CARD PR-1

Medicare Managed Care Plans
Alabama

F. VIVA Medicare Plus

G. Seniors First (Healthspring of Alabama, Inc.)

H. United Healthcare Medicare Complete Choice (United Healthcare Insurance Company)

I. Blue Advantage (Blue Cross Blue Shield of Alabama)

J. Human Gold Choice/ HumanaChoice PPO (Humana Insurance Company)

K. SecureHorizons Direct (Healthspring of Alabama, Inc.)

 

 

CARD PR-2

Plan Names
Alabama

C. Maternity Care Program

D. Partnership Hospital Program

E. Patient 1st

 

 

CARD HX-3

Sample Medicaid Card
Alabama

Sample Medicaid Card for the state of Alabama

 

 

CARD HX-5

Medicare Managed Care Plans
Alabama

F. VIVA Medicare Plus

G. Seniors First (Healthspring of Alabama, Inc.)

H. United Healthcare Medicare Complete Choice (United Healthcare Insurance Company)

I. Blue Advantage (Blue Cross Blue Shield of Alabama)

J. Human Gold Choice/ HumanaChoice PPO (Humana Insurance Company)

K. SecureHorizons Direct (Healthspring of Alabama, Inc.)

 

 

CARD HX-6

Plan Names
Alabama

C. Maternity Care Program

D. Partnership Hospital Program

E. Patient 1st

 

 

CARD HX-8

PLAN NAMES (FOR FEDERAL CIVILIAN EMPLOYEES)
ALABAMA

F. NALC

H. Association Benefit Plan

J. Foreign Service Benefit Plan

L. Panama Canal Area Benefit Plan

M. Rural Carrier Benefit Plan

Z. Mail Handlers – Standard

CC. PBP Health Plan – Standard

EE. APWU Health Plan – High

FF. APWU Health Plan – Consumer Driven

GG. PBP Health Plan – High

HH. GEHA Benefit Plan – Standard

II. GEHA Benefit Plan – High

JJ. Mail Handlers – High

KK. Blue Cross and Blue Shield Service Benefit Plan - Standard

LL. Blue Cross and Blue Shield Service Benefit Plan – Basic

MM. SAMBA – High

NN. SAMBA – Standard

OO. Mail Handlers High Deductible Plan

PP. Aetna HealthFund CDHP

QQ. Aetna Healthfund HDHP

 

 

CARD IN-2A

State TANF Program
Alabama

Family Assistance Program

 

 

CARD PR-1

Medicare Managed Care Plans
Alaska

A. Secure Horizons Direct

 

 

CARD PR-2

Plan Names
Alaska

None

 

 

CARD HX-3

Sample Medicaid Card
Alaska

Sample Medicaid Card for the state of Alaska

 

 

CARD HX-5

HX-5 Medicare Managed Care Plans
Alaska

A. Secure Horizons Direct

 

 

CARD HX-6

Plan Names
Alaska

None

 

 

CARD HX-8

PLAN NAMES (FOR FEDERAL CIVILIAN EMPLOYEES)
ALASKA

C. APWU

D. GEHA Benefit Plan

E. Mail Handlers

F. NALC

H. Association Benefit Plan

J. Foreign Service Benefit Plan

L. Panama Canal Area Benefit Plan

M. Rural Carrier Benefit Plan

N. SAMBA

P. Blue Cross Blue Shield Service Benefit Plan – Standard

Q. Blue Cross Blue Shield Service Benefit Plan – Basic

S. APWU Health Plan - High

T. APWU Health Plan – Consumer Driven

U. GEHA Benefit Plan – High

V. GEHA Benefit Plan – Standard

W. Mail Handlers – High

X. Mail Handlers – Standard

Y. PBP Health Plan – High

Z. PBP Health Plan – Standard

 

 

CARD IN-2A

State TANF Program
Alaska

Alaska Temporary Assistance Program (ATAP)

 

 

CARD PR-1

Medicare Managed Care Plans
Arizona

S. SeniorCare (Health Net of Arizona, Inc.)

U. MedisunONE (Sun Health MedisunOne)

AA. CIGNA HealthCare for Seniors

BB. Evercare Premiere (United Healthcare Insurance Company)

CC. Humana Gold Classic (Humana Health Plan, Inc.)

FF. United Healthcare Medicare Complete (United Healthcare of Arizona, Inc.)

GG. Abrazo Advantage (Abrazo Advantage Health Plan)

HH. Aetna Golden (Aetna Medicare)

II. Desert Canyon Community Care

JJ. Health Net Preferred (Health Net)

KK. SecureHorizons Direct

LL. Sierra Spectrum

MM. Sun Health MediSun (MediSun Private Fee for Service)

NN. Sun Health MediSunONE

OO. Today’s Options

 

 

CARD PR-2

Plan Names
Arizona

G. DES/CMDP (Department of Economic Security/ Comprehensive Medical and Dental Program)

K. Health Choice Arizona

N. Mercy Care Plan

W. Phoenix Health Plan/Community Connection

Y. University Family Care

Z. AHCCCS (The Arizona Health Care Cost Containment System)

AA. Evercare Select

CC. APIPA

DD. Care 1st Arizona

EE. PINAL/GILA LTC

FF. Conchise Health Systems

HH. YAVAPAI Long Term Care

II. LTC DD DES

JJ. Arizona Department of Health Services

KK. Maricopa Health Plan

LL. Mercy Care LTC

MM. Pima Health System

NN. Pimal LTC

 

 

CARD HX-3

Sample Medicaid Card
Arizona

Sample of Medicaid Card for the state of Arizona

 

 

CARD HX-5

Medicare Managed Care Plans
Arizona

S. SeniorCare (Health Net of Arizona, Inc.)

U. MedisunONE (Sun Health MedisunOne)

AA. CIGNA HealthCare for Seniors

BB. Evercare Premiere (United Healthcare Insurance Company)

CC. Humana Gold Classic (Humana Health Plan, Inc.)

FF. United Healthcare Medicare Complete (United Healthcare of Arizona, Inc.)

GG. Abrazo Advantage (Abrazo Advantage Health Plan)

HH. Aetna Golden (Aetna Medicare)

II. Desert Canyon Community Care

JJ. Health Net Preferred (Health Net)

KK. SecureHorizons Direct

LL. Sierra Spectrum

MM. Sun Health MediSun (MediSun Private Fee for Service)

NN. Sun Health MediSunONE

OO. Today’s Options

 

 

CARD HX-6

Plan Names
Arizona

G. DES/CMDP (Department of Economic Security/ Comprehensive Medical and Dental Program)

K. Health Choice Arizona

N. Mercy Care Plan

W. Phoenix Health Plan/Community Connection

Y. University Family Care

Z. AHCCCS (The Arizona Health Care Cost Containment System)

AA. Evercare Select

CC. APIPA

DD. Care 1st Arizona

EE. PINAL/GILA LTC

FF. Conchise Health Systems

HH. YAVAPAI Long Term Care

II. LTC DD DES

JJ. Arizona Department of Health Services

KK. Maricopa Health Plan

LL. Mercy Care LTC

MM. Pima Health System

NN. Pimal LTC

 

 

CARD HX-8

PLAN NAMES (FOR FEDERAL CIVILIAN EMPLOYEES)
ARIZONA

F. NALC

H. Association Benefit Plan

J. Foreign Service Benefit Plan

L. Panama Canal Area Benefit Plan

M. Rural Carrier Benefit Plan

Y. GEHA Benefit Plan – High

Z. GEHA Benefit Plan – Standard

AA. Mail Handlers – High

BB. Mail Handlers – Standard

CC. PBP Health Plan – High

DD. PBP Health Plan – Standard

HH APWU Health Plan - High

II. APWU Health Plan – Consumer Driven

KK. Blue Cross and Blue Shield Service Benefit Plan – Standard

LL. Blue Cross and Blue Shield Service Benefit Plan – Basic

MM. SAMBA – High

NN. SAMBA – Standard

OO. GEHA – High Deductible Health Plan

PP. Mail Handlers High Deductible Plan

QQ. Aetna HealthFund CDHP

RR. Aetna HealthFund HDHP

SS. Humana CoverageFirst CDHP

TT. Aetna Open Access

UU. Health Net of Arizona, Inc.

VV. PacifiCare Desert Region (AZ)

 

 

CARD IN-2A

State TANF Program
Arizona

Employing and Moving People Off Welfare and Encouraging Responsibility Program (EMPOWER)

 

 

CARD PR-1

Medicare Managed Care Plans
Arkansas

E. Arkansas Community Care (Arkansas Community Care, Inc.)

F. Humana Gold Choice/HumanaChoice PPO (Humana Insurance Company)

G. SecureHorizons Direct

H. SecurityChoice (Unicare Life and Health Ins. Company)

I. United Healthcare Medicare Complete (United Healthcare of Arkansas, Inc.)

 

 

CARD PR-2

Plan Names
Arkansas

NONE AVAILABLE

 

 

CARD HX-3

Sample Medicaid Card
Arkansas

Sample Medicaid Card for the state of Arkansas

 

 

CARD HX-5

Medicare Managed Care Plans
Arkansas

E. Arkansas Community Care (Arkansas Community Care, Inc.)

F. Humana Gold Choice/HumanaChoice PPO (Humana Insurance Company)

G. SecureHorizons Direct

H. SecurityChoice (Unicare Life and Health Ins. Company)

I. United Healthcare Medicare Complete (United Healthcare of Arkansas, Inc.)

 

 

CARD HX-6

Plan Names
Arkansas

NONE AVAILABLE

 

 

CARD HX-8

PLAN NAMES (FOR FEDERAL CIVILIAN EMPLOYEES)
ARKANSAS

F. NALC

H. Association Benefit Plan

J. Foreign Service Benefit Plan

L. Panama Canal Area Benefit Plan

M. Rural Carrier Benefit Plan

W. GEHA Benefit Plan – High

X. GEHA Benefit Plan – Standard

Y. Mail Handlers – High

Z. Mail Handlers – Standard

AA. PBP Health Plan – High

BB. PBP Health Plan – Standard

CC. APWU Health Plan - High

DD. APWU Health Plan – Consumer Driven

EE. Blue Cross and Blue Shield Service Benefit Plan – Standard

FF. Blue Cross and Blue Shield Service Benefit Plan – Basic

GG. SAMBA – High

HH. SAMBA – Standard

II. GEHA High Deductible Health Plan

JJ. Mail Handlers High Deductible Plan

KK. Aetna HealthFund CDHP

LL. Aetna HealthFund HDHP

 

 

CARD IN-2A

State TANF Program
Arkansas

Transitional Employment Assistance Program (TEA)

 

 

CARD PR-1

Medicare Managed Care Plans
California

AAA. Blue Shield 65 Plus (Blue Shield of California, Inc.)

HHH. UHP Healthcare for Seniors (UHP Healthcare for Seniors)

JJJ. WHA Care + (Western Health Advantage)

KKK. Blue Cross Senior Secure (Blue Cross of California)

MMM. Aetna Golden Medicare Plan (Aetna Health of California, Inc.)

OOO. Health Net Seniority (Health Net of CA)

QQQ. CCHP (Chinese Community Health Plan)

RRR. California Medicare Advantage (CIS)

SSS. SCAN Health Plan (SCAN Health Plan)

TTT. Health Advantage (Universal Care Health Advantage)

UUU. Kaiser Permanente Senior Advantage (Kaiser Permanente)

VVV. Secure Horizons (Secure Horizons Medicare Advantage Plan)

WWW. Caremore Value PLUS (CIS)

XXX. InterValley Health Plan

YYY. Aetna Golden (Aetna Medicare)

ZZZ. Central Health Medicare Plan

AAAA. Citizens Choice Healthplan

BBBB. Freedom Blue (BC Life and Health Insurance Company)

CCCC. Health Net Options Plus (Health Net Life Insurance Company)

EEEE. SecureHorizons Direct

FFFF. SmartValue (Blue Cross of California)

GGGG. Universal Care Health Advantage

 

 

CARD PR-2

Plan Names – California

B. Blue Cross of California

K. Contra Costa Health Plan

Q. Health Plan of San Mateo

KK. Sutter Senior Care

QQ. Alameda Alliance for Health

VV. Community Health Group

ZZ. Health Plan of San Joaquin

AAA. Inland Empire Health Plan

CCC. Kern Family Health Care

DDD. L.A. Care Health Plan

NNN. San Francisco Health Plan

PPP. Santa Clara Family Health Plan

YYY. Center for Elders Independence

ZZZ. Central Coast Alliance for Health

XXXX. Partnership Health Plan of California

YYYY. Molina Healthcare of California

ZZZZ. Family Mosaic Project

AB. Kaiser Foundation Health Plan, Inc.

AC. On Lok Senior Health

AE. Western Health Advantage

AJ. AltaMed

AK. Care 1st

AM. Santa Barbara Regional Health Authority

AN. SCAN Health Plan

AO. Stanislaus County Local Initiative

AP. Tulare County Local Initiative (Blue Cross)

AR. CalOPTIMA

AS. AIDS Healthcare Centers

AT. Blue Cross Partnership Plan

AU. Health Net Community Solutions

 

 

CARD HX-3

Sample Medicaid Card
California

Sample Medicaid Card for the state of California

 

 

CARD HX-5

Medicare Managed Care Plans
California

AAA. Blue Shield 65 Plus (Blue Shield of California, Inc.)

HHH. UHP Healthcare for Seniors (UHP Healthcare for Seniors)

JJJ. WHA Care + (Western Health Advantage)

KKK. Blue Cross Senior Secure (Blue Cross of California)

MMM. Aetna Golden Medicare Plan (Aetna Health of California, Inc.)

