OF NORTH CAROLINA, INC.3Tier 1Tier 1: 3
WELLCARE HEALTH PLANS OF NEW JERSEY, INC.3Tier 1Tier 1: 3
WELLCARE OF CALIFORNIA, INC.2Tier 1Tier 1: 2
WELLCARE OF CONNECTICUT, INC.3Tier 1Tier 1: 3
WELLCARE OF GEORGIA, INC.13Tier 1Tier 1: 13
WELLCARE OF IOWA, INC.4Tier 1Tier 1: 4
WELLCARE OF MAINE, INC.2Tier 1Tier 1: 2
WELLCARE OF MISSISSIPPI, INC.2Tier 1Tier 1: 2
WELLCARE OF MISSOURI HEALTH INSURANCE COMPANY, INC2Tier 1Tier 1: 2
WELLCARE OF SOUTH CAROLINA, INC.5Tier 1Tier 1: 5
WELLCARE OF TEXAS, INC.12Tier 1Tier 1: 12
WELLCARE PRESCRIPTION INSURANCE, INC.68Tier 1–3Tier 1: 34 · Tier 3: 34
WELLMARK IA & SD, & BCBS MN, MT, NE, ND,& WY1Tier 2Tier 2: 1
WELLPOINT HEALTH PLANS, INC.6Tier 1Tier 1: 6
WELLPOINT INSURANCE COMPANY33Tier 1Tier 1: 33
WELLPOINT IOWA, INC.1Tier 1Tier 1: 1
WELLPOINT NEW JERSEY, INC.3Tier 1Tier 1: 3
WELLPOINT TENNESSEE, INC.9Tier 1Tier 1: 9
WELLPOINT TEXAS, INC.8Tier 1Tier 1: 8
WELLPOINT WEST VIRGINIA , INC.3Tier 1Tier 1: 3
WEST VIRGINIA SENIOR ADVANTAGE, INC.1Tier 1Tier 1: 1
WYOBLUE ADVANTAGE INC2Tier 3Tier 3: 2
ZING HEALTH OF MICHIGAN, INC.36Tier 1Tier 1: 36

Plan-level detail

Search the complete plan list by plan name, organization, contract, or plan number.

