2021 Medicare Advantage and Prescription Drug Plans ......2 2021 Medicare Advantage Plans Offered by...

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SENIOR MARKETS 2021 Medicare Advantage and Prescription Drug Plans Offered by Blue Cross and Blue Shield Companies UPDATED NOVEMBER 2020

Transcript of 2021 Medicare Advantage and Prescription Drug Plans ......2 2021 Medicare Advantage Plans Offered by...

Page 1: 2021 Medicare Advantage and Prescription Drug Plans ......2 2021 Medicare Advantage Plans Offered by Blue Cross and Blue Shield Companies Key: PPO = Preferred Provider Organization

S E N I O R M A R K ET S

2021 Medicare Advantage and Prescription Drug Plans Offered by Blue Cross and Blue Shield Companies

UPDATED NOVEMBER 2020

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2021 Medicare Advantage Plans Offered by Blue Cross and Blue Shield Companies

Key: PPO = Preferred Provider Organization HMO = Health Maintenance Organization PFFS = Private Fee-For-Service Cost = Cost Contract SNP = Special Needs Plan MSA = Medical Savings Account POS – HMO with Point-Of-Service Option

Medicare Advantage plans must include the Medicare prescription drug coverage in at least one of their MA benefit options (except for private fee for service and cost plans where it is optional). Regional PPOs and SNPs must offer drug coverage in all of their options.

State Regional

PPO Local PPO

HMO HMO- POS

PFFS Cost SNP Blue Cross and Blue Shield Plan Sponsor

Product Name

Alabama

Blue Cross and Blue Shield of Alabama

Blue Advantage Complete (Local PPO)

Blue Cross and Blue Shield of Alabama

Blue Advantage Premier (Local PPO)

Arizona

Blue Cross and Blue Shield of Arizona

Blue Medicare Advantage Classic (HMO)

Blue Cross and Blue Shield of Arizona

Blue Medicare Advantage Plus (HMO)

Blue Cross and Blue Shield of Arizona

Blue Medicare Advantage Standard (HMO)

Blue Cross and Blue Shield of Arizona

BlueJourney (PPO)

Blue Cross and Blue Shield of Arizona

BluePathway Plan 1 (HMO)

Blue Cross and Blue Shield of Arizona

BluePathway Plan 2 (HMO)

Blue Cross and Blue Shield of Arizona

BluePathway Plan 3 (HMO)

Arkansas

Arkansas Blue Cross and Blue Shield

BlueMedicare Premier (HMO)

Arkansas Blue Cross and Blue Shield

Health Advantage Blue Classic (HMO)

Arkansas Blue Cross and Blue Shield

Health Advantage Blue Premier (HMO)

Arkansas Blue Cross and Blue Shield

BlueMedicare Premier Choice (PPO)

Arkansas Blue Cross and Blue Shield

BlueMedicare Saver Choice (PPO)

Arkansas Blue Cross and Blue Shield

BlueMedicare Value Choice (PPO)

Arkansas Blue Cross and Blue Shield

BlueMedicare Preferred (PFFS)

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State Regional

PPO Local PPO

HMO HMO- POS

PFFS Cost SNP Blue Cross and Blue Shield Plan Sponsor

Product Name

Arkansas Blue Cross and Blue Shield

BlueMedicare Value (PFFS)

California

Anthem Blue Cross Anthem MediBlue Access (PPO)

Anthem Blue Cross Anthem MediBlue Care On Site (HMO I-SNP)

Anthem Blue Cross Anthem MediBlue Care To You (HMO I-SNP)

Anthem Blue Cross Anthem MediBlue Connect (HMO D-SNP)

Anthem Blue Cross Anthem MediBlue Connect Plus (HMO)

Anthem Blue Cross Anthem MediBlue Coordination Plus (HMO)

Anthem Blue Cross Anthem MediBlue Diabetes (HMO C-SNP)

Anthem Blue Cross Anthem MediBlue Diabetes Care (HMO C-SNP)

Anthem Blue Cross Anthem MediBlue Diabetes Care Plus (HMO C-SNP)

Anthem Blue Cross Anthem MediBlue Dual Access (PPO D-SNP)

Anthem Blue Cross Anthem MediBlue Dual Advantage (HMO D-SNP)

Anthem Blue Cross Anthem MediBlue Dual Plus (HMO D-SNP)

Anthem Blue Cross Anthem MediBlue ESRD Care (HMO C-SNP)

Anthem Blue Cross Anthem MediBlue ESRD Care (PPO C-SNP)

Anthem Blue Cross Anthem MediBlue Heart (HMO C-SNP)

Anthem Blue Cross Anthem MediBlue Heart Care (HMO C-SNP)

Anthem Blue Cross

Anthem MediBlue Lung (HMO C-SNP)

Anthem Blue Cross

Anthem MediBlue Lung Care (HMO C-SNP)

Anthem Blue Cross Anthem MediBlue Extra (HMO)

Anthem Blue Cross Anthem MediBlue Plus (HMO)

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State Regional

PPO Local PPO

HMO HMO- POS

PFFS Cost SNP Blue Cross and Blue Shield Plan Sponsor

Product Name

Anthem Blue Cross Anthem MediBlue Select (HMO)

Anthem Blue Cross Anthem MediBlue StartSmart Plus (HMO)

Anthem Blue Cross Anthem MediBlue Value (HMO)

Anthem Blue Cross Anthem MediBlue Value Plus (HMO)

California (cont.) Blue Shield of California Blue Shield 65 Plus (HMO)

Blue Shield of California Blue Shield 65 Plus Choice Plan (HMO)

Blue Shield of California Blue Shield 65 Plus Plan 2 (HMO)

Blue Shield of California

Blue Shield AdvantageOptimum Plan (HMO)

Blue Shield of California

Blue Shield AdvantageOptimum Plan 1 (HMO)

Blue Shield of California

Blue Shield AdvantageOptimum Plan 2 (HMO)

Blue Shield of California Blue Shield Coordinated Choice Plan (HMO)

Blue Shield of California Blue Shield Inspire (HMO)

Blue Shield of California Blue Shield Inspire (PPO)