OOO. Health Net Seniority (Health Net of CA)

QQQ. CCHP (Chinese Community Health Plan)

RRR. California Medicare Advantage (CIS)

SSS. SCAN Health Plan (SCAN Health Plan)

TTT. Health Advantage (Universal Care Health Advantage)

UUU. Kaiser Permanente Senior Advantage (Kaiser Permanente)

VVV. Secure Horizons (Secure Horizons Medicare Advantage Plan)

WWW. Caremore Value PLUS (CIS)

XXX. InterValley Health Plan

YYY. Aetna Golden (Aetna Medicare)

ZZZ. Central Health Medicare Plan

AAAA. Citizens Choice Healthplan

BBBB. Freedom Blue (BC Life and Health Insurance Company)

CCCC. Health Net Options Plus (Health Net Life Insurance Company)

EEEE. SecureHorizons Direct

FFFF. SmartValue (Blue Cross of California)

GGGG. Universal Care Health Advantage

 

 

CARD HX-6

Plan Names California

B. Blue Cross of California

K. Contra Costa Health Plan

Q. Health Plan of San Mateo

KK. Sutter Senior Care

QQ. Alameda Alliance for Health

VV. Community Health Group

ZZ. Health Plan of San Joaquin

AAA. Inland Empire Health Plan

CCC. Kern Family Health Care

DDD. L.A. Care Health Plan

NNN. San Francisco Health Plan

PPP. Santa Clara Family Health Plan

YYY. Center for Elders Independence

ZZZ. Central Coast Alliance for Health

XXXX. Partnership Health Plan of California

YYYY. Molina Healthcare of California

ZZZZ. Family Mosaic Project

AB. Kaiser Foundation Health Plan, Inc.

AC. On Lok Senior Health

AE. Western Health Advantage

AJ. AltaMed

AK. Care 1st

AM. Santa Barbara Regional Health Authority

AN. SCAN Health Plan

AO. Stanislaus County Local Initiative

AP. Tulare County Local Initiative (Blue Cross)

AR. CalOPTIMA

AS. AIDS Healthcare Centers

AT. Blue Cross Partnership Plan

AU. Health Net Community Solutions

 

 

CARD HX-8

PLAN NAMES (FOR FEDERAL CIVILIAN EMPLOYEES)
CALIFORNIA

F. NALC

H. Association Benefit Plan

J. Foreign Service Benefit Plan

L. Panama Canal Area Benefit Plan

M. Rural Carrier Benefit Plan

X. Health Net of CA

JJ. GEHA Benefit Plan – High

KK. GEHA Benefit Plan – Standard

LL. Mail Handlers – High

MM. Mail Handlers – Standard

NN. PBP Health Plan – High

OO. PBP Health Plan – Standard

QQ. Blue Cross – HMO

RR. Blue Shield of CA Access+

UU. UHP HEALTHCARE

XX. APWU Health Plan – High

YY. APWU Health Plan – Consumer Driven

ZZ. Blue Cross and Blue Shield Service Benefit Plan – Standard

AAA. Blue Cross and Blue Shield Service Benefit Plan – Basic

CCC. SAMBA – High

DDD. SAMBA – Standard

EEE. GEHA High Deductible Health Plan

FFF. Mail Handlers High Deductible Plan

LLL. PacifiCare of California

MMM. Universal Care – High – S. CA

NNN. Aetna HealthFund CDHP

OOO. Aetna HealthFund HDHP

QQQ Aetna HMO

RRR Kaiser Permanente

 

 

CARD IN-2A

State TANF Program
California

CalWORKS
(California Work Opportunity and Responsibility to Kids)

 

 

CARD PR-1

Medicare Managed Care Plans
Colorado

Z. Senior Advantage (Kaiser Permanente)

BB. Secure Horizons (Secure Horizons Medicare Advantage Plan)

DD. RMHP (Rocky Mountain Health Plans)

EE. SecureHorizons Direct

 

 

CARD PR-2

Plan Names
Colorado

F. Rocky Mountain HMO

H. Colorado Access

P. Primary Care Physician Program

V. Denver Health

W. Management Team Solutions

 

 

CARD HX-3

Sample Medicaid Card
Colorado

Sample Medicaid Card for the state of Colorado front side

Sample Medicaid Card for the state of Colorado back side

 

 

CARD HX-5

Medicare Managed Care Plans
Colorado

Z. Senior Advantage (Kaiser Permanente)

BB. Secure Horizons (Secure Horizons Medicare Advantage Plan)

DD. RMHP (Rocky Mountain Health Plans)

EE. SecureHorizons Direct

 

 

CARD HX-6

Plan Names
Colorado

F. Rocky Mountain HMO

H. Colorado Access

P. Primary Care Physician Program

V. Denver Health

W. Management Team Solutions

 

 

CARD HX-8

PLAN NAMES (FOR FEDERAL CIVILIAN EMPLOYEES)
COLORADO

F. NALC

H. Association Benefit Plan

J. Foreign Service Benefit Plan

L. Panama Canal Area Benefit Plan

M. Rural Carrier Benefit Plan

AA. GEHA Benefit Plan – High

BB. GEHA Benefit Plan – Standard

CC. Mail Handlers – High

DD. Mail Handlers – Standard

EE. PBP Health Plan – High

FF. PBP Health Plan – Standard

KK. APWU Health Plan – High

LL. APWU Health Plan – Consumer Driven

MM. Blue Cross and Blue Shield Service Benefit Plan – Standard

NN. Blue Cross and Blue Shield Service Benefit Plan – Basic

OO. SAMBA – High

PP. SAMBA – Standard

QQ. GEHA High Deductible Health Plan

RR. Mail Handlers High Deductible Plan

SS. Aetna – Denver Area

TT. Kaiser Permanente – High

UU. Kaiser Permanente – Std

VV. PacifiCare of Colorado

WW. Aetna HealthFund CDHP

XX. Aetna HealthFund HDHP

YY. Humana Coverage First CDHP

ZZ. United Healthcare of Colorado

 

 

CARD IN-2A

State TANF Program
Colorado

Colorado Works

 

 

CARD PR-1

Medicare Managed Care Plans
Connecticut

M. Oxford Medicare Advantage (Oxford Health Plans (CT), Inc.)

N. Health Net SmartChoice for Connecticut (Health Net of Connecticut)

P. WellCare

Q. SecureHorizons Direct

 

 

CARD PR-2

Plan Names
Connecticut

D. Community Health Network of Connecticut

P. Anthem Blue Care Family Plan

S. Husky A/B

T. Healthy Start

U. Health Net

 

 

CARD HX-3

Sample Medicaid Card
Connecticut

Sample Medicaid Card for the state of Connecticut front side

Sample Medicaid Card for the state of Connecticut back side

 

 

CARD HX-5

Medicare Managed Care Plans
Connecticut

M. Oxford Medicare Advantage (Oxford Health Plans (CT), Inc.)

N. Health Net SmartChoice for Connecticut (Health Net of Connecticut)

P. WellCare

Q. SecureHorizons Direct

 

 

CARD HX-6

Plan Names
Connecticut

D. Community Health Network of Connecticut

P. Anthem Blue Care Family Plan

S. Husky A/B

T. Healthy Start

U. Health Net

 

 

CARD HX-8

PLAN NAMES (FOR FEDERAL CIVILIAN EMPLOYEES)
CONNECTICUT

F. NALC

H. Association Benefit Plan

J. Foreign Service Benefit Plan

L. Panama Canal Area Benefit Plan

M. Rural Carrier Benefit Plan

Q. ConnectiCare

EE. GEHA Benefit Plan – High

FF. GEHA Benefit Plan – Standard

GG. Mail Handlers – High

HH. Mail Handlers – Standard

II. PBP Health Plan – High

JJ. PBP Health Plan – Standard

LL. APWU Health Plan-High

MM. APWU Health Plan – Consumer Driven

NN. Blue Cross and Blue Shield Service Benefit Plan – Standard

OO. Blue Cross and Blue Shield Service Benefit Plan – Basic

PP. SAMBA – High

QQ. SAMBA – Standard

RR. GEHA High Deductible Health Plan

SS. Mail Handlers High Deductible Plan

TT. Aetna HealthFund CDHP

UU. Aetna HealthFund HDHP

VV. Aetna Open Access

 

 

CARD IN-2A

State TANF Program
Connecticut

JOBS FIRST

 

 

CARD PR-1

Medicare Managed Care Plans
District of Columbia

G. Kaiser Permanente Medicare Plus (Kaiser Permanente Medicare Plus)

H. Aetna Golden (Aetna Medicare)

I. Elder Health (Elder Health Mid-Atlantic, Inc)

J. Kaiser Permanente Medicare Plus

K. SecureHorizons Direct

 

 

CARD PR-2

Plan Names
District of Columbia

J. Health Right, Inc.

N. D.C. Chartered Health Plan, Inc.

O. Health Services for Children with Special Needs, Inc. (HSCSN)

P. Amerigroup

 

 

CARD HX-3

Sample Medicaid Card
District of Columbia

Sample Medicaid Card for the Disctrict of Columbia

 

 

CARD HX-5

Medicare Managed Care Plans
District of Columbia

G. Kaiser Permanente Medicare Plus (Kaiser Permanente Medicare Plus)

H. Aetna Golden (Aetna Medicare)

I. Elder Health (Elder Health Mid-Atlantic, Inc)

J. Kaiser Permanente Medicare Plus

K. SecureHorizons Direct

 

 

CARD HX-6

Plan Names
District of Columbia

J. Health Right, Inc.

N. D.C. Chartered Health Plan, Inc.

O. Health Services for Children with Special Needs, Inc. (HSCSN)

P. Amerigroup

 

 

CARD HX-8

PLAN NAMES (FOR FEDERAL CIVILIAN EMPLOYEES)
DISTRICT OF COLUMBIA

F. NALC

H. Association Benefit Plan

J. Foreign Service Benefit Plan

L. Panama Canal Area Benefit Plan

M. Rural Carrier Benefit Plan

Q. Care First – Blue Choice

BB. M.D. IPA

II. GEHA Benefit Plan – High

JJ. GEHA Benefit Plan – Standard

KK. Mail Handlers – High

LL. Mail Handlers – Standard

MM. PBP Health Plan – High

NN. PBP Health Plan – Standard

QQ. APWU Health Plan – High

RR. APWU Health Plan – Consumer Driven

SS. Blue Cross and Blue Shield Service Benefit Plan – Basic

TT. Blue Cross and Blue Shield Service Benefit Plan - Standard

WW. SAMBA – High

XX. SAMBA – Standard

YY. GEHA High Deductible Health Plan

ZZ. Mail Handlers High Deductible Plan

AAA. Aetna Open Access – High

BBB. Aetna Open Access – Basic

CCC. Kaiser Permanente – High

DDD. Kaiser Permanente – Standard

EEE. Aetna HealthFund CDHP

FFF. Aetna HealthFund HDHP

 

 

CARD PR-1

Medicare Managed Care Plans
Delaware

G. Aetna Golden (Aetna Medicare)

H. SecureHorizons Direct

 

 

CARD PR-2

Plan Names
Delaware

H. Diamond State Health Plan

J. Delaware Physicians Care Inc. (DPCI)

K. Diamond State Partners (DSP)

 

 

CARD HX-3

Sample Medicaid Card
Delaware

Sample Medicaid Card for the state of Delaware

 

 

CARD HX-5

Medicare Managed Care Plans
Delaware

G. Aetna Golden (Aetna Medicare)

H. SecureHorizons Direct

 

 

CARD HX-6

Plan Names
Delaware

H. Diamond State Health Plan

J. Delaware Physicians Care Inc. (DPCI)

K. Diamond State Partners (DSP)

 

 

CARD HX-8

PLAN NAMES (FOR FEDERAL CIVILIAN EMPLOYEES)
DELAWARE

F. NALC

H. Association Benefit Plan

J. Foreign Service Benefit Plan

L. Panama Canal Area Benefit Plan

M. Rural Carrier Benefit Plan

X. GEHA Benefit Plan – High

Y. GEHA Benefit Plan – Standard

Z. Mail Handlers – High

AA. Mail Handlers – Standard

BB. PBP Health Plan – High

CC. PBP Health Plan – Standard

DD. APWU Health Plan – High

EE. APWU Health Plan – Consumer Driven

FF. Blue Cross and Blue Shield Service Benefit Plan – Standard

GG. Blue Cross and Blue Shield Service Benefit Plan – Basic

HH. SAMBA – High

II. SAMBA – Standard

JJ. GEHA High Deductible Health Plan

KK. Mail Handlers High Deductible Plan

LL. Aetna HealthFund CDHP

MM. Aetna HealthFund HDHP

NN. Coventry Healthcare of Delaware (HDHP)

OO. Coventry Health Care of Delaware

 

 

CARD IN-2A

State TANF Program
Delaware

A Better Chance (ABC)

 

 

CARD PR-1

Medicare Managed Care Plans
Florida

PP. Florida Health Care Plan, Inc. (Florida Health Care Plan, Inc.)

RR. Humana Gold (Humana Medical Plan, Inc.)

TT. Medicare Advantage (Vista Health Plan, Inc.)

VV. Medicare and More (Health Options, Inc./BC BS FL)

FFF. Capital Health Plan Medicare (Capital Health Plan, Inc.)

HHH. Medicare Masterpiece (Medicare Masterpiece)

III. PSO Health Plan (Preferred Care Partners, Inc.)

LLL. UnitedHealthCare Medicare Complete (United Healthcare Insurance Company, Inc.)

MMM. AvMed Premier Care (AvMed Medicare Plan)

NNN. CareOne Plan (CarePlus Health Plans, Inc.)

OOO. WellCare/Choice Value Plan (WellCare)

PPP. America’s Healthy Rewards Treasure Coast (America’s Health Choice Medical Plans, Inc.)