Showing 100 of 5,495 matching plans

Plan nameOrganizationContract / plan / segmentTier
Wellcare Absolute Total Care Dual Align (HMO D-SNP)ABSOLUTE TOTAL CARE, INC.H5272 / 001 / 000Tier 1
Aetna Medicare Chronic Care (HMO-POS C-SNP)AETNA BETTER HEALTH INC. (CT)H6303 / 001 / 000Tier 1
Aetna Medicare Enhanced (HMO-POS)AETNA BETTER HEALTH INC. (CT)H6303 / 002 / 000Tier 2
Aetna Medicare Full Dual Extra (HMO-POS D-SNP)AETNA BETTER HEALTH INC. (CT)H6303 / 004 / 000Tier 2
Aetna Medicare QMB Only Extra (HMO-POS D-SNP)AETNA BETTER HEALTH INC. (CT)H6303 / 005 / 000Tier 2
Aetna Medicare Chronic Care (HMO C-SNP)AETNA BETTER HEALTH INC. (GA)H3146 / 037 / 000Tier 1
Aetna Medicare Chronic Care (HMO C-SNP)AETNA BETTER HEALTH INC. (GA)H3146 / 038 / 000Tier 1
Aetna Medicare Chronic Care (HMO C-SNP)AETNA BETTER HEALTH INC. (GA)H3146 / 053 / 000Tier 1
Aetna Medicare Chronic Care Total (HMO C-SNP)AETNA BETTER HEALTH INC. (GA)H3146 / 036 / 000Tier 1
Aetna Medicare Chronic Care Value (HMO C-SNP)AETNA BETTER HEALTH INC. (GA)H3146 / 044 / 000Tier 1
Aetna Medicare Enhanced (HMO)AETNA BETTER HEALTH INC. (GA)H3146 / 039 / 000Tier 2
Aetna Medicare Enhanced (HMO)AETNA BETTER HEALTH INC. (GA)H3146 / 040 / 000Tier 2
Aetna Medicare Enhanced (HMO)AETNA BETTER HEALTH INC. (GA)H3146 / 047 / 000Tier 2
Aetna Medicare Enhanced (HMO)AETNA BETTER HEALTH INC. (GA)H3146 / 058 / 000Tier 2
Aetna Medicare Enhanced (HMO)AETNA BETTER HEALTH INC. (GA)H3146 / 059 / 000Tier 2
Aetna Medicare Full Dual (HMO D-SNP)AETNA BETTER HEALTH INC. (GA)H3146 / 002 / 000Tier 2
Aetna Medicare Full Dual (HMO D-SNP)AETNA BETTER HEALTH INC. (GA)H3146 / 016 / 000Tier 2
Aetna Medicare Full Dual Care (HMO D-SNP)AETNA BETTER HEALTH INC. (GA)H3146 / 022 / 000Tier 2
Aetna Medicare Full Dual Care (HMO D-SNP)AETNA BETTER HEALTH INC. (GA)H3146 / 023 / 000Tier 2
Aetna Medicare Prime (HMO)AETNA BETTER HEALTH INC. (GA)H3146 / 007 / 000Tier 2
Aetna Medicare Signature (HMO)AETNA BETTER HEALTH INC. (GA)H3146 / 001 / 000Tier 2
Aetna Medicare Signature (HMO)AETNA BETTER HEALTH INC. (GA)H3146 / 004 / 000Tier 2
Aetna Medicare Signature (HMO)AETNA BETTER HEALTH INC. (GA)H3146 / 014 / 000Tier 2
Aetna Medicare Signature (HMO)AETNA BETTER HEALTH INC. (GA)H3146 / 048 / 000Tier 2
Aetna Medicare Signature (HMO)AETNA BETTER HEALTH INC. (GA)H3146 / 049 / 000Tier 2
Aetna Medicare Signature (HMO)AETNA BETTER HEALTH INC. (GA)H3146 / 051 / 000Tier 2
Aetna Medicare Signature (HMO)AETNA BETTER HEALTH INC. (GA)H3146 / 052 / 000Tier 2
Aetna Medicare Signature (HMO)AETNA BETTER HEALTH INC. (GA)H3146 / 060 / 000Tier 2
Aetna Medicare Signature Extra (HMO)AETNA BETTER HEALTH INC. (GA)H3146 / 050 / 000Tier 2
Aetna Medicare Value Plus (HMO)AETNA BETTER HEALTH INC. (GA)H3146 / 006 / 000Tier 2
Aetna Medicare Value Plus (HMO)AETNA BETTER HEALTH INC. (GA)H3146 / 011 / 000Tier 2
Aetna Medicare Value Plus (HMO)AETNA BETTER HEALTH INC. (GA)H3146 / 012 / 000Tier 2
Aetna Medicare FIDE (HMO D-SNP)AETNA BETTER HEALTH INC. (NJ)H6399 / 001 / 000Tier 2
Aetna Medicare Prime Extra (HMO)AETNA BETTER HEALTH OF CALIFORNIA INC.H4982 / 025 / 000Tier 2
Aetna Medicare Prime Extra (HMO)AETNA BETTER HEALTH OF CALIFORNIA INC.H4982 / 026 / 000Tier 2
Aetna Medicare Prime Value Plus (HMO)AETNA BETTER HEALTH OF CALIFORNIA INC.H4982 / 022 / 000Tier 2