Blue Shield of California Blue Shield Vital (HMO)

Blue Shield of California Blue Shield Inspire (HMO D-SNP)

Blue Shield of California Blue Shield Total Dual Plan (HMO D-SNP)

Colorado

Anthem Blue Cross and Blue Shield

Anthem MediBlue Care On Site (HMO I-SNP)

Anthem Blue Cross and Blue Shield

Anthem MediBlue Diabetes Care (HMO C-SNP)

Anthem Blue Cross and Blue Shield

Anthem MediBlue Dual Advantage (HMO D-SNP)

Anthem Blue Cross and Blue Shield

Anthem MediBlue Plus (HMO)

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State Regional

PPO Local PPO

HMO HMO- POS

PFFS Cost SNP Blue Cross and Blue Shield Plan Sponsor

Product Name

Connecticut

Anthem Blue Cross and Blue Shield

Anthem MediBlue Care To You (HMO I-SNP)

Anthem Blue Cross and Blue Shield

Anthem MediBlue Dual Advantage (HMO D-SNP)

Anthem Blue Cross and Blue Shield

Anthem MediBlue Dual Advantage Select (HMO D-SNP)

Anthem Blue Cross and Blue Shield

Anthem MediBlue ESRD Care (HMO-POS C-SNP)

Anthem Blue Cross and Blue Shield

Anthem MediBlue Extra (HMO)

Anthem Blue Cross and Blue Shield

Anthem MediBlue Plus (HMO)

Anthem Blue Cross and Blue Shield

Anthem MediBlue Prime (HMO)

Anthem Blue Cross and Blue Shield

Anthem MediBlue Select (HMO)

Anthem Blue Cross and Blue Shield

Anthem MediBlue Access Select (PPO)

Florida

Florida

(cont.)

Florida Blue BlueMedicare Classic (HMO)

Florida Blue BlueMedicare Premier (HMO)

Florida Blue BlueMedicare Saver (HMO)

Florida Blue (Capital Health Plan)

Capital Health Plan Advantage Plus (HMO)

Florida Blue (Capital Health Plan)

Capital Health Plan Preferred Advantage (HMO)

Florida Blue (Capital Health Plan)

Capital Health Plan Silver Advantage (HMO)

Florida Blue (Florida Health Care Plans)

FCHP Medicare Flagler Advantage (HMO)

Florida Blue (Florida Health Care Plans)

FCHP Medicare Premier Advantage (HMO)

Florida Blue (Florida Health Care Plans)

FCHP Medicare Premier Plus (HMO)

Florida Blue (Florida Health Care Plans)

FCHP Medicare Rx (HMO)

Florida Blue (Florida Health Care Plans)

FCHP Medicare Rx Savings (HMO)

Florida Blue (Florida Health Care Plans)

FHCP Medicare Choice (HMO-POS)

Florida Blue (Florida Health Care Plans)

FHCP Medicare Rx Plus (HMO-POS)

Florida Blue BlueMedicare Select (PPO)

Florida Blue BlueMedicare Value (PPO)

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State Regional

PPO Local PPO

HMO HMO- POS

PFFS Cost SNP Blue Cross and Blue Shield Plan Sponsor

Product Name

Florida Blue BlueMedicare Patriot (PPO)

Florida Blue BlueMedicare Choice (Regional PPO)

Florida Blue BlueMedicare Complete (HMO D-SNP)

Georgia

Anthem Blue Cross and Blue Shield

Anthem MediBlue Essential (HMO)

Anthem Blue Cross and Blue Shield

Anthem MediBlue Extra (HMO)

Anthem Blue Cross and Blue Shield

Anthem MediBlue Plus (HMO)

Anthem Blue Cross and Blue Shield

Anthem MediBlue Core (HMO)

Anthem Blue Cross and Blue Shield

Anthem MediBlue Access (PPO)

Anthem Blue Cross and Blue Shield

Anthem MediBlue Access Basic (PPO)

Anthem Blue Cross and Blue Shield

Anthem MediBlue Dual Advantage (HMO D-SNP)

Hawaii

HMSA HMSA Akamai Advantage Complete (PPO)

HMSA HMSA Akamai Advantage Complete Plus (PPO)

HMSA HMSA Akamai Advantage Standard (PPO)

HMSA HMSA Akamai Advantage Standard Plus (PPO)

HMSA HMSA Akamai Advantage Dual Care (PPO D-SNP)

The Regence Group Regence | St. Luke's Health Partners Align (HMO)

The Regence Group Regence | St. Luke's Health Partners Align Plus (HMO)

The Regence Group Regence Blue MedAdvantage HMO (HMO)

The Regence Group Regence Blue MedAdvantage HMO Plus (HMO)

The Regence Group Regence | St. Luke's Health Partners Align No Rx (HMO)

The Regence Group Regence MedAdvantage + Rx Classic (PPO)

The Regence Group Regence MedAdvantage + Rx Enhanced (PPO)

The Regence Group Regence MedAdvantage + Rx Primary (PPO)

The Regence Group Regence Valiance (PPO)

Blue Cross of Idaho True Blue Rx (HMO)

Idaho

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State Regional

PPO Local PPO

HMO HMO- POS

PFFS Cost SNP Blue Cross and Blue Shield Plan Sponsor

Product Name

Blue Cross of Idaho True Blue Rx | St. Luke's Health Partners (HMO)

Blue Cross of Idaho True Blue Rx Essentials (HMO)

Blue Cross of Idaho True Blue Rx Gem (HMO)

Blue Cross of Idaho True Blue Rx Option I (HMO)

Blue Cross of Idaho True Blue Rx Option II (HMO)

Blue Cross of Idaho True Blue Rx Preferred (HMO)

Blue Cross of Idaho True Blue no Rx (HMO)

Blue Cross of Idaho True Blue Special Needs Plan (HMO D-SNP)

Illinois

Blue Cross and Blue Shield of Illinois

Blue Cross Medicare Advantage Basic (HMO)

Blue Cross and Blue Shield of Illinois

Blue Cross Medicare Advantage Basic Plus (HMO-POS)