QQQ. CitrusCare (Citrus Health Care, Inc.)

RRR. Doctorcare Health Advantage (Doctorcare, Inc.)

TTT. Health Options, Inc./BCBSFL

UUU. Humana Choice PPO (Humana Insurance Company)

WWW. AdvantageCare

XXX. Advantage Silver/Gold (Quality Health Plans, Inc.)

YYY. Aetna Golden (Aetna Health, Inc.)

ZZZ. American Spirit Plan (Physicians United)

AAAA. Blue Preferred (Blue Cross/Blue Shield of Florida)

BBBB. Care (CarePlus Health Plans, Inc.)

CCCC. Classic/value Secure (Health First Medicare Plan)

DDDD. FHCP Medvantage (Florida Health Care Plan, Inc.)

EEEE. Humana Choice PPO (Humana Insurance Company)

FFFF. Leon Cares (Leon Medical Centers Health, Inc.)

GGGG. Medicare & More/Actively You (Health Options

HHHH. MedicareMax (Medica HealthCare Plans, Inc.)

IIII. Patriot Plan (Freedom Health, Inc.)

JJJJ. SecureHorizons Direct

KKKK. Summit Ideal Plan (Summit Health Plan, Inc.)

LLLL. SunCoast Physicians Health Plan, Inc.

MMMM. SunPlus Advantage Plan (Healthsun Health Plans, Inc.)

NNNN. The Value/Classic Secure Plan (United Healthcare of Florida, Inc.)

 

 

CARD PR-2

Plan Names
Florida

HH. Staywell Health Plan

PP. Humana Family Health Plan

SS. Medipass

UU. Preferred Medical Plan

ZZ. HealthEase

AAA. Citrus Health Care

BBB. United Healthcare of Florida

CCC. Amerigroup Florida, Inc.

DDD. Universal Health Plan

EEE. United/Evercare at Home

FFF. Jackson Memorial Hospital

GGG. Buena Vista

III. Healthy Palm Beaches/Personal

JJJ. Total Health Choice

 

 

CARD HX-3

Sample Medicaid Card
Florida

Sample Medicaid Card for the state of Florida front side

Sample Medicaid Card for the state of Florida back side

 

 

CARD HX-5

Florida Medicare Managed Care Plans

PP. Florida Health Care Plan, Inc. (Florida Health Care Plan, Inc.)

RR. Humana Gold (Humana Medical Plan, Inc.)

TT. Medicare Advantage (Vista Health Plan, Inc.)

VV. Medicare and More (Health Options, Inc./BC BS FL)

FFF. Capital Health Plan Medicare (Capital Health Plan, Inc.)

HHH. Medicare Masterpiece (Medicare Masterpiece)

III. PSO Health Plan (Preferred Care Partners, Inc.)

LLL. UnitedHealthCare Medicare Complete (United Healthcare Insurance Company, Inc.)

MMM. AvMed Premier Care (AvMed Medicare Plan)

NNN. CareOne Plan (CarePlus Health Plans, Inc.)

OOO. WellCare Choice/Value Plan (WellCare)

PPP. America’s Healthy Rewards Treasure Coast (America’s Health Choice Medical Plans, Inc.)

QQQ. CitrusCare (Citrus Health Care, Inc.)

RRR. Doctorcare Health Advantage (Doctorcare, Inc.)

TTT. Health Options, Inc./BCBSFL

UUU. Humana Choice PPO (Humana Insurance Company)

WWW. AdvantageCare

XXX. Advantage Silver/Gold (Quality Health Plans, Inc.)

YYY. Aetna Golden (Aetna Health, Inc.)

ZZZ. American Spirit Plan (Physicians United)

AAAA. Blue Preferred (Blue Cross/Blue Shield of Florida)

BBBB. Care (CarePlus Health Plans, Inc.)

CCCC. Classic/value Secure (Health First Medicare Plan)

DDDD. FHCP Medvantage (Florida Health Care Plan, Inc.)

EEEE. Humana Choice PPO (Humana Insurance Company)

FFFF. Leon Cares (Leon Medical Centers Health, Inc.)

GGGG. Medicare & More/Actively You (Health Options

HHHH. MedicareMax (Medica HealthCare Plans, Inc.)

IIII. Patriot Plan (Freedom Health, Inc.)

JJJJ. SecureHorizons Direct

KKKK. Summit Ideal Plan (Summity Health Plan, Inc.)

LLLL. SunCoast Physicians Health Plan, Inc.

MMMM. SunPlus Advantage Plan (Healthsun Health Plans, Inc.)

NNNN. The Value/Classic Secure Plan (United Healthcare of Florida, Inc.

 

 

CARD HX-6

Plan Names
Florida

HH. Staywell Health Plan

PP. Humana Family Health Plan

SS. Medipass DCMM

UU. Preferred Medical Plan

ZZ. HealthEase

AAA. Citrus Health Care

BBB. United Healthcare of Florida

CCC. Amerigroup Florida, Inc.

DDD. Universal Health Plan

EEE. United/Evercare at Home

FFF. Jackson Memorial Hospital

GGG. Buena Vista

III. Health Palm Beaches/Personal

JJJ. Total Health Choice

 

 

CARD HX-8

PLAN NAMES (FOR FEDERAL CIVILIAN EMPLOYEES)
FLORIDA

F. NALC

H. Association Benefit Plan

J. Foreign Service Benefit Plan

M. Rural Carrier Benefit Plan

R. Capital Health Plan

AA. Humana Medical Plan

LL. GEHA Benefit Plan – High

MM. GEHA Benefit Plan – Standard

NN. Mail Handlers – High

OO. Mail Handlers – Standard

PP. PBP Health Plan – High

QQ. PBP Health Plan – Standard

TT. APWU Health Plan – High

UU. APWU Health Plan – Consumer Driven

VV. Blue Cross and Blue Shield Service Benefit Plan – Standard

WW. Blue Cross and Blue Shield Service Benefit Plan – Basic

CCC. SAMBA – High

DDD. SAMBA – Standard

EEE. GEHA High Deductible Health Plan

FFF. Mail Handlers High Deductible Plan

GGG. Av-Med Health Plan – High

HHH. Av-Med Health Plan – Std

III. Vista Healthplan – South Florida

JJJ. Vista Healthplan – Gainesville

KKK. Vista Healthplan – Tallahassee

LLL. Vista Healthplan of South Florida

MMM. Aetna HealthFund CDHP – Jacksonville/Miami/Orlando/Tampa Areas

NNN. Aetna HealthFund HDHP – Jacksonville/Miami/Orlando/Tampa Areas

OOO. Humana CoverageFirst CDHP – Tampa

PPP. Humana CoverageFirst CDHP – Jacksonville

QQQ. Humana CoverageFirst CDHP – South Florida

RRR. Humana CoverageFirst CDHP – Orlando

SSS. JMH Health Plan

TTT. Panama Canal Area Benefit Plan

 

 

CARD IN-2A

State TANF Program
Florida

Welfare Transition Program

 

 

CARD PR-1

Medicare Managed Care Plans
Georgia

M. Kaiser Permanente Senior Advantage (Kaiser Permanente Senior Advantage, Inc.)

N. Humana Gold (Humana Insurance Company)

P. Aetna Golden (Aetna Medicare)

Q. InStil InChoice/InCare (Instil Health Insurance Company)

R. SecureHorizons Direct

S. SmartValue/BlueValue (Blue Cross/Blue Shield Healthcare Plan of GA)

T. United Healthcare Medicare Complete (United Healthcare of GA, Inc.)

U. WellCare

 

 

CARD PR-2

Plan Names
Georgia

I. Amerigroup

J. PeachState (Centene)

K. WellCare

 

 

CARD HX-3

Sample Medicaid Card
Georgia

Sample Medicaid Card for the state of Georgia front side

Sample Medicaid Card for the state of Georgia back side

 

 

CARD HX-5

Medicare Managed Care Plans
Georgia

M. Kaiser Permanente Senior Advantage (Kaiser Permanente Senior Advantage, Inc.)

N. Humana Gold (Humana Insurance Company)

P. Aetna Golden (Aetna Medicare)

Q. InStil InChoice/InCare (Instil Health Insurance Company)

R. SecureHorizons Direct

S. SmartValue/BlueValue (Blue Cross/Blue Shield Healthcare Plan of GA)

T. United Healthcare Medicare Complete (United Healthcare of GA, Inc.)

U. WellCare

 

 

CARD HX-6

Plan Names
Georgia

I. Amerigroup

J. PeachState (Centene)

K. WellCare

 

 

CARD HX-8

PLAN NAMES (FOR FEDERAL CIVILIAN EMPLOYEES)
GEORGIA

F. NALC

H. Association Benefit Plan

J. Foreign Service Benefit Plan

L. Panama Canal Area Benefit Plan

M. Rural Carrier Benefit Plan

AA. GEHA Benefit Plan – High

BB. GEHA Benefit Plan – Standard

CC. Mail Handlers – High

DD. Mail Handlers – Standard

EE. PBP Health Plan – High

FF. PBP Health Plan – Standard

HH. APWU Health Plan – High

II. APWU Health Plan – Consumer Driven

KK. Blue Cross and Blue Shield Service Benefit Plan - Standard

LL. Blue Cross and Blue Shield Service Benefit Plan – Basic

MM. SAMBA – High

NN. SAMBA – Standard

OO. GEHA High Deductible Health Plan

PP. Mail Handlers High deductible Plan

QQ. Aetna

TT. Aetna HealthFund CDHP

UU. Aetna HealthFund HDHP

VV. Coventry Health Care of GA HDHP

WW. Kaiser Foundation Health Plan of Georgia, Inc.

XX. Humana CoverageFirst (Consumer Driven Plan)

YY. Kaiser Foundation Health Plan of Georgia, Inc. – HDHP

 

 

CARD IN-2A

State TANF Program
Georgia

Temporary Assistance for Needy Families

 

 

CARD PR-1

Medicare Managed Care Plans
Hawaii

F. Kaiser Permanente Senior Advantage (Kaiser Foundation Health Plan, Inc.)

G. 65C Plus Plan (Hawaii Medical Service Association)

H. AlohaCare Advantage (AlohaCare)

I. SecureHorizons Direct

J. United Healthcare Medicare Complete (United Healthcare Insurance Company)

 

 

CARD PR-2

Plan Names
Hawaii

M. Hawaii Quest

 

 

CARD HX-3

Sample Medicaid Card
Hawaii

Sample Medicaid Card for the state of Hawaii front side

Sample Medicaid Card for the state of Hawaii back side

 

 

CARD HX-5

Medicare Managed Care Plans
Hawaii

F. Kaiser Permanente Senior Advantage (Kaiser Foundation Health Plan, Inc.)

G. 65C Plus Plan (Hawaii Medical Service Association)

H. AlohaCare Advantage (AlohaCare)

I. SecureHorizons Direct

J. United Healthcare Medicare Complete (United Healthcare Insurance Company)

 

 

CARD HX-6

Plan Names
Hawaii

M. Hawaii Quest

 

 

CARD HX-8

PLAN NAMES (FOR FEDERAL CIVILIAN EMPLOYEES)
HAWAII

F. NALC

H. Association Benefit Plan

J. Foreign Service Benefit Plan

L. Panama Canal Area Benefit Plan

M. Rural Carrier Benefit Plan

Q. HMSA

S. Kaiser Permanente – High

T. Kaiser Permanente – Standard

W. GEHA Benefit Plan – High

X. GEHA Benefit Plan – Standard

Y. Mail Handlers – High

Z. Mail Handlers – Standard

AA. PBP Health Plan - High

BB. PBP Health Plan – Standard

CC. APWU Health Plan – High

DD. APWU Health Plan – Consumer Driven

EE. Blue Cross and Blue Shield Service Benefit Plan - Standard

FF. Blue Cross and Blue Shield Service Benefit Plan – Basic

GG. SAMBA – High

HH. SAMBA – Standard

II. GEHA High Deductible Health Plan

JJ. Mail Handlers High Deductible Plan

KK. Kaiser Permanente – High

LL. Kaiser Permanente – Standard

 

 

CARD IN-2A

State TANF Program
Hawaii

Temporary Assistance for Needy Families

 

 

CARD PR-1

Medicare Managed Care Plans
Idaho

D. True Blue (Blue Cross of Idaho)

E. Humana Gold Choice (Humana Insurance Company)

F. MedAdvantage (Regence Blue Shield of Idaho)

G. Secure Blue (Blue Cross of Idaho Health Services, Inc.)

H. SecureHorizons Direct

I. United Healthcare Medicare Complete (United Healthcare Insurance Company)

 

 

CARD PR-2

Plan Names
Idaho

A. Healthy Connections

 

 

CARD HX-3

Sample Medicaid Card
Idaho

Sample Medicaid Card for the state of Idaho

 

 

CARD HX-5

Medicare Managed Care Plans
Idaho

D. True Blue (Blue Cross of Idaho)

E. Humana Gold Choice (Humana Insurance Company)

F. MedAdvantage (Regence Blue Shield of Idaho)

G. Secure Blue (Blue Cross of Idaho Health Services, Inc.)

H. SecureHorizons Direct

I. United Healthcare Medicare Complete (United Healthcare Insurance Company)

 

 

CARD HX-6

Plan Names
Idaho

A. Healthy Connections

 

 

CARD HX-8

PLAN NAMES (FOR FEDERAL CIVILIAN EMPLOYEES)
IDAHO

F. NALC

H. Association Benefit Plan

J. Foreign Service Benefit Plan

L. Panama Canal Area Benefit Plan

M. Rural Carrier Benefit Plan

U. GEHA Benefit Plan – High

V. GEHA Benefit Plan – Standard

W. Mail Handlers – High

X. Mail Handlers – Standard

Y. PBP Health Plan – High

Z. PBP Health Plan – Standard

BB. APWU Health Plan – High

CC. APWU Health Plan – Consumer Driven

DD. Blue Cross and Blue Shield Service Benefit Plan – Standard

EE. Blue Cross and Blue Shield Service Benefit Plan – Basic

FF. SAMBA – High

GG. SAMBA – Standard

HH. GEHA High Deductible Health Plan

II. Mail Handlers High Deductible Plan

JJ. Group Health Cooperative – High

KK. Group Health Cooperative – Standard

LL. Aetna HealthFund CDHP

MM. Aetna HealthFund HDHP

 

 

CARD IN-2A

State TANF Program
Idaho

Temporary Assistance for Families in Idaho

 

 

CARD PR-1

Medicare Managed Care Plans
Illinois

EE. Medical Associates Advantage Plan (Medical Associates Health Plan, Inc.)