Aetna Medicare Signature (HMO)AETNA BETTER HEALTH OF CALIFORNIA INC.H4982 / 001 / 000Tier 2
Aetna Medicare Signature (HMO)AETNA BETTER HEALTH OF CALIFORNIA INC.H4982 / 002 / 000Tier 2
Aetna Medicare Signature (HMO)AETNA BETTER HEALTH OF CALIFORNIA INC.H4982 / 003 / 000Tier 2
Aetna Medicare Signature (HMO)AETNA BETTER HEALTH OF CALIFORNIA INC.H4982 / 007 / 000Tier 2
Aetna Medicare Signature Extra (HMO)AETNA BETTER HEALTH OF CALIFORNIA INC.H4982 / 030 / 000Tier 2
Aetna Medicare Elite (HMO)AETNA BETTER HEALTH OF MICHIGAN INC.H2056 / 003 / 000Tier 2
Aetna Medicare Elite (HMO)AETNA BETTER HEALTH OF MICHIGAN INC.H2056 / 005 / 000Tier 2
Aetna Medicare HIDE (HMO D-SNP)AETNA BETTER HEALTH OF MICHIGAN INC.H9314 / 001 / 000Tier 2
Aetna Medicare Signature (HMO)AETNA BETTER HEALTH OF OKLAHOMA INC.H4835 / 002 / 000Tier 2
Aetna Medicare Full Dual Care (HMO D-SNP)AETNA BETTER HEALTH OF TEXAS INC.H8597 / 001 / 000Tier 2
Aetna Medicare Full Dual Care (HMO D-SNP)AETNA BETTER HEALTH OF TEXAS INC.H8597 / 002 / 000Tier 2
Aetna Medicare Full Dual Care (HMO D-SNP)AETNA BETTER HEALTH OF TEXAS INC.H8597 / 003 / 000Tier 2
Aetna Medicare QMB Only Care (HMO D-SNP)AETNA BETTER HEALTH OF TEXAS INC.H8597 / 004 / 000Tier 2
Aetna Medicare QMB Only Care (HMO D-SNP)AETNA BETTER HEALTH OF TEXAS INC.H8597 / 005 / 000Tier 2
Aetna Medicare QMB Only Care (HMO D-SNP)AETNA BETTER HEALTH OF TEXAS INC.H8597 / 006 / 000Tier 2
Aetna Medicare Chronic Care (HMO C-SNP)AETNA BETTER HEALTH OF WASHINGTON, INC.H3748 / 020 / 000Tier 1
Aetna Medicare Signature (HMO)AETNA BETTER HEALTH OF WASHINGTON, INC.H3748 / 003 / 000Tier 2
Aetna Medicare FIDE (HMO D-SNP)AETNA BETTER HEALTH PREMIER PLAN MMAI INC.H9771 / 001 / 000Tier 2
Aetna Medicare Chronic Care (HMO C-SNP)AETNA BETTER HEALTH, INC. (LA)H3239 / 030 / 000Tier 1
Aetna Medicare Dual Care (HMO D-SNP)AETNA BETTER HEALTH, INC. (LA)H3239 / 010 / 000Tier 2
Aetna Medicare Dual Care (HMO D-SNP)AETNA BETTER HEALTH, INC. (LA)H3239 / 012 / 000Tier 2
Aetna Medicare Dual Extra (HMO D-SNP)AETNA BETTER HEALTH, INC. (LA)H3239 / 005 / 000Tier 2
Aetna Medicare Dual Extra Care (HMO D-SNP)AETNA BETTER HEALTH, INC. (LA)H3239 / 002 / 000Tier 2
Aetna Medicare Dual Extra Care (HMO D-SNP)AETNA BETTER HEALTH, INC. (LA)H3239 / 015 / 000Tier 2
Aetna Medicare Full Dual Care (HMO D-SNP)AETNA BETTER HEALTH, INC. (LA)H3239 / 026 / 000Tier 2
Aetna Medicare Full Dual Care (HMO D-SNP)AETNA BETTER HEALTH, INC. (LA)H3239 / 027 / 000Tier 2
Aetna Medicare Full Dual Care (HMO D-SNP)AETNA BETTER HEALTH, INC. (LA)H3239 / 028 / 000Tier 2
Aetna Medicare Partial Dual Care (HMO D-SNP)AETNA BETTER HEALTH, INC. (LA)H3239 / 023 / 000Tier 2
Aetna Medicare QMB Only Care (HMO D-SNP)AETNA BETTER HEALTH, INC. (LA)H3239 / 001 / 000Tier 2
Aetna Medicare Signature (HMO)AETNA BETTER HEALTH, INC. (LA)H3239 / 014 / 000Tier 2
Aetna Medicare Signature Care (HMO)AETNA BETTER HEALTH, INC. (LA)H3239 / 017 / 000Tier 2
Aetna Medicare Signature Care (HMO)AETNA BETTER HEALTH, INC. (LA)H3239 / 020 / 000Tier 2
Aetna Medicare Signature Care (HMO)AETNA BETTER HEALTH, INC. (LA)H3239 / 022 / 000Tier 2
Aetna Medicare Signature Extra Care (HMO)AETNA BETTER HEALTH, INC. (LA)H3239 / 031 / 000Tier 2