Blue Cross and Blue Shield of Illinois

Blue Cross Medicare Advantage Premier Plus (HMO-POS)

Blue Cross and Blue Shield of Illinois

Blue Medicare Advocate Health (HMO)

Blue Cross and Blue Shield of Illinois

Blue Cross Medicare Advantage Choice Plus (PPO)

Blue Cross and Blue Shield of Illinois

Blue Cross Medicare Advantage Choice Premier (PPO)

Blue Cross and Blue Shield of Illinois

Blue Cross Medicare Advantage Classic (PPO)

Indiana

Anthem Blue Cross and Blue Shield

Anthem MediBlue Extra (HMO)

Anthem Blue Cross and Blue Shield

Anthem MediBlue Plus (HMO)

Anthem Blue Cross and Blue Shield

Anthem MediBlue Access (PPO)

Anthem Blue Cross and Blue Shield

Anthem MediBlue Access Plus (PPO)

Anthem Blue Cross and Blue Shield

Anthem MediBlue Access Preferred (PPO)

Anthem Blue Cross and Blue Shield

Anthem MediBlue Access Basic (Regional PPO)

Anthem Blue Cross and Blue Shield hem

Anthem MediBlue Dual Advantage (HMO D-SNP)

Kansas

Blue Cross and Blue Shield of Kansas

Blue Medicare Advantage (PPO)

Blue Cross and Blue Shield of Kansas

Blue Medicare Advantage Comprehensive (PPO)

Blue Cross and Blue Shield of Kansas City

Blue Medicare Advantage Complete (HMO)

Idaho

(cont.)

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State Regional

PPO Local PPO

HMO HMO- POS

PFFS Cost SNP Blue Cross and Blue Shield Plan Sponsor

Product Name

Blue Cross and Blue Shield of Kansas City

Blue Medicare Advantage Plus (HMO)

Blue Cross and Blue Shield of Kansas City

Blue Medicare Advantage Spira Care (HMO)

Blue Cross and Blue Shield of Kansas City

Blue Medicare Advantage Access (PPO)

Blue Cross and Blue Shield of Kansas City

Blue Medicare Advantage Essential (PPO)

Blue Cross and Blue Shield of Kansas City

Blue Medicare Advantage Flex (no Part D) (PPO)

Kentucky

Anthem Blue Cross and Blue Shield

Anthem MediBlue Plus (HMO)

Anthem Blue Cross and Blue Shield

Anthem MediBlue Access (PPO)

Anthem Blue Cross and Blue Shield

Anthem MediBlue Access Plus (PPO)

Anthem Blue Cross and Blue Shield

Anthem MediBlue Access Core (PPO)

Anthem Blue Cross and Blue Shield

Anthem MediBlue Access Basic (Regional PPO)

Anthem Blue Cross and Blue Shield

Anthem MediBlue Dual Advantage (HMO D-SNP)

Louisiana

Blue Cross Blue Shield of Louisiana

Blue Advantage (HMO)

Blue Cross Blue Shield of Louisiana

Blue Advantage (PPO)

Blue Cross Blue Shield of Louisiana

Healthy Blue Dual Advantage (HMO D-SNP)

Maine

Anthem Blue Cross and Blue Shield

Anthem l MaineHealth Advantage Choice (HMO-POS)

Anthem Blue Cross and Blue Shield

Anthem l MaineHealth Advantage Extra (HMO)

Anthem Blue Cross and Blue Shield

Anthem l MaineHealth Advantage Plus (HMO)

Anthem Blue Cross and Blue Shield

Anthem l MaineHealth Advantage Access (PPO)

Anthem Blue Cross and Blue Shield

Anthem l MaineHealth Advantage Dual Plus (HMO D-SNP)

Maryland

CareFirst Blue Cross Blue Shield

CareFirst BlueCross BlueShield Advantage Core (HMO)

CareFirst Blue Cross Blue Shield

CareFirst BlueCross BlueShield Advantage Enhanced (HMO)

Massachusetts

Blue Cross Blue Shield of Massachusetts

Medicare HMO Blue FlexRx (HMO-POS)

Blue Cross Blue Shield of Massachusetts

Medicare HMO Blue PlusRx (HMO)

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State Regional

PPO Local PPO

HMO HMO- POS

PFFS Cost SNP Blue Cross and Blue Shield Plan Sponsor

Product Name

Blue Cross Blue Shield of Massachusetts

Medicare HMO Blue SaverRx (HMO)

Blue Cross Blue Shield of Massachusetts

Medicare HMO Blue ValueRx (HMO)

Blue Cross Blue Shield of Massachusetts

Medicare PPO Blue PlusRx (PPO)

Blue Cross Blue Shield of Massachusetts

Medicare PPO Blue SaverRx (PPO)

Blue Cross Blue Shield of Massachusetts

Medicare PPO Blue ValueRx (PPO)

Michigan

Blue Care Network (Blue Cross Blue Shield of Michigan)

BCN Advantage Community Value (HMO-POS)

Blue Care Network (Blue Cross Blue Shield of Michigan)

BCN Advantage HMO ConnectedCare (HMO)

Blue Care Network (Blue Cross Blue Shield of Michigan)

BCN Advantage HMO-POS Classic (HMO-POS)

Blue Care Network (Blue Cross Blue Shield of Michigan)

BCN Advantage HMO-POS Prestige (HMO-POS)

Blue Care Network (Blue Cross Blue Shield of Michigan)

BCN Advantage Prime Value (HMO-POS)

Blue Care Network (Blue Cross Blue Shield of Michigan)

BCN Advantage HMO-POS Elements (HMO-POS)

Blue Cross Blue Shield of Michigan

Medicare Plus Blue PPO Assure (PPO)

Blue Cross Blue Shield of Michigan

Medicare Plus Blue PPO Essential (PPO)

Blue Cross Blue Shield of Michigan

Medicare Plus Blue PPO Signature (PPO)

Blue Cross Blue Shield of Michigan

Medicare Plus Blue PPO Vitality (PPO)

Minnesota

Blue Cross and Blue Shield of Minnesota

Platinum Blue Choice Plan with Rx (Cost)