FF. OSF Care Advantage/Preferred (OSF Care Advantage/Preferred)

GG. PremierPlus (Mercy Health Plans, Inc.)

II. United Healthcare Medicare Complete (United Healthcare Plans of the Midwest, Inc.)

JJ. Advantra/Gold Advantage (Group Health Plan, Inc.)

MM. Humana Gold Choice (Humana Insurance Company)

NN. Health Alliance Medicare HMO (Health Alliance Medical Plans)

OO. Security Choice (Unicare Life & Health Insurance Company)

PP. Aetna Golden (Aetna Medicare)

QQ. Essence (Essence, Inc.)

RR. Health Spring Advantage (HealthSpring, Inc.)

SS. SecureHorizons Direct

TT. Secure Plus (John Deere Health Plan, Inc.)

UU. WellCare

 

 

CARD PR-2

Plan Names
Illinois

R. Family Health Network

S. Harmony Health Plan

X. Amerigroup Illinois, Inc.

 

 

CARD HX-3

Sample Medicaid Card
Illinois

Sample Medicaid Card for the state of Illinois front side

Sample Medicaid Card for the state of Illinois back side

 

 

CARD HX-5

Medicare Managed Care Plans
Illinois

EE. Medical Associates Advantage Plan (Medical Associates Health Plan, Inc.)

FF. OSF Care Advantage/Preferred (OSF Care Advantage/Preferred)

GG. PremierPlus (Mercy Health Plans, Inc.)

II. United Healthcare Medicare Complete (United Healthcare Plans of the Midwest, Inc.)

JJ. Advantra/Gold Advantage (Group Health Plan, Inc.)

MM. Humana Gold Choice (Humana Insurance Company)

NN. Health Alliance Medicare HMO (Health Alliance Medical Plans)

OO. Security Choice (Unicare Life & Health Insurance Company)

PP. Aetna Golden (Aetna Medicare)

QQ. Essence (Essence, Inc.)

RR. Health Spring Advantage (HealthSpring, Inc.)

SS. SecureHorizons Direct

TT. Secure Plus (John Deere Health Plan, Inc.)

UU. WellCare

 

 

CARD HX-6

Plan Names
Illinois

R. Family Health Network

S. Harmony Health Plan

X. Amerigroup Illinois, Inc.

 

 

CARD HX-8

PLAN NAMES (FOR FEDERAL CIVILIAN EMPLOYEES)
ILLINOIS

F. NALC

H. Association Benefit Plan

J. Foreign Service Benefit Plan

L. Panama Canal Area Benefit Plan

M. Rural Carrier Benefit Plan

S. BlueCHOICE

Y. Health Alliance HMO

CC. John Deere Health Plan

HH. Personal Care’s HMO

QQ. GEHA Benefit Plan – High

RR. GEHA Benefit Plan – Standard

SS. Mail Handlers – High

TT. Mail Handlers – Standard

UU. PBP Health Plan – High

VV. PBP Health Plan – Standard

WW. Mercy Health Plans/Premier Health Plans

YY. UNICARE HMO

ZZ. Union Health Service

AAA. Humana Health Plan, Inc. - Standard

BBB. APWU Health Plan – High

CCC. APWU Health Plan – Consumer Driven

DDD. Blue Cross and Blue Shield Service Benefit Plan – Standard

EEE. Blue Cross and Blue Shield Service Benefit Plan – Basic

FFF. SAMBA – High

GGG. SAMBA – Standard

HHH. GEHA High Deductible Health Plan

III. Mail Handlers High Deductible Plan

JJJ. Aetna

KKK. Group Health Plan – High

LLL. Humana Health Plan, Inc. – High

MMM. OSF HealthPlans – High

NNN. Aetna HealthFund CDHP

OOO. Aetna HealthFund HDHP

PPP. Group Health Plan, Inc. HDHP

QQQ. Humana CoverageFirst CDHP

RRR. OSF HealthPlans HDHP

SSS. Aetna Open Access

TTT. United Health BBcare of the Midwest

 

 

CARD PR-1

Medicare Managed Care Plans
Indiana

K. ADVANTAGE Preferred Plus (Advantage Health Solutions, Inc.)

O. Security Choice (Unicare Life and Health Insurance Company)

P. Welborn Health Plans

Q. Blue Medicare Access/Anthem (Anthem Blue Cross and Blue Shield)

R. Humana Choice PPO/Humana Gold Choice (Humana Insurance Company)

S. SecureHorizons Direct

T. Senior Smart Choice (The M Plan, Senior Smart Choice)

U. United Healthcare Medicare Complete (United Healthcare Insurance Company)

 

 

CARD PR-2

Plan Names
Indiana

C. Managed Health Services

E. AmeriChoice

F. Harmony Health Plans

H. Hoosier Healthwise

I. MD Wise

J. PCCM (Primestep)

K. CareSource

L. Molina Healthcare of Indiana, Inc.

M. Medicaid Select

 

 

CARD HX-3

Sample Medicaid Card
Indiana

Sample Medicaid Card for the state of Indiana front side

Sample Medicaid Card for the state of Indiana back side

 

 

CARD HX-5

Medicare Managed Care Plans
Indiana

K. ADVANTAGE Preferred Plus (Advantage Health Solutions, Inc.)

O. Security Choice (Unicare Life and Health Insurance Company)

P. Welborn Health Plans

Q. Blue Medicare Access/Anthem (Anthem Blue Cross and Blue Shield)

R. Humana Choice PPO/Humana Gold Choice (Humana Insurance Company)

S. SecureHorizons Direct

T. Senior Smart Choice (The M Plan, Senior Smart Choice)

U. United Healthcare Medicare Complete (United Healthcare Insurance Company)

 

 

CARD HX-6

Plan Names
Indiana

C. Managed Health Services

E. AmeriChoice

F. Harmony Health Plans

H. Hoosier Healthwise

I. MD Wise

J. PCCM (Primestep)

K. CareSource

L. Molina Healthcare of Indiana, Inc.

M. Medicaid Select

 

 

CARD HX-8

PLAN NAMES (FOR FEDERAL CIVILIAN EMPLOYEES)
INDIANA

F. NALC

H. Association Benefit Plan

J. Foreign Service Benefit Plan

L. Panama Canal Area Benefit Plan

M. Rural Carrier Benefit Plan

R. Arnett HMO

U. Health Alliance HMO

Y. Humana Health Plan

FF. Physicians HP of N. Indiana

JJ. The M*Plan

NN. GEHA Benefit Plan – High

OO. GEHA Benefit Plan – Standard

PP. Mail Handlers – High

QQ. Mail Handlers – Standard

RR. PBP Health Plan – High

SS. PBP Health Plan – Standard

WW. UNICARE HMO

XX. APWU Health Plan – High

YY. APWU Health Plan – Consumer Driven

ZZ. Blue Cross and Blue Shield Service Benefit Plan – Standard

AAA. Blue Cross and Blue Shield Service Benefit Plan – Basic

CCC. Humana Health Plan, Inc. – High

DDD. Human Health Plan, Inc. – Standard

EEE. SAMBA – High

FFF. SAMBA – Standard

GGG. GEHA High Deductible Health Plan

HHH. Mail Handlers High Deductible Plan

III. Advantage Health Solutions, Inc. – High

JJJ. Aetna – N. Indiana

KKK. Aetna – SE Indiana

LLL. Aetna HealthFund CDHP

MMM. Aetna HealthFund HDHP

OOO. Humana CoverageFirst CDHP

 

 

CARD PR-1

Medicare Managed Care Plans
Iowa

J. Medical Associates Advantage Plan (Medical Associates Health Plan, Inc.)

N. Security Choice (Unicare Life and Health Insurance Company)

O. Humana Gold Choice (Humana Insurance Company)

P. United HealthCare Medicare Complete (United HealthCare Insurance Company)

Q. Coventry Advantra (Coventry Health and Life Ins. Company)

R. Medicare Blue PPO (Wellmark Blue Cross and Blue Shield of IA)

S. SecureHorizons Direct

T. Secure Plus (John Deere Health Plan, Inc.)

U. Today’s Options

 

 

CARD PR-2

Plan Names
Iowa

K. Coventry Health Care

L. Iowa Plan for Behavioral Health

N. Medipass

 

 

CARD HX-3 A

Sample Medicaid Card
Iowa

Sample Medicaid Card for the state of Iowa back side

Sample Medicaid Card for the state of Iowa front side

 

 

CARD HX-5

Medicare Managed Care Plans
Iowa

J. Medical Associates Advantage Plan (Medical Associates Health Plan, Inc.)

N. Security Choice (Unicare Life and Health Insurance Company)

O. Humana Gold Choice (Humana Insurance Company)

P. United HealthCare Medicare Complete (United HealthCare Insurance Company)

Q. Coventry Advantra (Coventry Health and Life Ins. Company)

R. Medicare Blue PPO (Wellmark Blue Cross and Blue Shield of IA)

S. SecureHorizons Direct

T. Secure Plus (John Deere Health Plan, Inc.)

U. Today’s Options

 

 

CARD HX-6

Plan Names
Iowa

K. Coventry Health Care

L. Iowa Plan for Behavioral Health

N. Medipass

 

 

CARD HX-8

PLAN NAMES (FOR FEDERAL CIVILIAN EMPLOYEES)
IOWA

F. NALC

H. Association Benefit Plan

J. Foreign Service Benefit Plan

L. Panama Canal Area Benefit Plan

M. Rural Carrier Benefit Plan

R. John Deere Health Plan

AA. GEHA Benefit Plan – High

BB. GEHA Benefit Plan – Standard

CC. Mail Handlers – High

DD. Mail Handlers – Standard

EE. PBP Health Plan – High

FF. PBP Health Plan – Standard

GG. Avera Health Plan

II. Health Alliance HMO

JJ. APWU Health Plan – High

KK. APWU Health Plan – Consumer Driven

LL. Blue Cross and Blue Shield Service Benefit Plan - Standard

MM. Blue Cross and Blue Shield Service Benefit Plan – Basic

NN. SAMBA – High

OO. SAMBA – Standard

PP. GEHA High Deductible Health Plan

QQ. Mail Handlers High Deductible Plan

RR. Coventry Health Care of Iowa – High

SS. Sioux Valley Health Plan – High

TT. Sioux Valley Health Plan – Standard

UU. Coventry Health Care of Iowa – HDHP

VV. HealthPartners Classic/Open Access Deductible

 

 

CARD PR-1

Medicare Managed Care Plans
Kansas

K. Advantra (Coventry Health Care of Kansas, Inc.)

M. Humana Choice PPO/Humana Gold (Humana Insurance Company)

N. SecureHorizons Direct

O. United HealthCare Medicare Complete (United Healthcare Insurance Company)

 

 

CARD PR-2

Plan Names
Kansas

G. Health Connect Kansas

I. HealthWave 19

 

 

CARD HX-3

Sample Medicaid Card Kansas

Sample Medicaid Card for the state of Kansas

 

 

CARD HX-5

Medicare Managed Care Plans
Kansas

K. Advantra (Coventry Health Care of Kansas, Inc.)

M. Humana Choice PPO/Humana Gold (Humana Insurance Company)

N. SecureHorizons Direct

O. United HealthCare Medicare Complete (United Healthcare Insurance Company)

 

 

CARD HX-6

Plan Names
Kansas

G. Health Connect Kansas

I. HealthWave 19

 

 

CARD HX-8

PLAN NAMES (FOR FEDERAL CIVILIAN EMPLOYEES)
KANSAS

F. NALC

H. Association Benefit Plan

J. Foreign Service Benefit Plan

L. Panama Canal Area Benefit Plan

M. Rural Carrier Benefit Plan

U. Preferred Plus of Kansas

AA. GEHA Benefit Plan – High

BB. Mail Handlers – High

CC. Mail Handlers – Standard

DD. PBP Health Plan – High

EE. PBP Health Plan – Standard

HH. APWU Health Plan – High

II. APWU Health Plan – Consumer Driven

JJ. GEHA Benefit Plan – Standard

LL. Humana Health Plan, Inc. – High

MM. Humana Health Plan, Inc. – Standard

NN. Blue Cross and Blue Shield Service Benefit Plan - Standard

OO. Blue Cross and Blue Shield Service Benefit Plan – Basic

PP. SAMBA – High

QQ. SAMBA – Standard

RR. GEHA High Deductible Health Plan

SS. Mail Handlers High Deductible Plan

TT. Aetna

UU. Coventry Health Care of Kansas – Wichita/Salinas – High

VV. Coventry Health Care of Kansas – Wichita/Salinas – Std.

WW. Coventry Health Care of Kansas – Kansas City – High

XX. Coventry Health Care of Kansas – Kansas City – Std.

YY. Aetna HealthFund CDHP

ZZ. Aetna HealthFund HDHP

AAA. Coventry Health Care of Kansas, Inc. HDHP

BBB. Coventry Health Care of Kansas – Kansas City – HDHP

CCC. Humana CoverageFirst CDHP Plan

DDD. Community Health Plan

EEE. United Health BBcare of the Midwest

 