Aetna Medicare Dual Care (PPO D-SNP)AETNA HEALTH AND LIFE INSURANCE COMPANYH3288 / 053 / 000Tier 2
Aetna Medicare Elite (PPO)AETNA HEALTH AND LIFE INSURANCE COMPANYH3288 / 027 / 000Tier 2
Aetna Medicare Enhanced (PPO)AETNA HEALTH AND LIFE INSURANCE COMPANYH3288 / 007 / 000Tier 2
Aetna Medicare Enhanced (PPO)AETNA HEALTH AND LIFE INSURANCE COMPANYH3288 / 009 / 000Tier 2
Aetna Medicare Enhanced (PPO)AETNA HEALTH AND LIFE INSURANCE COMPANYH3288 / 042 / 000Tier 2
Aetna Medicare Enhanced (PPO)AETNA HEALTH AND LIFE INSURANCE COMPANYH3288 / 047 / 000Tier 2
Aetna Medicare Signature (PPO)AETNA HEALTH AND LIFE INSURANCE COMPANYH3288 / 005 / 000Tier 2
Aetna Medicare Signature (PPO)AETNA HEALTH AND LIFE INSURANCE COMPANYH3288 / 008 / 000Tier 2
Aetna Medicare Signature (PPO)AETNA HEALTH AND LIFE INSURANCE COMPANYH3288 / 011 / 000Tier 2
Aetna Medicare Signature (PPO)AETNA HEALTH AND LIFE INSURANCE COMPANYH3288 / 020 / 000Tier 2
Aetna Medicare Signature (PPO)AETNA HEALTH AND LIFE INSURANCE COMPANYH3288 / 046 / 000Tier 2
Aetna Medicare Signature Extra (PPO)AETNA HEALTH AND LIFE INSURANCE COMPANYH3288 / 006 / 000Tier 2
Aetna Medicare Value Plus (PPO)AETNA HEALTH AND LIFE INSURANCE COMPANYH3288 / 001 / 000Tier 2
Aetna Medicare Value Plus (PPO)AETNA HEALTH AND LIFE INSURANCE COMPANYH3288 / 002 / 000Tier 2
Aetna Medicare Value Plus (PPO)AETNA HEALTH AND LIFE INSURANCE COMPANYH3288 / 003 / 000Tier 2
Aetna Medicare Value Plus (PPO)AETNA HEALTH AND LIFE INSURANCE COMPANYH3288 / 004 / 000Tier 2
Aetna Medicare Value Plus (PPO)AETNA HEALTH AND LIFE INSURANCE COMPANYH3288 / 017 / 000Tier 2
Aetna Medicare Value Plus (PPO)AETNA HEALTH AND LIFE INSURANCE COMPANYH3288 / 018 / 000Tier 2
Aetna Medicare Value Plus (PPO)AETNA HEALTH AND LIFE INSURANCE COMPANYH3288 / 019 / 000Tier 2
Aetna Medicare Value Plus (PPO)AETNA HEALTH AND LIFE INSURANCE COMPANYH3288 / 048 / 000Tier 2
Aetna Medicare Full Dual (HMO-POS D-SNP)AETNA HEALTH INC. (CT)H5793 / 017 / 000Tier 2
Aetna Medicare Prime Care (HMO-POS)AETNA HEALTH INC. (CT)H5793 / 019 / 000Tier 2
Aetna Medicare QMB Only (HMO-POS D-SNP)AETNA HEALTH INC. (CT)H5793 / 020 / 000Tier 2
Aetna Medicare Signature (HMO-POS)AETNA HEALTH INC. (CT)H5793 / 001 / 000Tier 2
Aetna Medicare Signature (HMO-POS)AETNA HEALTH INC. (CT)H5793 / 014 / 000Tier 2
Aetna Medicare Signature (HMO-POS)AETNA HEALTH INC. (CT)H5793 / 018 / 000Tier 2
Aetna Medicare Chronic Care (HMO C-SNP)AETNA HEALTH INC. (FL)H1609 / 080 / 000Tier 1
Aetna Medicare Chronic Care (HMO C-SNP)AETNA HEALTH INC. (FL)H1609 / 081 / 000Tier 1
Aetna Medicare Chronic Care (HMO C-SNP)AETNA HEALTH INC. (FL)H1609 / 082 / 000Tier 1
Aetna Medicare Chronic Care (HMO C-SNP)AETNA HEALTH INC. (FL)H1609 / 084 / 000Tier 1

Plan year 2027 · Source: CMS · Checked 2026-10-30

Care and Living Guide is not connected with or endorsed by the U.S. government or the federal Medicare program. For official information visit Medicare.gov or call 1-800-MEDICARE.

Coverage and costs change. Drug lists (formularies), tiers, and copays can change during the year and differ by plan. Always check with your insurance company or plan directly to confirm what is covered and what you will pay.

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