Blue Cross and Blue Shield of Minnesota

Platinum Blue Complete Plan with Rx (Cost)

Blue Cross and Blue Shield of Minnesota

Platinum Blue Core Plan with Rx (Cost)

Blue Cross and Blue Shield of Minnesota

Platinum Blue Choice Plan (Cost)

Blue Cross and Blue Shield of Minnesota

Platinum Blue Complete Plan (Cost)

Blue Cross and Blue Shield of Minnesota

Platinum Blue Core Plan (Cost)

Blue Cross and Blue Shield of Minnesota

Blue Cross Medicare Advantage Choice (PPO)

Blue Cross and Blue Shield of Minnesota

Blue Cross Medicare Advantage Complete (PPO)

Blue Cross and Blue Shield of Minnesota

Blue Cross Medicare Advantage Core (PPO)

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State Regional

PPO Local PPO

HMO HMO- POS

PFFS Cost SNP Blue Cross and Blue Shield Plan Sponsor

Product Name

Blue Cross and Blue Shield of Minnesota

Blue Cross Medicare Advantage Choice MA Only (PPO)

Blue Cross and Blue Shield of Minnesota

SecureBlue (HMO D-SNP)

Missouri

Anthem Blue Cross and Blue Shield

Anthem MediBlue Plus (HMO)

Anthem Blue Cross and Blue Shield

Anthem MediBlue Access (PPO)

Anthem Blue Cross and Blue Shield

Anthem MediBlue Access Basic (PPO)

Anthem Blue Cross and Blue Shield

Anthem MediBlue Dual Advantage (HMO D-SNP)

Blue Cross and Blue Shield of Kansas City

Blue Medicare Advantage Complete (HMO)

Blue Cross and Blue Shield of Kansas City

Blue Medicare Advantage Plus (HMO)

Blue Cross and Blue Shield of Kansas City

Blue Medicare Advantage Access (PPO)

Blue Cross and Blue Shield of Kansas City

Blue Medicare Advantage Essential (PPO)

Blue Cross and Blue Shield of Kansas City

Blue Medicare Advantage Flex (no Part D) (PPO)

Montana

Blue Cross and Blue Shield of Montana

Blue Cross Medicare Advantage Classic (PPO)

Blue Cross and Blue Shield of Montana

Blue Cross Medicare Advantage Optimum (PPO)

Nebraska

Blue Cross and Blue Shield of Nebraska

Blue Cross Blue Shield Nebraska MA Access (PPO)

Blue Cross and Blue Shield of Nebraska

Blue Cross Blue Shield Nebraska MA Choice (HMO-POS)

Blue Cross Blue Shield of Nebraska

Blue Cross Blue Shield Nebraska MA Core (HMO)

Nevada

Anthem Blue Cross and Blue Shield

Anthem MediBlue Connect Plus (HMO)

Anthem Blue Cross and Blue Shield

Anthem MediBlue Coordination Plus (HMO)

Anthem Blue Cross and Blue Shield

Anthem MediBlue Plus (HMO)

Anthem Blue Cross and Blue Shield

Anthem MediBlue StartSmart Plus (HMO)

Anthem Blue Cross and Blue Shield

Anthem MediBlue Value Plus (HMO)

Anthem Blue Cross and Blue Shield

Anthem MediBlue Care On Site (HMO I-SNP)

Anthem Blue Cross and Blue Shield

Anthem MediBlue Connect (HMO D-SNP)

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State Regional

PPO Local PPO

HMO HMO- POS

PFFS Cost SNP Blue Cross and Blue Shield Plan Sponsor

Product Name

Anthem Blue Cross and Blue Shield

Anthem MediBlue Diabetes Care (HMO C-SNP)

Anthem Blue Cross and Blue Shield

Anthem MediBlue Dual Advantage (HMO D-SNP)

Anthem Blue Cross and Blue Shield

Anthem MediBlue Heart Care (HMO C-SNP)

Anthem Blue Cross and Blue Shield

Anthem MediBlue Lung Care (HMO C-SNP)

New

Hampshire

Anthem Blue Cross and Blue Shield

Anthem MediBlue Coordination Plus (HMO)

Anthem Blue Cross and Blue Shield

Anthem MediBlue Plus (HMO)

Anthem Blue Cross and Blue Shield

Anthem MediBlue Select (HMO)

Anthem Blue Cross and Blue Shield

Anthem MediBlue Access (PPO)

New Jersey

Horizon Blue Cross Blue Shield of New Jersey

Braven Medicare Plus (HMO)

Horizon Blue Cross Blue Shield of New Jersey

Horizon Medicare Blue Advantage (HMO)

Horizon Blue Cross Blue Shield of New Jersey

Horizon Medicare Blue Choice w/Rx (HMO)

Horizon Blue Cross Blue Shield of New Jersey

Horizon Medicare Blue Select (HMO-POS)

Horizon Blue Cross Blue Shield of New Jersey

Horizon Medicare Blue Value w/Rx (HMO)

Horizon Blue Cross Blue Shield of New Jersey

Horizon Medicare Blue Value (HMO)

Horizon Blue Cross Blue Shield of New Jersey

Braven Medicare Choice (PPO)

Horizon Blue Cross Blue Shield of New Jersey

Braven Medicare Freedom (PPO)

Horizon Blue Cross Blue Shield of New Jersey

Horizon Medicare Blue Access (PPO)

Horizon Blue Cross Blue Shield of New Jersey

Horizon NJ TotalCare (HMO D-SNP)

New Mexico

Blue Cross and Blue Shield of New Mexico

Blue Cross Medicare Advantage Basic (HMO)

Blue Cross and Blue Shield of New Mexico

Blue Cross Medicare Advantage Select (HMO)

Blue Cross and Blue Shield of New Mexico

Blue Cross Medicare Advantage Choice Plus (PPO)

Blue Cross and Blue Shield of New Mexico

Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP)

New York

Empire BlueCross BlueShield Empire MediBlue Choice (HMO-POS)

Empire BlueCross BlueShield Empire MediBlue Extra Select (HMO)