 

CARD PR-1

Medicare Managed Care Plans
Kentucky

G. Security Choice (Unicare Life and Health Insurance Company)

H. Blue Medicare Access/Anthem Sr. Advantage (Anthem Blue Cross and Blue Shield)

I. Humana Choice PPO (Humana Insurance Company)

J. SecureHorizons Direct

 

 

CARD PR-2

Plan Names
Kentucky

B. Passport Health Plan

C. Human Service Transportation

E. Kentucky Patient Access and Care (KENPAC)

 

 

CARD HX-3 A

Sample Medicaid Card
Kentucky

Sample Medicaid Card for the state of Kentucky

 

 

CARD HX-5

Medicare Managed Care Plans
Kentucky

G. Security Choice (Unicare Life and Health Insurance Company)

H. Blue Medicare Access/Anthem Sr. Advantage (Anthem Blue Cross and Blue Shield)

I. Humana Choice PPO (Humana Insurance Company)

J. SecureHorizons Direct

 

 

CARD HX-6

Plan Names
Kentucky

B. Passport Health Plan

C. Human Service Transportation

E. Kentucky Patient Access and Care (KENPAC)

 

 

CARD HX-8

PLAN NAMES (FOR FEDERAL CIVILIAN EMPLOYEES)
KENTUCKY

F. NALC

H. Association Benefit Plan

J. Foreign Service Benefit Plan

L. Panama Canal Area Benefit Plan

M. Rural Carrier Benefit Plan

Z. GEHA Benefit Plan – High

AA. GEHA Benefit Plan – Standard

BB. Mail Handlers – High

CC. Mail Handlers – Standard

DD. PBP Health Plan – High

EE. PBP Health Plan – Standard

II. APWU Health Plan – High

JJ. APWU Health Plan – Consumer Driven

MM. Blue Cross and Blue Shield Service Benefit Plan - Standard

NN. Blue Cross and Blue Shield Service Benefit Plan – Basic

PP. SAMBA – High

QQ. SAMBA – Standard

RR. GEHA High Deductible Health Plan

SS. Mail Handlers High Deductible Plan

TT. Aetna

UU. United Healthcare of Ohio, Inc. – High

VV. United Healthcare of Ohio, Inc. – Std

WW. Aetna HealthFund CDHP

XX. Aetna HealthFund HDHP

YY. Humana CoverageFirst CDHP – Lexington

ZZ. Humana CoverageFirst CDHP – Louisville

AAA. Humana CoverageFirst CDHP – N. Kentucky

 

 

CARD IN-2A

State TANF Program
Kentucky

Kentucky Transitional Assistance Program (KTAP)

 

 

CARD PR-1

Medicare Managed Care Plans
Louisiana

M. HealthCare Select (HealthCare Select)

N. Tenet Choices 65 (Tenet Choices 65)

O. Humana Gold Plus (Humana Health Benefit Plan of Louisiana, Inc.)

P. WellCare Choice (WellCare)

Q. Humana Choice PPO (Humana Insurance Company)

R. SecureHorizons Direct

S. Tenet Choices 65

 

 

CARD PR-2

Plan Names
Louisiana

A. Community Care Program (PCCM)

 

 

CARD HX-3

Sample Medicaid Card
Louisiana

Sample Medicaid Card for the state of Louisiana front side

Sample Medicaid Card for the state of Louisiana back side

 

 

CARD HX-5

Medicare Managed Care Plans
Louisiana

M. HealthCare Select (HealthCare Select)

N. Tenet Choices 65 (Tenet Choices 65)

O. Humana Gold Plus (Humana Health Benefit Plan of Louisiana, Inc.)

P. WellCare Choice (WellCare)

Q. Humana Choice PPO (Humana Insurance Company)

R. SecureHorizons Direct

S. Tenet Choices 65

 

 

CARD HX-6

Plan Names
Louisiana

A. Community Care Program (PCCM)

 

 

CARD HX-8

PLAN NAMES (FOR FEDERAL CIVILIAN EMPLOYEES)
LOUISIANA

F. NALC

H. Association Benefit Plan

J. Foreign Service Benefit Plan

L. Panama Canal Area Benefit Plan

M. Rural Carrier Benefit Plan

AA. GEHA Benefit Plan – High

BB. GEHA Benefit Plan – Standard

CC. Mail Handlers – High

DD. Mail Handlers – Standard

EE. PBP Health Plan – High

FF. PBP Health Plan – Standard

MM. APWU Health Plan – High

NN. APWU Health Plan – Consumer Driven

QQ. Blue Cross and Blue Shield Service Benefit Plan - Standard

RR. Blue Cross and Blue Shield Service Benefit Plan – Basic

SS. SAMBA – High

TT. SAMBA – Standard

UU. GEHA High Deductible Health Plan

VV. Mail Handlers High Deductible Plan

WW. Coventry Healthcare Louisiana – High – New Orleans

XX. Coventry Healthcare Louisiana – Baton Rouge

YY. Vantage HealthPlan – Monroe/Shreveport/Alexandria

ZZ. Coventry Healthcare Louisiana HDHP – New Orleans

AAA. Coventry Healthcare Louisiana HDHP – Baton Rouge

BBB. Humana CoverageFirst CDHP – New Orleans

CCC. Humana CoverageFirst CDHP – Baton Rouge

DDD. Humana CoverageFirst CDHP – Shreveport

EEE. Aetna HealthFund

 

 

CARD IN-2A

State TANF Program
Louisiana

Family Independence Temporary Assistance Program (FITAP)

Strategies to Empower People (STEP)

 

 

CARD PR-1

Medicare Managed Care Plans
Maine

A. SecureHorizons Direct

B. Today’s Options

C. United Healthcare Medicare Complete (United Healthcare Insurance Company)

 

 

CARD PR-2

Plan Names
Maine

B. Maine Care (PCCM)

 

 

CARD HX-3

Sample Medicaid Card – Maine

Sample Medicaid Card for the state of Maine

 

 

CARD HX-5

Medicare Managed Care Plans
Maine

A. SecureHorizons Direct

B. Today’s Options

C. United Healthcare Medicare Complete (United Healthcare Insurance Company)

 

 

CARD HX-6

Plan Names
Maine

B. Maine Care (PCCM)

 

 

CARD HX-8

PLAN NAMES (FOR FEDERAL CIVILIAN EMPLOYEES)
MAINE

F. NALC

H. Association Benefit Plan

J. Foreign Service Benefit Plan

L. Panama Canal Area Benefit Plan

M. Rural Carrier Benefit Plan

U. GEHA Benefit Plan – High

V. GEHA Benefit Plan – Standard

W. Mail Handlers – High

X. Mail Handlers – Standard

Y. PBP Health Plan – High

Z. PBP Health Plan – Standard

AA. APWU Health Plan – High

BB. APWU Health Plan – Consumer Driven

CC. Blue Cross and Blue Shield Service Benefit Plan – Standard

DD. Blue Cross and Blue Shield Service Benefit Plan – Basic

EE. SAMBA – High

FF. SAMBA – Standard

GG. GEHA High Deductible Health Plan

HH. Mail Handlers High Deductible Plan

II. Aetna HealthFund

 

 

CARD IN-2A

State TANF Program
Maine

TANF

ASPIRE (Additional Support for People in Retraining and Employment)

 

 

CARD PR-1

Medicare Managed Care Plans
Maryland

T. Aetna Golden Choice Plan (Aetna Health, Inc.)

U. Kaiser Permanente Medicare Plus (Kaiser Permanente Medicare Plus)

W. Elder Health (Elder Health Maryland HMO, Inc.)

Y. Erickson Advantage (United Healthcare Insurance Company)

Z. SecureHorizons Direct

 

 

CARD PR-2

Plan Names
Maryland

H. Helix Family Choice, Inc.

I. JAI Medical Systems, Inc.

J. Maryland Physicians Care

R. Amerigroup Maryland, Inc.

S. HealthChoice

V. UnitedHealthcare

W. Priority Partners

X. Diamond Plan

 

 

CARD HX-3

Sample Medicaid Card
Maryland

Sample Medicaid Card for the state of Maryland

 

 

CARD HX-5

Medicare Managed Care Plans
Maryland

T. Aetna Golden Choice Plan (Aetna Health, Inc.)

U. Kaiser Permanente Medicare Plus (Kaiser Permanente Medicare Plus)

W. Elder Health (Elder Health Maryland HMO, Inc.)

Y. Erickson Advantage (United Healthcare Insurance Company)

Z. SecureHorizons Direct

 

 

CARD HX-6

Plan Names
Maryland

H. Helix Family Choice, Inc.

I. JAI Medical Systems, Inc.

J. Maryland Physicians Care

R. Amerigroup Maryland, Inc.

S. HealthChoice

V. UnitedHealthcare

W. Priority Partners

X. Diamond Plan

 

 

CARD HX-8

PLAN NAMES (FOR FEDERAL CIVILIAN EMPLOYEES)
MARYLAND

F. NALC

H. Association Benefit Plan

J. Foreign Service Benefit Plan

L. Panama Canal Area Benefit Plan

M. Rural Carrier Benefit Plan

DD. M.D. IPA

MM. GEHA Benefit Plan – High

NN. GEHA Benefit Plan – Standard

OO. Mail Handlers – High

PP. Mail Handlers – Standard

QQ. PBP Health Plan – High

RR. PBP Health Plan – Standard

UU. APWU Health Plan – High

VV. APWU Health Plan – Consumer Driven

WW. Blue Cross and Blue Shield Service Benefit Plan – Standard

XX. Blue Cross and Blue Shield Service Benefit Plan – Basic

YY. CareFirst BlueChoice

BBB. SAMBA – High

CCC. SAMBA – Standard

DDD. GEHA High Deductible Health Plan

EEE. Mail Handlers High Deductible Plan

FFF. Aetna Open Access – High

GGG. Aetna Open Access – Basic

HHH. Coventry Health Care of Delaware – High

III. Kaiser Permanente – High

JJJ. Kaiser Permanente – Standard

KKK. Aetna HealthFund CDHP

LLL. Aetna HealthFund HDHP

MMM. Coventry Health Care of Delaware – HDHP

 

 

CARD IN-2A

State TANF Program
Maryland

Family Investment Program (FIP)

 

 

CARD PR-1

Medicare Managed Care Plans
Massachusetts

V. Fallon Senior Plan (Fallon Community Health Plan)

W. Secure Horizons (Secure Horizons, Tufts Health Plan)

Y. First Seniority (Harvard Pilgrim Health Care)

Z. Erickson Advantage

AA. Fresenius Medical Care Health Plan, Inc.

BB. Medicare PPO/HMO (Blue Cross/Blue Shield of Massachusetts, Inc.)

CC. Medicare Preferred PPO/HMO (Tufts Health Plan)

 

 

CARD PR-2

Plan Names
Massachusetts

J. Fallon Community Health Plan

N. Neighborhood Health Plan

R. Massachusetts Behavioral Health Partnership

S. Boston Medical Center Healthnet Plan

X. Mass Health

Z. Network Health

AA. Primary Care Clinician Plan

BB. Program of All-Inclusive Care/Elderly (PACE)

 

 

CARD HX-3

Sample Medicaid Card
Massachusetts

Sample Medicaid Card for the state of Massachusetts front side

Sample Medicaid Card for the state of Massachusetts back side

 

 

CARD HX-5

Medicare Managed Care Plans
Massachusetts

V. Fallon Senior Plan (Fallon Community Health Plan)

W. Secure Horizons (Secure Horizons, Tufts Health Plan)

Y. First Seniority (Harvard Pilgrim Health Care)

Z. Erickson Advantage

AA. Fresenius Medical Care Health Plan, Inc.

BB. Medicare PPO/HMO (Blue Cross/Blue Shield of Massachusetts, Inc.)

CC. Medicare Preferred PPO/HMO (Tufts Health Plan)

 

 

CARD HX-6

Plan Names
Massachusetts

J. Fallon Community Health Plan

N. Neighborhood Health Plan

R. Massachusetts Behavioral Health Partnership

S. Boston Medical Center Healthnet Plan

X. Mass Health

Z. Network Health

AA. Primary Care Clinician Plan

BB. Program of All-Inclusive Care/Elderly (PACE)

 

 

CARD HX-8

PLAN NAMES (FOR FEDERAL CIVILIAN EMPLOYEES)
MASSACHUSETTS

F. NALC

H. Association Benefit Plan

J. Foreign Service Benefit Plan

L. Panama Canal Area Benefit Plan

M. Rural Carrier Benefit Plan

GG. GEHA Benefit Plan – High

HH. GEHA Benefit Plan – Standard

II. Mail Handlers – High

JJ. Mail Handlers – Standard

KK. PBP Health Plan – High

LL. PBP Health Plan – Standard

MM. Blue Chip, Coord Health Partners, Inc.

NN. ConnectiCare

OO. APWU Health Plan – High

PP. APWU Health Plan – Consumer Driven

QQ. Blue Cross and Blue Shield Service Benefit Plan – Standard

RR. Blue Cross and Blue Shield Service Benefit Plan – Basic

SS. SAMBA – High

TT. SAMBA –Standard

UU. GEHA High Deductible Health Plan

VV. Mail Handlers High Deductible Plan

WW. Fallon Community Health Plan – High

XX. Fallon Community Health Plan – Std

YY. Aetna HealthFund CDHP

ZZ. Aetna HealthFund HDHP

 

 

CARD IN-2A

State TANF Program
Massachusetts

Transitional Aid to Families with Dependent Children (TAFDC)

Employment Services Program (ESP)

 

 

CARD PR-1

Medicare Managed Care Plans
Michigan

O. HAP Senior Plus (Health Alliance Plan of Michigan)

S. Security Choice (Unicare Life & Health Ins. Company)

T. HealthPlus Senior (HealthPlus of Michigan)

U. Alliance Medicare PPO (Alliance Medicare HMO)

V. BCN Advantage (Blue Care Network)

W. Humana Gold Choice/Humana Choice PPO (Humana Insurance Company)

X. Medicare Plus Blue (Blue Cross Blue Shield of Michigan)

Y. Paramount Elite

Z. Priority Medicare

AA. SecureHorizons Direct

 

 

CARD PR-2

Plan Names
Michigan

K. Midwest Health Plan

M. OmniCare Health Plan

U. Community Choice Michigan

EE. McLaren Health Plan

MM. Pro-Care Health Plan

RR. Cape Health Plan, Inc.

UU. Great Lakes Health Plan

VV. M-CAID

WW. Molina Healthcare of Michigan

AAA. Health Plan of Michigan, Inc

CCC. Health Plus Partners, Inc.

DDD. PHP-mm Family Care

EEE. PHP of Southwest Michigan

FFF. Priority Health Government Programs, Inc.

GGG. UP Health Plan

HHH. Total Health Care

 

 

CARD HX-3

Sample Medicaid Card
Michigan

Sample Medicaid Card for the state of Michigan

 

 

CARD HX-5

Medicare Managed Care Plans
Michigan

O. HAP Senior Plus (Health Alliance Plan of Michigan)

S. Security Choice (Unicare Life & Health Ins. Company)

T. HealthPlus Senior (HealthPlus of Michigan)

U. Alliance Medicare PPO (Alliance Medicare HMO)

V. BCN Advantage (Blue Care Network)

W. Humana Gold Choice/Humana Choice PPO (Humana Insurance Company)

X. Medicare Plus Blue (Blue Cross Blue Shield of Michigan)

Y. Paramount Elite

Z. Priority Medicare

AA. SecureHorizons Direct

 

 

CARD HX-6

Plan Names
Michigan

K. Midwest Health Plan

M. OmniCare Health Plan

U. Community Choice Michigan

EE. McLaren Health Plan

MM. Pro-Care Health Plan

RR. Cape Health Plan, Inc.

UU. Great Lakes Health Plan

VV. M-CAID

WW. Molina Healthcare of Michigan

AAA. Health Plan of Michigan, Inc

CCC. Health Plus Partners, Inc.

DDD. PHP-mm Family Care

EEE. PHP of Southwest Michigan

FFF. Priority Health Government Programs, Inc.

GGG. UP Health Plan

HHH. Total Health Care

 

 

CARD HX-8

PLAN NAMES (FOR FEDERAL CIVILIAN EMPLOYEES)
MICHIGAN

F. NALC

H. Association Benefit Plan

J. Foreign Service Benefit Plan

L. Panama Canal Area Benefit Plan

M. Rural Carrier Benefit Plan

V. Grand Valley Health Plan

X. HealthPlus of MI

Y. M-CARE

II. GEHA Benefit Plan – High

JJ. GEHA Benefit Plan – Standard

KK. Mail Handlers – High

LL. Mail Handlers – Standard

MM. PBP Health Plan – High

NN. PBP Health Plan – Standard

PP. Bluecare Network of MI – Midland County

SS. Bluecare Network of MI – Kent County

TT. Bluecare Network of MI – Mid Michigan

UU. Health Alliance – S.E. MI

WW. APWU Health Plan – High

XX. APWU Health Plan – Consumer Driven

YY. Blue Cross Blue Shield Service Benefit Plan – Standard

ZZ. Blue Cross Blue Shield Service Befit Plan – Basic

AAA. Bluecare Network of MI – Southeast Michigan

BBB. SAMBA – High

CCC. SAMBA – Standard

DDD. GEHA High Deductible Health Plan

EEE. Mail Handlers High Deductible Plan

FFF. Aetna HealthFund CDHP

GGG. Aetna HealthFund HDHP

HHH. Humana CoverageFirst (Consumer Driven Plan)

 

 

CARD IN-2A

State TANF Program
Michigan

Family Independence Program (FIP)

 

 

CARD PR-1

Medicare Managed Care Plans
Minnesota

T. Security Choice (Unicare Life and Health Insurance Company)

U. UCare for Seniors (UCare Minnesota)

W. Humana Gold Choice (Humana Insurance Company)

X. Prime Solution Basic/Enhanced (Medica Insurance Company)

Y. Advantage/Prime Solution (Medica Insurance Company)

Z. HealthPartners Freedom Plan (HealthPartners)

AA. Medicare/Medica Advantage Solution (Medica Health Plans)

BB. MedicareBlue PPO (Blue Cross/Blue Shield of Minnesota)

CC. North Star Advantage

DD. SecureHorizons Direct

EE. Today’s Options

 

 

CARD PR-2

Plan Names
Minnesota

A. Blue Plus

E. Metropolitan Health Plan (MHP)

L. Itasca Medical Care

M. Medica

N. First Plan Blue

O. HealthPartners

Q. UCare

R. UCare Minnesota

S. South Country Health Alliance

T. Prime West Health System

 

 

CARD HX-3

Sample Medicaid Card
Minnesota

Sample Medicaid Card for the state of Minnesota front side

Sample Medicaid Card for the state of Minnesota back side

 

 

CARD HX-5

Medicare Managed Care Plans Minnesota

T. Security Choice (Unicare Life and Health Insurance Company)

U. UCare for Seniors (UCare Minnesota)

W. Humana Gold Choice (Humana Insurance Company)

X. Prime Solution Basic/Enhanced (Medica Insurance Company)

Y. Advantage/Prime Solution (Medica Insurance Company)

Z. HealthPartners Freedom Plan (HealthPartners)

AA. Medicare/Medica Advantage Solution (Medica Health Plans)

BB. MedicareBlue PPO (Blue Cross/Blue Shield of Minnesota)

CC. North Star Advantage

DD. SecureHorizons Direct

EE. Today’s Options

 

 

CARD HX-6

Plan Names
Minnesota

A. Blue Plus

E. Metropolitan Health Plan (MHP)

L. Itasca Medical Care

M. Medica

N. First Plan Blue

O. HealthPartners

Q. UCare

R. UCare Minnesota

S. South Country Health Alliance

T. Prime West Health System

 

 

CARD HX-8

PLAN NAMES (FOR FEDERAL CIVILIAN EMPLOYEES)
MINNESOTA

F. NALC

H. Association Benefit Plan

J. Foreign Service Benefit Plan

L. Panama Canal Area Benefit Plan

M. Rural Carrier Benefit Plan

W. GEHA Benefit Plan – High

X. GEHA Benefit Plan – Standard

Y. Mail Handlers – High

Z. Mail Handlers – Standard

AA. PBP Health Plan – High

BB. PBP Health Plan – Standard

CC. Health Partners Classic - High

EE. Health Partners Primary Clinic Plan

FF. APWU Health Plan – High

GG. APWU Health Plan – Consumer Driven

HH. Blue Cross and Blue Shield Service Benefit Plan – Standard

II. Blue Cross and Blue Shield Service Benefit Plan – Basic

JJ. Avera Health Plans

KK. SAMBA – High

LL. SAMBA – Standard

MM. GEHA High Deductible Health Plan

NN. Mail Handlers High Deductible Plan

OO. Health Partners Open Access Deductible

 

 

CARD IN-2A

State TANF Program
Minnesota

Minnesota Family Investment Program (MFIP)

 

 

CARD PR-1

Medicare Managed Care Plans
Mississippi

D. HealthSpring (HealthSpring, Inc.)

E. Humana Gold/Humana Choice PPO (Humana Insurance Company)

F. SecureHorizons Direct

 

 

CARD PR-2

Plan Names
Mississippi

None Available

 

 

CARD HX-3

Sample Medicaid Card
Mississippi

Sample Medicaid Card for the state of Mississippi front side

Sample Medicaid Card for the state of Mississippi back side

 

 

CARD HX-5

Medicare Managed Care Plans
Mississippi

D. HealthSpring (HealthSpring, Inc.)

E. Humana Gold/Humana Choice PPO (Humana Insurance Company)

F. SecureHorizons Direct

 

 

CARD HX-6

Plan Names
Mississippi

None Available

 

 

CARD HX-8

PLAN NAMES (FOR FEDERAL CIVILIAN EMPLOYEES)
MISSISSIPPI

F. NALC

H. Association Benefit Plan

J. Foreign Service Benefit Plan

L. Panama Canal Area Benefit Plan

M. Rural Carrier Benefit Plan

S. GEHA Benefit Plan – High

T. GEHA Benefit Plan – Standard

U. Mail Handlers – High

V. Mail Handlers – Standard

W. PBP Health Plan – High

X. PBP Health Plan – Standard

Y APWU Health Plan – High

Z. APWU Health Plan – Consumer Driven

AA. Blue Cross and Blue Shield Service Benefit Plan – Standard

BB. Blue Cross and Blue Shield Service Benefit Plan – Basic

CC. SAMBA – High

DD. SAMBA – Standard

EE. GEHA High Deductible Health Plan

FF. Mail Handlers High Deductible Plan

GG. Aetna HealthFund CDHP

HH. Aetna HealthFund HDHP

 

 

CARD PR-1

Medicare Managed Care Plans
Missouri

V. Advantra (Coventry Health Care of Kansas, Inc.)

AA. St. Johns Premier Plus (Mercy Health Plans, Inc.)

BB. United Healthcare Medicare Complete (United Healthcare of the Midwest, Inc.)

CC. Advantra/Gold Advantage (Group Health Plan, Inc.)

DD. Essence (Essence, Inc.)

 

 

CARD PR-2

Plan Names
Missouri

D. HealthCare USA

M. Family Health Partners

N. First Guard

T. Missouri Care

V. Blue Advantage +

X. Community Care Plus

Y. Managed Care Plus (MC+)

Z. Mercy Health Plans

AA. Program of All-Inclusive Care/Elderly (PACE)

 

 

CARD HX-3

Sample Medicaid Card
Missouri

Sample of Medicaid Card for the state of Missouri front side

Sample of Medicaid Card for the state of Missouri back side

 

 

CARD HX-5

Medicare Managed Care Plans
Missouri

V. Advantra (Coventry Health Care of Kansas, Inc.)

AA. St. Johns Premier Plus (Mercy Health Plans, Inc.)

BB. United Healthcare Medicare Complete (United Healthcare of the Midwest, Inc.)

CC. Advantra/Gold Advantage (Group Health Plan, Inc.)

DD. Essence (Essence, Inc.)

 

 

CARD HX-6

Plan Names
Missouri

D. HealthCare USA

M. Family Health Partners

N. First Guard

T. Missouri Care

V. Blue Advantage +

X. Community Care Plus

Y. Managed Care Plus (MC+)

Z. Mercy Health Plans

AA. Program of All-Inclusive Care/Elderly (PACE)

 

 

CARD HX-8

PLAN NAMES (FOR FEDERAL CIVILIAN EMPLOYEES)
MISSOURI

F. NALC

H. Association Benefit Plan

J. Foreign Service Benefit Plan

L. Panama Canal Area Benefit Plan

M. Rural Carrier Benefit Plan

P. BlueCHOICE

EE. GEHA Benefit Plan – High

FF. GEHA Benefit Plan – Standard

GG. Mail Handlers – High

HH. Mail Handlers – Standard

II. PBP Health Plan – High

JJ. PBP Health Plan – Standard

LL. Mercy Health Plans/Premier Health Plans

MM. APWU Health Plan – High

NN. APWU Health Plan – Consumer Driven

OO. Blue Cross and Blue Shield Service Benefit Plan – Standard

PP. Blue Cross and Blue Shield Service Benefit Plan - Basic

RR. Humana Health Plan, Inc. – High

SS. Humana Health Plan, Inc. – Standard

TT. SAMBA – High

UU. SAMBA – Standard

VV. GEHA High Deductible Health Plan

WW. Mail Handlers High Deductible Plan

XX. Aetna

YY. Community Health Plan

ZZ. Coventry Health Care of Kansas – Kansas City – High

AAA. Coventry Health Care of Kansas – Kansas City – Std.

BBB. Group Health Plan – High

CCC. Aetna HealthFund CDHP

DDD. Aetna HealthFund HDHP

EEE. Coventry Health Care of Kansas – Kansas City – HDHP

FFF. Group Health Plan, Inc.