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State Regional

PPO Local PPO

HMO HMO- POS

PFFS Cost SNP Blue Cross and Blue Shield Plan Sponsor

Product Name

Empire BlueCross BlueShield Empire MediBlue HealthPlus (HMO)

Empire BlueCross BlueShield Empire MediBlue Plus (HMO)

Empire BlueCross BlueShield Empire MediBlue Select (HMO)

Empire BlueCross BlueShield Empire MediBlue Core (HMO)

Empire BlueCross BlueShield Empire MediBlue Core Select (HMO)

Empire BlueCross BlueShield Empire MediBlue Access (PPO)

Empire BlueCross BlueShield Empire MediBlue Dual Advantage (HMO D-SNP)

Empire BlueCross BlueShield Empire MediBlue Dual Advantage Select (HMO D-SNP)

Empire BlueCross BlueShield Empire MediBlue HealthPlus Dual Advantage (HMO D-SNP)

Empire BlueCross BlueShield Empire MediBlue HealthPlus Dual Connect (HMO D-SNP)

Empire BlueCross BlueShield Empire MediBlue HealthPlus Dual Plus (HMO D-SNP)

Excellus BlueCross BlueShield

Medicare Bassett (HMO-POS)

Excellus BlueCross BlueShield

Medicare Blue Choice Advanced (HMO-POS)

Excellus BlueCross BlueShield

Medicare Blue Choice Optimum (HMO-POS)

Excellus BlueCross BlueShield

Medicare Blue Choice Select (HMO)

Excellus BlueCross BlueShield

Medicare Blue Choice Value (HMO)

Excellus BlueCross BlueShield

Medicare Blue Choice Value Plus (HMO-POS)

Excellus BlueCross BlueShield

Medicare Blue Choice Platinum (HMO-POS)

Excellus BlueCross BlueShield

Medicare BlueClassic (PPO)

Excellus BlueCross BlueShield

Medicare BlueEnhanced (PPO)

Excellus BlueCross BlueShield

Medicare BlueEssential (PPO)

Excellus BlueCross BlueShield

Medicare BluePlus (PPO)

Excellus BlueCross BlueShield

Medicare BlueSecure (PPO)

Excellus BlueCross BlueShield

Medicare BlueBasic (PPO)

HealthNow BlueCross BlueShield BlueSaver (HMO)

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State Regional

PPO Local PPO

HMO HMO- POS

PFFS Cost SNP Blue Cross and Blue Shield Plan Sponsor

Product Name

HealthNow BlueCross BlueShield Senior Blue 651 (HMO)

HealthNow BlueCross BlueShield Senior Blue Select (HMO)

HealthNow BlueShield Freedom Plus (HMO)

HealthNow BlueShield Freedom Premier (HMO)

HealthNow BlueShield Freedom Value (HMO)

HealthNow BlueShield Senior Blue 652 (HMO)

HealthNow BlueCross BlueShield Senior Blue 601 (HMO)

HealthNow BlueShield Freedom No Rx (HMO)

HealthNow BlueCross BlueShield Forever Blue 751 (PPO)

HealthNow BlueCross BlueShield Forever Blue Value (PPO)

HealthNow BlueCross BlueShield Freedom Nation (PPO)

HealthNow BlueShield Forever Blue 770 (PPO)

HealthNow BlueShield Freedom Nation (PPO)

North

Carolina

Blue Cross and Blue Shield of North Carolina

Blue Medicare Choice (HMO)

Blue Cross and Blue Shield of North Carolina

Blue Medicare Enhanced (HMO)

Blue Cross and Blue Shield of North Carolina

Blue Medicare Essential (HMO)

Blue Cross and Blue Shield of North Carolina

Blue Medicare Essential Plus (HMO)

Blue Cross and Blue Shield of North Carolina

Experience Health Medicare Advantage (HMO)

Blue Cross and Blue Shield of North Carolina

Blue Medicare Medical Only (HMO)

Blue Cross and Blue Shield of North Carolina

Blue Medicare PPO Enhanced (PPO)

North Dakota

Blue Cross Blue Shield of North Dakota

NextBlue Classic PPO (PPO)

Blue Cross Blue Shield of North Dakota

NextBlue Premium PPO (PPO)

Ohio

Anthem Blue Cross and Blue Shield

Anthem MediBlue Essential (HMO)

Anthem Blue Cross and Blue Shield

Anthem MediBlue Extra (HMO)

Anthem Blue Cross and Blue Shield

Anthem MediBlue Plus (HMO)

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State Regional

PPO Local PPO

HMO HMO- POS

PFFS Cost SNP Blue Cross and Blue Shield Plan Sponsor

Product Name

Anthem Blue Cross and Blue Shield

Anthem MediBlue Preferred (HMO)

Anthem Blue Cross and Blue Shield

Anthem MediBlue Preferred Plus (HMO)

Anthem Blue Cross and Blue Shield

Anthem MediBlue Prime Select (HMO)

Anthem Blue Cross and Blue Shield

Anthem MediBlue Access (PPO)

Anthem Blue Cross and Blue Shield

Anthem MediBlue Access Plus (PPO)

Anthem Blue Cross and Blue Shield

Anthem MediBlue Access Basic (Regional PPO)

Anthem Blue Cross and Blue Shield

Anthem MediBlue Access Core (Regional PPO)

Anthem Blue Cross and Blue Shield

Anthem MediBlue Dual Advantage (HMO D-SNP)

Oklahoma Blue Cross and Blue Shield of Oklahoma

Blue Cross Medicare Advantage Basic (HMO)

Oregon Regence BlueCross BlueShield of Oregon

Regence MedAdvantage + Rx Primary (Local PPO)

Regence BlueCross BlueShield of Oregon

Regence MedAdvantage + Rx Enhanced (Local PPO)

Regence BlueCross BlueShield of Oregon

Regence MedAdvantage + Rx Classic (Local PPO)

Regence BlueCross BlueShield of Oregon

Regence BlueAdvantage HMO (HMO)

Regence BlueCross BlueShield of Oregon

Regence BlueAdvantage HMO Plus (HMO)

Regence BlueCross BlueShield of Oregon

Regence MedAdvantage + Rx Enhanced (Local PPO)

Regence BlueCross BlueShield of Oregon

Regence MedAdvantage + Rx Classic (Local PPO)

Pennsylvania Capital Blue Cross BlueJourney Essential (HMO)

Capital Blue Cross BlueJourney Premier (HMO)

Capital Blue Cross BlueJourney Value (HMO)

Pennsylvania

Capital Blue Cross BlueJourney Classic (PPO)

Capital Blue Cross BlueJourney Prime (PPO)

Capital Blue Cross BlueJourney Select (PPO)

Highmark Inc. Community Blue Medicare HMO Prestige (HMO)

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State Regional

PPO Local PPO

HMO HMO- POS

PFFS Cost SNP Blue Cross and Blue Shield Plan Sponsor

Product Name

Highmark Inc. Community Blue Medicare HMO Signature (HMO)

Highmark Inc. Security Blue HMO-POS Deluxe (HMO-POS)

Highmark Inc. Security Blue HMO-POS Standard (HMO-POS)

Highmark Inc. Security Blue HMO-POS ValueRx (HMO-POS)

Highmark Inc. Security Blue HMO-POS Basic (HMO-POS)

Highmark Inc. Community Blue Medicare Plus PPO Distinct (PPO)

Highmark Inc. Community Blue Medicare Plus PPO Signature (PPO)

Highmark Inc. Community Blue Medicare PPO Distinct (PPO)

Highmark Inc. Community Blue Medicare PPO Signature (PPO)

Highmark Inc. Complete Blue PPO Distinct (PPO)

Highmark Inc. Freedom Blue PPO Classic (PPO)

Highmark Inc. Freedom Blue PPO Deluxe (PPO)

Highmark Inc. Freedom Blue PPO Select (PPO)

Highmark Inc. Freedom Blue PPO Standard (PPO)

Highmark Inc. Freedom Blue PPO ValueRx (PPO)

Highmark Inc. Freedom Blue PPO Basic (PPO)

Independence Blue Cross Keystone 65 Basic Rx (HMO)

Independence Blue Cross Keystone 65 Focus Rx (HMO-POS)

Independence Blue Cross Keystone 65 Preferred Rx (HMO)

Independence Blue Cross Keystone 65 Select Rx (HMO)

Independence Blue Cross Keystone 65 Preferred Medical Only (HMO)

Independence Blue Cross Keystone 65 Select Medical Only (HMO)

Independence Blue Cross Personal Choice 65 Prime Rx (PPO)

Independence Blue Cross Personal Choice 65 Rx (PPO)

Independence Blue Cross Personal Choice 65 Medical Only (PPO)

Independence Blue Cross Keystone First VIP Choice (HMO D-SNP)

Puerto Rico Triple-S Advantage Brillante (HMO-POS)

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State Regional

PPO Local PPO

HMO HMO- POS

PFFS Cost SNP Blue Cross and Blue Shield Plan Sponsor

Product Name

Triple-S Advantage Enlace (HMO)

Triple-S Advantage Magno (HMO-POS)

Triple-S Advantage Real (HMO)

Triple-S Advantage Basic (HMO)

Triple-S Advantage Óptimo Plus (PPO)

Triple-S Advantage Óptimo (PPO)

Triple-S Advantage Contigo Plus (HMO C-SNP)

Triple-S Advantage Platino Advance (HMO D-SNP)

Triple-S Advantage Platino Alcance (HMO D-SNP)

Triple-S Advantage Platino Blindao (HMO D-SNP)

Triple-S Advantage Platino Enlace (HMO D-SNP)

Triple-S Advantage Platino Plus (HMO D-SNP)

Triple-S Advantage Platino Ultra (HMO D-SNP)

Rhode Island

Blue Cross & Blue Shield of Rhode Island

BlueCHiP for Medicare Advance (HMO)

Blue Cross & Blue Shield of Rhode Island

BlueCHiP for Medicare Extra (HMO-POS)

Blue Cross & Blue Shield of Rhode Island

BlueCHiP for Medicare Plus (HMO)

Blue Cross & Blue Shield of Rhode Island

BlueCHiP for Medicare Preferred (HMO-POS)

Blue Cross & Blue Shield of Rhode Island

BlueCHiP for Medicare Standard with Drugs (HMO)

Blue Cross & Blue Shield of Rhode Island

BlueCHiP for Medicare Value (HMO-POS)

Blue Cross & Blue Shield of Rhode Island

BlueCHiP for Medicare Core (HMO)

Blue Cross & Blue Shield of Rhode Island

HealthMate for Medicare (PPO)

South Carolina BlueCross BlueShield of South Carolina

BlueCross Secure (HMO)

BlueCross BlueShield of South Carolina

BlueCross Total (PPO)

BlueCross BlueShield of South Carolina

BlueCross Total Value (PPO)

Tennessee

BlueCross BlueShield of Tennessee, Inc.

BlueAdvantage Diamond (PPO)

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State Regional

PPO Local PPO

HMO HMO- POS

PFFS Cost SNP Blue Cross and Blue Shield Plan Sponsor

Product Name

BlueCross BlueShield of Tennessee, Inc.

BlueAdvantage Emerald (PPO)

BlueCross BlueShield of Tennessee, Inc.

BlueAdvantage Garnet (PPO)

BlueCross BlueShield of Tennessee, Inc.

BlueAdvantage Ruby (PPO)

BlueCross BlueShield of Tennessee, Inc.

BlueAdvantage Sapphire (PPO)

BlueCross BlueShield of Tennessee, Inc.

BlueCare Plus (HMO D-SNP)

BlueCross BlueShield of Tennessee, Inc.

BlueCare Plus Choice (HMO D-SNP)

BlueCross BlueShield of Tennessee, Inc.