GGG. Humana CoverageFirst CDHP

HHH. United Health BBcare of the Midwest

III. United Healthcare of the Midwest

 

 

CARD IN-2A

State TANF Program
Missouri

Beyond Welfare

 

 

CARD PR-1

Medicare Managed Care Plans
Montana

B. Humana Gold Choice (Humana Insurance Company)

C. MedicareBlue PPO (Blue Cross/Blue Shield of Montana)

D. New West Medicare

E. SecureHorizons Direct

F. Sterling Partners - Montana

 

 

CARD PR-2

Plan Names
Montana

D. Passport to Health

 

 

CARD HX-3 (front)

Sample Medicaid Card - Montana

Sample of Medicaid Card for the state of Montana front side

Sample of Medicaid Card for the state of Montana back side

 

 

CARD HX-5

Medicare Managed Care Plans
Montana

B. Humana Gold Choice (Humana Insurance Company)

C. MedicareBlue PPO (Blue Cross/Blue Shield of Montana)

D. New West Medicare

E. SecureHorizons Direct

F. Sterling Partners - Montana

 

 

CARD HX-6

Plan Names
Montana

D. Passport to Health

 

 

CARD HX-8

PLAN NAMES (FOR FEDERAL CIVILIAN EMPLOYEES)
MONTANA

F. NALC

H. Association Benefit Plan

J. Foreign Service Benefit Plan

L. Panama Canal Area Benefit Plan

M. Rural Carrier Benefit Plan

R. GEHA Benefit Plan – High

S. GEHA Benefit Plan – Standard

T. Mail Handlers – High

U. Mail Handlers – Standard

V. PBP Health Plan – High

W. PBP Health Plan – Standard

X. APWU Health Plan - High

Y. APWU Health Plan – Consumer Driven

AA. Blue Cross and Blue Shield Service Benefit Plan – Standard

BB. Blue Cross and Blue Shield Service Benefit Plan - Basic

CC. New West Health Plan Services

DD. SAMBA – High

EE. SAMBA – Standard

FF. GEHA High Deductible Health Plan

GG. Mail Handlers High Deductible Plan

 

 

CARD IN-2A

State TANF Program
Montana

Families Achieving Independence in Montana (FAIM)

 

 

CARD PR-1

Medicare Managed Care Plans
North Carolina

J. PARTNERS Medicare Choice (PARTNERS National Health Plans - NC, Inc.)

K. United Healthcare Medicare Complete (United Healthcare of North Carolina, Inc.)

L. Humana Gold Choice (Humana Insurance Company)

M. Security Choice (United Life & Health Ins. Company)

N. SecureHorizons Direct

O. Today’s Options

 

 

CARD PR-2

Plan Names
North Carolina

D. Carolina Access

P. HEALTHCARE CONNECTION

R. South Care

U. Carolina Access II

V. Community Care of North Carolina (CCNC)

W. WellPath Select Inc.

 

 

CARD HX-3

Sample Medicaid Card
North Carolina

Sample of Medicaid Card for the state of North Carolina

 

 

CARD HX-5

Medicare Managed Care Plans
North Carolina

J. PARTNERS Medicare Choice (PARTNERS National Health Plans - NC, Inc.)

K. United Healthcare Medicare Complete (United Healthcare of North Carolina, Inc.)

L. Humana Gold Choice (Humana Insurance Company)

M. Security Choice (United Life & Health Ins. Company)

N. SecureHorizons Direct

O. Today’s Options

 

 

CARD HX-6

Plan Names
North Carolina

D. Carolina Access

P. HEALTHCARE CONNECTION

R. South Care

U. Carolina Access II

V. Community Care of North Carolina (CCNC)

W. WellPath Select Inc.

 

 

CARD HX-8

PLAN NAMES (FOR FEDERAL CIVILIAN EMPLOYEES)
NORTH CAROLINA

F. NALC

H. Association Benefit Plan

J. Foreign Service Benefit Plan

L Panama Canal Area Benefit Plan

M. Rural Carrier Benefit Plan

Z. GEHA Benefit Plan – High

AA. GEHA Benefit Plan – Standard

BB. Mail Handlers – High

CC. Mail Handlers – Standard

DD. PBP Health Plan – High

EE. PBP Health Plan – Standard

FF. APWU Health Plan – High

GG. APWU Health Plan – Consumer Driven

HH. Blue Cross and Blue Shield Service Benefit Plan – Standard

II. Blue Cross and Blue Shield Service Benefit Plan – Basic

JJ. SAMBA – High

KK. SAMBA – Standard

LL. GEHA High Deductible Health Plan

MM. Mail Handlers High Deductible Plan

NN. Aetna HealthFund CDHP

OO. Aetna HealthFund HDHP

 

 

CARD IN-2A

State TANF Program
North Carolina

Work First

 

 

CARD PR-1

Medicare Managed Care Plans
North Dakota

F. Humana Gold Choice (Humana Insurance Company)

H. MedicareBlue PPO (Blue Cross/Blue Shield of North Dakota)

I. Prime Solution/Medicare Advantage Solution (Medica Insurance Company/Medica Health Plans)

J. SecureHorizons Direct

 

 

CARD PR-2

Plan Names
North Dakota

B. AltruCare

C. Primary Care Provider Program

 

 

CARD HX-3

Sample Medicaid Card - North Dakota

Sample of Medicaid Card for the state of North Dakota front side

Sample of Medicaid Card for the state of North Dakota back side

 

 

CARD HX-5

Medicare Managed Care Plans
North Dakota

F. Humana Gold Choice (Humana Insurance Company)

H. MedicareBlue PPO (Blue Cross/Blue Shield of North Dakota)

I. Prime Solution/Medicare Advantage Solution (Medica Insurance Company/Medica Health Plans)

J. SecureHorizons Direct

 

 

CARD HX-6

Plan Names
North Dakota

B. AltruCare

C. Primary Care Provider Program

 

 

CARD HX-8

PLAN NAMES (FOR FEDERAL CIVILIAN EMPLOYEES)
NORTH DAKOTA

F. NALC

H. Association Benefit Plan

J. Foreign Service Benefit Plan

L. Panama Canal Area Benefit Plan

M. Rural Carrier Benefit Plan

T. GEHA Benefit Plan – High

U. GEHA Benefit Plan – Standard

V. Mail Handlers – High

W. Mail Handlers – Standard

X. PBP Health Plan – High

Y. PBP Health Plan – Standard

Z. APWU Health Plan - High

AA. APWU Health Plan – Consumer Driven

BB. Blue Cross and Blue Shield Service Benefit Plan – Standard

CC. Blue Cross and Blue Shield Service Benefit Plan – Basic

DD. SAMBA – High

EE. SAMBA – Standard

FF. GEHA High Deductible Health Plan

GG. Mail Handlers High Deductible Plan

HH. Heart of America Health Plan

II. HealthPartners Classic/Open Access Deductible

 

 

CARD IN-2A

State TANF Program
North Dakota

Training, Employment, Education Management (TEEM)

 

 

CARD PR-1

Medicare Managed Care Plans
Nebraska

D. United Healthcare Medicare Complete (United Healthcare of the Midlands, Inc.)

E. Security Choice (Unicare Life and Health Insurance Company)

F. Humana Gold Choice (Humana Insurance Company)

G. MedicareBlue PPO (Blue Cross and Blue Shield of Nebraska)

H. SecureHorizons Direct

 

 

CARD PR-2

Plan Names
Nebraska

F. Magellan Behavioral Health

G. Primary Care Plus

H. Share Advantage

 

 

CARD HX-3

Sample Medicaid Card – Nebraska

Sample of Medicaid Card for the state of Nebraska front side1

Sample of Medicaid Card for the state of Nebraska front side2 Sample of Medicaid Card for the state of Nebraska back side

 

 

CARD HX-5

Medicare Managed Care Plans
Nebraska

D. United Healthcare Medicare Complete (United Healthcare of the Midlands, Inc.)

E. Security Choice (Unicare Life and Health Insurance Company)

F. Humana Gold Choice (Humana Insurance Company)

G. MedicareBlue PPO (Blue Cross and Blue Shield of Nebraska)

H. SecureHorizons Direct

 

 

CARD HX-6

Plan Names
Nebraska

F. Magellan Behavioral Health

G. Primary Care Plus

H. Share Advantage

 

 

CARD HX-8

PLAN NAMES (FOR FEDERAL CIVILIAN EMPLOYEES)
NEBRASKA

F. NALC

H. Association Benefit Plan

J. Foreign Service Benefit Plan

L. Panama Canal Area Benefit Plan

M. Rural Carrier Benefit Plan

V. GEHA Benefit Plan – High

W. GEHA Benefit Plan – Standard

X. Mail Handlers – High

Y. Mail Handlers – Standard

Z. PBP Health Plan – High

AA. PBP Health Plan – Standard

BB. APWU Health Plan - High

CC. APWU Health Plan – Consumer Driven

DD. Blue Cross and Blue Shield Service Benefit Plan – Standard

EE. Blue Cross and Blue Shield Service Benefit Plan – Basic

FF. SAMBA – High

GG. SAMBA – Standard

HH. GEHA High Deductible Health Plan

II. Mail Handlers High Deductible Plan

JJ. Coventry Health Care of Nebraska

KK. Avera Health Plans

 

 

CARD PR-1

Medicare Managed Care Plans
Nevada

H. Senior Care Plus

I. Senior Dimensions

K. Secure Horizons Medicare POS/Classic Plan (Secure Horizons Medicare POS/Advantage Plan)

L. Humana Gold Choice (Humana Insurance Company)

M. SecureHorizons Direct

N. Sierra Nevada Spectrum

O. Sierra Spectrum

 

 

CARD PR-2

Plan Names
Nevada

F. Health Plan of Nevada

I. NevadaCare DBA Nevada Health Solutions

 

 

CARD HX-3

Sample Medicaid Card
Nevada

Sample of Medicaid Card for the state of Nevada front side

Sample of Medicaid Card for the state of Nevada back side

 

 

CARD HX-5

Medicare Managed Care Plans
Nevada

H. Senior Care Plus

I. Senior Dimensions

K. Secure Horizons Medicare POS/Classic Plan (Secure Horizons Medicare POS/Advantage Plan)

L. Humana Gold Choice (Humana Insurance Company)

M. SecureHorizons Direct

N. Sierra Nevada Spectrum

O. Sierra Spectrum

 

 

CARD HX-6

Plan Names
Nevada

F. Health Plan of Nevada

I. NevadaCare DBA Nevada Health Solutions

 

 

CARD HX-8

PLAN NAMES (FOR FEDERAL CIVILIAN EMPLOYEES)
NEVADA

F. NALC

H. Association Benefit Plan

J. Foreign Service Benefit Plan

L. Panama Canal Area Benefit Plan

M. Rural Carrier Benefit Plan

W. GEHA Benefit Plan – High

X. GEHA Benefit Plan – Standard

Y. Mail Handlers – High

Z. Mail Handlers – Standard

AA. PBP Health Plan – High

BB. PBP Health Plan – Standard

EE. APWU Health Plan – High

FF. APWU Health Plan – Consumer Driven

GG. Blue Cross and Blue Shield Service Benefit Plan – Standard

HH. Blue Cross and Blue Shield Service Benefit Plan – Basic

II. SAMBA – High

JJ. SAMBA – Standard

KK. GEHA High Deductible Health Plan

LL. Mail Handlers High Deductible Plan

MM. Aetna

NN. Health Plan of Nevada – Northern area

OO. Health Plan of Nevada – Las Vegas area

PP. NevadaCare

RR. Aetna HealthFund CDHP

SS. Aetna Health Fund HDHP

TT. PacifiCare Desert Region (NV)

 

 

CARD PR-1

Medicare Managed Care Plans
New Hampshire

F. First Seniority (Harvard Pilgrim Health Care of New England)

G. SecureHorizons Direct

H. Today’s Option

 

 

CARD PR-2

Plan Names
New Hampshire

None Available

 

 

CARD HX-3

Sample Medicaid Card
New Hampshire

Sample of Medicaid Card for the state of New Hampshire front side

Sample of Medicaid Card for the state of New Hampshire back side

 

 

CARD HX-5

Medicare Managed Care Plans
New Hampshire

F. First Seniority (Harvard Pilgrim Health Care of New England)

G. SecureHorizons Direct

H. Today’s Option

 

 

CARD HX-6

Plan Names
New Hampshire

None Available

 

 

CARD HX-8

PLAN NAMES (FOR FEDERAL CIVILIAN EMPLOYEES)
NEW HAMPSHIRE

F. NALC

H. Association Benefit Plan

J. Foreign Service Benefit Plan

L Panama Canal Area Benefit Plan

M. Rural Carrier Benefit Plan

X. GEHA Benefit Plan – High

Y. GEHA Benefit Plan – Standard

Z. Mail Handlers – High

AA. Mail Handlers – Standard

BB. PBP Health Plan – High

CC. PBP Health Plan – Standard

DD. APWU Health Plan – High

EE. APWU Health Plan – Consumer Driven

FF. Blue Cross and Blue Shield Service Benefit Plan – Standard

GG. Blue Cross and Blue Shield Service Benefit Plan – Basic

HH. SAMBA – High

II. SAMBA – Standard

JJ. GEHA High Deductible Health Plan

KK. Mail Handlers High Deductible Plan

LL. Aetna HealthFund CDHP

MM. Aetna HealthFund HDHP

 

 

CARD IN-2A

State TANF Program
New Hampshire

New Hampshire Employment Program (NHEP)

Family Assistance Program (FAP)

 

 

CARD PR-1

Medicare Managed Care Plans
New Jersey

M. Oxford Medicare Advantage (Oxford Health Plans (New Jersey), Inc.)

T. AmeriHealth 65 Standard (AmeriHealth 65)

V. Horizon Medicare Blue (Horizon Healthcare of NJ, Inc.)

X. Aetna Golden Choice/Medicare (Aetna Health, Inc.)

Z. Erickson Advantage (United Health Care Insurance Company)

AA. SecureHorizons Direct

 

 

CARD PR-2

Plan Names
New Jersey

T. University Health Plans, Inc

X. AmeriChoice of New Jersey, Inc.

Y. AmeriGroup New Jersey, Inc.

Z. Health Net of New Jersey, Inc.

BB. Horizon NJ Health

 

 

CARD HX-3 A

Sample Medicaid Card
New Jersey

Sample of Medicaid Card for the state of New Jersey

 

 

CARD HX-5

Medicare Managed Care Plans
New Jersey

M. Oxford Medicare Advantage (Oxford Health Plans (New Jersey), Inc.)

T. AmeriHealth 65 Standard (AmeriHealth 65)

V. Horizon Medicare Blue (Horizon Healthcare of NJ, Inc.)

X. Aetna Golden Choice/Medicare (Aetna Health, Inc.)

Z. Erickson Advantage (United Health Care Insurance Company)

AA. SecureHorizons Direct

 