BlueEssential (HMO C-SNP)

Texas

Blue Cross and Blue Shield of Texas

Blue Cross Medicare Advantage Basic (HMO)

Blue Cross and Blue Shield of Texas

Blue Cross Medicare Advantage Value (HMO)

Blue Cross and Blue Shield of Texas

Blue Cross Medicare Advantage Choice Plus (PPO)

Blue Cross and Blue Shield of Texas

Blue Cross Medicare Advantage Choice Premier (PPO)

Blue Cross and Blue Shield of Texas

Blue Cross Medicare Advantage Dual Care Plus (HMO D-SNP)

Utah

Regence BlueCross BlueShield of Utah

Regence MedAdvantage + Rx Classic (PPO)

Regence BlueCross BlueShield of Utah

Regence MedAdvantage + Rx Enhanced (PPO)

Regence BlueCross BlueShield of Utah

Regence MedAdvantage + Rx Primary (PPO)

Regence BlueCross BlueShield of Utah

Regence Valiance (PPO)

Vermont

Blue Cross Blue Shield of Vermont

Vermont Blue Advantage

Unity HMO (HMO)

Blue Cross Blue Shield of Vermont

Vermont Blue Advantage

Freedom Plus PPO (PPO)

Blue Cross Blue Shield of Vermont

Vermont Blue Advantage

Freedom PPO (PPO)

Virginia Anthem Blue Cross and Blue Shield

Anthem MediBlue Essential

(HMO)

Anthem Blue Cross and Blue Shield

Anthem MediBlue Extra (HMO)

Anthem Blue Cross and Blue Shield Anthem MediBlue Local (HMO)

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State Regional

PPO Local PPO

HMO HMO- POS

PFFS Cost SNP Blue Cross and Blue Shield Plan Sponsor

Product Name

Anthem Blue Cross and Blue Shield Anthem MediBlue Plus (HMO)

Anthem Blue Cross and Blue Shield

Anthem MediBlue Smart Fit

(HMO)

Anthem Blue Cross and Blue Shield

Anthem MediBlue Access

(PPO)

Anthem Blue Cross and Blue Shield

Anthem MediBlue Care On Site

(HMO I-SNP)

Anthem Blue Cross and Blue Shield

Anthem MediBlue Care To You

(HMO I-SNP)

Anthem Blue Cross and Blue Shield

Anthem MediBlue COPD (HMO

C-SNP)

Anthem Blue Cross and Blue Shield

Anthem MediBlue Diabetes

(HMO C-SNP)

Anthem Blue Cross and Blue Shield

Anthem MediBlue Dual Access

(PPO D-SNP)

Anthem Blue Cross and Blue Shield

Anthem MediBlue Dual

Advantage (HMO D-SNP)

Anthem Blue Cross and Blue Shield

Anthem MediBlue Full Dual

Advantage (HMO D-SNP)

Premera Blue Cross Premera Blue Cross Medicare

Advantage (HMO)

Washington

Premera Blue Cross Premera Blue Cross Medicare Advantage Charter + Rx (HMO)

Premera Blue Cross Premera Blue Cross Medicare Advantage Classic (HMO)

Premera Blue Cross Premera Blue Cross Medicare Advantage Classic Plus (HMO)

Premera Blue Cross Premera Blue Cross Medicare Advantage Core (HMO)

Premera Blue Cross Premera Blue Cross Medicare Advantage Core Plus (HMO)

Premera Blue Cross Premera Blue Cross Medicare Advantage Peak + Rx (HMO)

Premera Blue Cross Premera Blue Cross Medicare Advantage Sound + Rx (HMO)

Premera Blue Cross Premera Blue Cross Medicare Advantage Total Health (HMO)

Premera Blue Cross Premera Blue Cross Medicare Advantage Alpine (HMO)

Regence BlueShield Regence Align (HMO)

Regence BlueShield Regence Align Plus (HMO)

Regence BlueShield Regence BlueAdvantage HMO (HMO)

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19

State Regional

PPO Local PPO

HMO HMO- POS

PFFS Cost SNP Blue Cross and Blue Shield Plan Sponsor

Product Name

Regence BlueShield Regence BlueAdvantage HMO Plus (HMO)

Regence BlueShield Regence Valiance (HMO)

Regence BlueShield Regence MedAdvantage + Rx Classic (PPO)

Regence BlueShield Regence MedAdvantage + Rx Enhanced (PPO)

Regence BlueShield Regence MedAdvantage + Rx Primary (PPO)

Regence BlueShield Regence Valiance (PPO)

West Virginia

Highmark Inc. Freedom Blue PPO Distinct (PPO)

Highmark Inc. Freedom Blue PPO Standard (PPO)

Wisconsin

Anthem Blue Cross and Blue Shield

Anthem MediBlue Plus (HMO)

Anthem Blue Cross and Blue Shield

Anthem MediBlue Access (PPO)

Anthem Blue Cross and Blue Shield

Anthem MediBlue Access Plus (PPO)

Anthem Blue Cross and Blue Shield

Anthem MediBlue Access Core (PPO)

Anthem Blue Cross and Blue Shield

Anthem MediBlue Dual Advantage (HMO D-SNP)

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2021 Standalone Prescription Drug Plans by State Offered by Blue Cross and Blue Shield Companies

State Basic Enhanced Blue Cross and Blue Shield Plan Sponsor Product Name

Alabama

Blue Cross and Blue Shield of Alabama

BlueRx Essential

BlueRx Enhanced

BlueRx Enhanced Plus

Arizona

Blue Cross Blue Shield of Arizona

Blue MedicareRx Value

Blue MedicareRx Enhanced

Blue MedicareRx Essential

Arkansas

Arkansas Blue Cross and Blue Shield

BlueMedicare Value Rx (PDP)

BlueMedicare Premier Rx (PDP)

BlueMedicare Saver Rx (PDP)

California

Anthem Blue Cross

Anthem Blue Cross MediBlue Rx Standard

Anthem Blue Cross MediBlue Rx Plus

Anthem Blue Cross MediBlue Rx Enhanced

Blue Shield of California

Blue Shield Rx Plus (PDP)

Blue Shield Rx Enhanced (PDP)

Colorado

Anthem Blue Cross and Blue Shield

Anthem Blue MedicareRx Standard

Anthem Blue MedicareRx Plus

Anthem Blue MedicareRx Enhanced

Connecticut

The Joint Enterprise**

Blue MedicareRx Value Plus

Blue MedicareRx Premier

Florida

Florida Blue

BlueMedicare Premier Rx (PDP)

BlueMedicare Complete Rx (PDP)

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21

State Basic Enhanced Blue Cross and Blue Shield Plan Sponsor Product Name

Georgia

Anthem Blue Cross and Blue Shield

Anthem MediBlue Rx Standard

Anthem MediBlue Rx Plus

Anthem MediBlue Rx Enhanced

Idaho

The Regence Group

Regence Medicare Script Basic

Regence Medicare Script Enhanced

Illinois

Health Care Service Corporation

Blue Cross MedicareRx Basic

Blue Cross MedicareRx Plus

Blue Cross MedicareRx Value

Indiana

Anthem Blue Cross and Blue Shield

Anthem MediBlue Rx Standard

Anthem MediBlue Rx Plus

Anthem MediBlue Rx Enhanced

Northern Plains Alliance***

MedicareBlue Rx Standard

MedicareBlue Rx Premier

Kansas

Blue Cross and Blue Shield of Kansas

Blue MedicareRx Value

Blue MedicareRx Plus

Blue MedicareRx Enhanced

Kentucky

Anthem Blue Cross and Blue Shield

Anthem MediBlue Rx Standard

Anthem MediBlue Rx Plus

Anthem MediBlue Rx Enhanced

Maine

Anthem Blue Cross and Blue Shield

Anthem MediBlue Rx Standard

Anthem MediBlue Rx Plus

Anthem MediBlue Rx Enhanced

Massachusetts

The Joint Enterprise**

Blue MedicareRx Value Plus

Blue MedicareRx Premier

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2021 Standalone Prescription Drug Plans by State Offered by Blue Cross and Blue Shield Companies

22

State Basic Enhanced Blue Cross and Blue Shield Plan Sponsor Product Name

Michigan

Blue Cross Blue Shield of Michigan

Prescription Blue Select

Prescription Blue Premium

Minnesota

Northern Plains Alliance***

MedicareBlue Rx Standard

Medicare Blue Rx Premier

Missouri

Anthem Blue Cross and Blue Shield

Blue MedicareRx Plus

Blue MedicareRx Enhanced

Blue MedicareRx Value

Montana

Northern Plains Alliance***

MedicareBlue Rx Standard

MedicareBlue Rx Premier

Nebraska

Northern Plains Alliance

MedicareBlue Rx Standard

MedicareBlue Rx Premier

Nevada

Anthem Blue Cross and Blue Shield

Anthem MediBlue Rx Standard

Anthem MediBlue Rx Plus

Anthem MediBlue Rx Enhanced

New Hampshire

Anthem Blue Cross and Blue Shield

Anthem MediBlue Rx Standard

Anthem MediBlue Rx Plus

Anthem MediBlue Rx Enhanced

New Jersey

Horizon Blue Cross Blue Shield of New Jersey

Horizon Medicare Blue Rx Standard

Horizon Medicare Blue Rx Enhanced

Horizon Medicare Blue Rx Saver

New Mexico

Health Care Service Corporation

Blue Cross MedicareRx Basic

Blue Cross MedicareRx Plus

Blue Cross MedicareRx Value

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23

State Basic Enhanced Blue Cross and Blue Shield Plan Sponsor Product Name

New York

BlueCross BlueShield: Empire, Excellus, WNY & NENY

Blue Rx Standard (PDP)

Blue Rx Enhanced (PDP)

Blue Rx Plus (PDP)

North Carolina

Blue Cross and Blue Shield of North Carolina

Blue Medicare Rx Standard

Blue Medicare Rx Enhanced

North Dakota

Northern Plains Alliance***

MedicareBlue Rx Standard

MedicareBlue Rx Premier

Ohio

Anthem Blue Cross and Blue Shield

Anthem MediBlue Rx Standard

Anthem MediBlue Rx Plus

Anthem MediBlue Rx Enhanced

Oklahoma

Health Care Service Corporation

Blue Cross MedicareRx Basic

Blue Cross MedicareRx Choice

Blue Cross MedicareRx Value

Pennsylvania

Highmark Inc.

Blue Rx PDP Plus

Blue Rx PDP Complete

Rhode Island

The Joint Enterprise**

Blue MedicareRx Value Plus

Blue MedicareRx Premier

South Carolina

BlueCross BlueShield of South Carolina

Blue Cross Rx Value

BlueCross Rx Plus

South Dakota

Northern Plains Alliance***

MedicareBlue Rx Standard

MedicareBlue Rx Premier

Tennessee

Blue Cross and Blue Shield of Alabama

BlueRx Essential

BlueRx Enhanced

BlueRx Enhanced Plus

Texas Health Care Service Corporation Blue Cross MedicareRx Basic

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24

State Basic Enhanced Blue Cross and Blue Shield Plan Sponsor Product Name

Blue Cross MedicareRx Plus

Blue Cross MedicareRx Value

Utah

The Regence Group

Regence Medicare Script Basic

Regence Medicare Script Enhanced

Vermont

The Joint Enterprise**

Blue MedicareRx Value Plus

Blue MedicareRx Premier

Virginia

Anthem Blue Cross and Blue Shield

Anthem MediBlue Rx Standard

Anthem MediBlue Rx Plus

Anthem MediBlue Rx Enhanced

West Virginia

Highmark Inc.

Blue Rx PDP Plus

Blue Rx PDP Complete

Wisconsin

Anthem Blue Cross and Blue Shield

Anthem MediBlue Rx Standard

Anthem MediBlue Rx Plus

Anthem MediBlue Rx Enhanced

Wyoming

Northern Plains Alliance***

MedicareBlue Rx Standard

MedicareBlue Rx Premier

Notes: **The Joint Enterprise is composed of Anthem Insurance Companies, Inc., Blue Cross Blue Shield of Massachusetts, Blue Cross Blue Shield of Rhode Island, and Blue Cross Blue Shield of Vermont. ***Northern Plains Alliance is composed of Blue Cross and Blue Shield of Minnesota, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of North Dakota, Blue Cross Blue Shield of Nebraska, Blue Cross Blue Shield of Wyoming, Wellmark Blue Cross Blue Shield of Iowa, and Wellmark Blue Cross Blue Shield of South Dakota