 

CARD HX-6

Plan Names
New Jersey

T. University Health Plans, Inc

X. AmeriChoice of New Jersey, Inc.

Y. AmeriGroup New Jersey, Inc.

Z. Health Net of New Jersey, Inc.

BB. Horizon NJ Health

 

 

CARD HX-8

PLAN NAMES (FOR FEDERAL CIVILIAN EMPLOYEES)
NEW JERSEY

F. NALC

H. Association Benefit Plan

J. Foreign Service Benefit Plan

L. Panama Canal Area Benefit Plan

M. Rural Carrier Benefit Plan

Q. AmeriHealth HMO, Inc.

FF. GEHA Benefit Plan – High

GG. GEHA Benefit Plan – Standard

HH. Mail Handlers – High

II. Mail Handlers – Standard

JJ. PBP Health Plan – High

KK. PBP Health Plan – Standard

NN. APWU Health Plan – High

OO. APWU Health Plan – Consumer Driven

PP. Blue Cross and Blue Shield Service Benefit Plan – Standard

QQ. Blue Cross and Blue Shield Service Benefit Plan – Basic

RR. SAMBA – High

SS. SAMBA – Standard

TT. GEHU High Deductible Health Plan

UU. Mail Handlers High Deductible Plan

VV. Aetna

WW. Coventry Health Care of Delaware – High

XX. GHI Health Plan – High

YY. Aetna HealthFund CDHP

ZZ. Aetna HealthFund HDHP

AAA. Coventry Health Care of Delaware – HDHP

 

 

CARD IN-2A

State TANF Program
New Jersey

Work First New Jersey (WFNJ)

 

 

CARD PR-1

Medicare Managed Care Plans
New Mexico

H. Lovelace Senior Plan (Lovelace Senior Plan)

J. Presbyterian Senior Care (Presbyterian Health Plan, Inc.)

K. Blue Medicare PPO (HISC-Blue Cross Blue Shield of New Mexico)

L. Human Gold Choice (Humana Insurance Company)

M. Presbyterian Medicare PPO

N. SecureHorizons Direct

O. United Healthcare Medicare Complete (United Healthcare Insurance Company)

 

 

CARD PR-2

Plan Names
New Mexico

E. Lovelace Community Health Plan

F. Presbyterian Salud!

G. Salud!

H. Molina Healthcare of New Mexico

 

 

CARD HX-3

Sample Medicaid Card – New Mexico

Sample of Medicaid Card for the state of New Mexico

 

 

CARD HX-5

Medicare Managed Care Plans
New Mexico

H. Lovelace Senior Plan (Lovelace Senior Plan)

J. Presbyterian Senior Care (Presbyterian Health Plan, Inc.)

K. Blue Medicare PPO (HISC-Blue Cross Blue Shield of New Mexico)

L. Human Gold Choice (Humana Insurance Company)

M. Presbyterian Medicare PPO

N. SecureHorizons Direct

O. United Healthcare Medicare Complete (United Healthcare Insurance Company)

 

 

CARD HX-6

Plan Names
New Mexico

E. Lovelace Community Health Plan

F. Presbyterian Salud!

G. Salud!

H. Molina Healthcare of New Mexico

 

 

CARD HX-8

PLAN NAMES (FOR FEDERAL CIVILIAN EMPLOYEES)
NEW MEXICO

F. NALC

H. Association Benefit Plan

J. Foreign Service Benefit Plan

L. Panama Canal Area Benefit Plan

M. Rural Carrier Benefit Plan

R. Lovelace Health Plan

S. Presbyterian Health Plan

W. GEHA Benefit Plan – High

X. GEHA Benefit Plan – Standard

Y. Mail Handlers – High

Z. Mail Handlers – Standard

AA. PBP Health Plan – High

BB. PBP Health Plan – Standard

DD. APWU Health Plan – High

EE. APWU Health Plan – Consumer Driven

FF. Blue Cross and Blue Shield Service Benefit Plan – Standard

GG. Blue Cross and Blue Shield Service Benefit Plan – Basic

HH. SAMBA – High

II. SAMBA – Standard

JJ. GEHA High Deductible Health Plan

KK. Mail Handlers High Deductible Plan

 

 

CARD IN-2A

State TANF Program
New Mexico

New Mexico Works

 

 

CARD PR-1

Medicare Managed Care Plans
New York

GGG. Elderplan (Elderplan, Inc.)

HHH. Encompass 65 (Independent Health)

NNN. Health Net SmartChoice (Health Net of NY)

PPP. Oxford Medicare Advantage (Oxford Health Plans (NY), Inc.)

RRR. Senior Blue (Senior Blue)

WWW. Aetna Golden Medicare/Choice Plan (Aetna Health, Inc.)

XXX. Fidelis Medicare Advantage (New York State Catholic Health Plan, Inc.)

YYY. HealthFirst (Health First PPO/Medicare Plan)

ZZZ. Preferred Care (Preferred Care)

AAAA. Senior Plan Direct (Empire BlueCross and BlueShield HMO)

CCCC. Traditional Blue Medicare PPO (Traditional Blue Medicare PPO)

DDDD. United Healthcare Medicare Complete (United Healthcare of New York, Inc.)

HHHH. GHI Medicare PPO (GHI Medicare Choice PPO)

IIII. Univera Medicare/Medicare Blue/Senior Choice (Excellus Health Plan, Inc.)

JJJJ. WellCare (WellCare)

KKKK. Today’s Options (American Progressive Life/Health Ins.)

LLLL. CDPHP Medicare Choice (CDPHP Medicare Choice)

MMMM. Liberty Health Advantage

NNNN. Medicare (TouchStone Health)

OOOO. Neighborhood Medicare (Neighborhood Health Providers)

PPPP. Open Access/Standard Co. (HIP Health Plan of Greater NY/HIP Insurance)

QQQQ. Preferred Care Gold (Preferred Care Gold/Gold Anywhere)

 

 

CARD PR-2

Plan Names New York

S. Fidelis (Catholic Services Health Plan)

JJJ. Capital District Physicians Health Plan

KKKK. Affinity Health Plan

LLLL. AmeriChoice

OOOO. Center Care

QQQQ. Community Premier Plus

UUUU. HealthFirst (PHSP)

VVVV. Health Now

YYYY. MetroPlus Health Plan

AG. Suffolk Health Plan

AJ. United Healthcare of New York

AM. WellCare

AP. Community Choice Health Plan of Westchester, Inc.

AQ. New York – Presbyterian System Select Health LLC

AR. PCMP II-A – Gold Choice

AT. Rochester Area HMO/Preferred Care

AU. SCHC Total Care, Inc.

AV. Southern Tier Priority Healthcare, Inc.

AX. Univera Community Health, Inc.

AY. VidaCare, Inc.

AZ. New York State Catholic Health Plan, Inc.

BA. MVP Health Plan, Inc.

BD. Managed Health, Inc.

BE. Independent Health Association, Inc.

BF. Hudson Health Plan, Inc.

BH. HealthPlus, Inc.

BI. HealthNow New York, Inc.

BJ. HealthNet of New York, Inc.

BK. Health Insurance Plan of Greater New York, Inc.

BL. GHI HMO Select, Inc.

BM. Excellus Health Plan, Inc.

BR. Broome MAX

BS. CarePlus, LLC

BW. CarePlus Connections

BX. Comprehensive Care Management

BY. CO-OP Care Plan

BZ. Eddy Seniorcare

CA. Elant Choice

CB. GHI PPO

CD. Guildnet

CE. Health Partners of NY

CF. Homefirst

CG. Independent Care Systems Inc.

CH. Independent Living for Seniors

CI. Liberty Health Advantage

CJ. Neighborhood Health Plan

CK. NY Presbyterian System Select Health

CL. Oxford Medicare Advantage

CM. Pace CNY

CN. Partners in Community Care

CO. Senior Health Partners, Inc.

CP. Senior Health Network

CQ. Southern Tier Pediatrics

CR. St. Barnabas Community Health (Partners in Health)

CS. NY Presbyterian Community Health Plan

CT. Total Aging In Place

CU. VNS Choice (PHSP)

 

 

CARD HX-3

Sample Medicaid Card
New York

Sample of Medicaid Card for the state of New York

 

 

CARD HX-5

Medicare Managed Care Plans
New York

GGG. Elderplan (Elderplan, Inc.)

HHH. Encompass 65 (Independent Health)

NNN. Health Net SmartChoice (Health Net of NY)

PPP. Oxford Medicare Advantage (Oxford Health Plans (NY), Inc.)

RRR. Senior Blue (Senior Blue)

WWW. Aetna Golden Medicare/Choice Plan (Aetna Health, Inc.)

XXX. Fidelis Medicare Advantage (New York State Catholic Health Plan, Inc.)

YYY. HealthFirst (Health First PPO/Medicare Plan)

ZZZ. Preferred Care (Preferred Care)

AAAA. Senior Plan Direct (Empire BlueCross and BlueShield HMO)

CCCC. Traditional Blue Medicare PPO (Traditional Blue Medicare PPO)

DDDD. United Healthcare Medicare Complete (United Healthcare of New York, Inc.)

HHHH. GHI Medicare PPO (GHI Medicare Choice PPO)

IIII. Univera Medicare/Medicare Blue/Senior Choice (Excellus Health Plan, Inc.)

JJJJ. WellCare (WellCare)

KKKK. Today’s Options (American Progressive Life/Health Ins.)

LLLL. CDPHP Medicare Choice (CDPHP Medicare Choice)

MMMM. Liberty Health Advantage

NNNN. Medicare (TouchStone Health)

OOOO. Neighborhood Medicare (Neighborhood Health Providers)

PPPP. Open Access/Standard Co. (HIP Health Plan of Greater NY/HIP Insurance)

QQQQ. Preferred Care Gold (Preferred Care Gold/Gold Anywhere)

 

 

CARD HX-6

Plan Names New York

S. Fidelis (Catholic Services Health Plan)

JJJ. Capital District Physicians Health Plan

KKKK. Affinity Health Plan

LLLL. AmeriChoice

OOOO. Center Care

QQQQ. Community Premier Plus

UUUU. HealthFirst (PHSP)

VVVV. Health Now

YYYY. MetroPlus Health Plan

AG. Suffolk Health Plan

AJ. United Healthcare of New York

AM. WellCare

AP. Community Choice Health Plan of Westchester, Inc.

AQ. New York – Presbyterian System Select Health LLC

AR. PCMP II-A – Gold Choice

AT. Rochester Area HMO/Preferred Care

AU. SCHC Total Care, Inc.

AV. Southern Tier Priority Healthcare, Inc.

AX. Univera Community Health, Inc.

AY. VidaCare, Inc.

AZ. New York State Catholic Health Plan, Inc.

BA. MVP Health Plan, Inc.

BD. Managed Health, Inc.

BE. Independent Health Association, Inc.

BF. Hudson Health Plan, Inc.

BH. HealthPlus, Inc.

BI. HealthNow New York, Inc.

BJ. HealthNet of New York, Inc.

BK. Health Insurance Plan of Greater New York, Inc.

BL. GHI HMO Select, Inc.

BM. Excellus Health Plan, Inc.

BR. Broome MAX

BS. CarePlus, LLC

BW. CarePlus Connections

BX. Comprehensive Care Management

BY. CO-OP Care Plan

BZ. Eddy Seniorcare

CA. Elant Choice

CB. GHI PPO

CD. Guildnet

CE. Health Partners of NY

CF. Homefirst

CG. Independent Care Systems Inc.

CH. Independent Living for Seniors

CI. Liberty Health Advantage

CJ. Neighborhood Health Plan

CK. NY Presbyterian System Select Health

CL. Oxford Medicare Advantage

CM. Pace CNY

CN. Partners in Community Care

CO. Senior Health Partners, Inc.

CP. Senior Health Network

CQ. Southern Tier Pediatrics

CR. St. Barnabas Community Health (Partners in Health)

CS. NY Presbyterian Community Health Plan

CT. Total Aging In Place

CU. VNS Choice (PHSP)

 

 

CARD HX-8

PLAN NAMES (FOR FEDERAL CIVILIAN EMPLOYEES)
NEW YORK

F. NALC

H. Association Benefit Plan

J. Foreign Service Benefit Plan

L. Panama Canal Area Benefit Plan

M. Rural Carrier Benefit Plan

P. Blue Choice

EE. Independent Health Association

MM. Preferred Care

UU. GEHA Benefit Plan - High

VV. GEHA Benefit Plan - Standard

WW. Mail Handlers – High

XX. Mail Handlers – Standard

YY. PBP Health Plan – High

ZZ. PBP Health Plan – Standard

III. HMO Blue

KKK. MVP Health Plan- Eastern

LLL. MVP Health Plan – Central

MMM. MVP Health Plan – Mid Hudson

PPP. Univera Healthcare – Western New York (N. Counties)

QQQ. Vytra Health Plans

RRR. APWU Health Plan – High

SSS. APWU Health Plan – Consumer Driven

TTT. HIP of Greater New York – High

UUU. HIP of Greater New York – Standard

XXX. Univera Healthcare – Western NY (S. Counties)

ZZZ. Blue Cross Blue Shield Service Benefit Plan - Standard

AAAA. Blue Cross Blue Shield Service Benefit Plan – Basic

CCCC. SAMBA – High

DDDD. SAMBA – Standard

EEEE. GEHA High Deductible Health Plan

FFFF. Mail Handlers High Deductible Plan

GGGG. Aetna

IIII. GHI HealthPlan – High

JJJJ. GHI HealthPlan – Standard

KKKK. GHI HMO Select – High – Brnx/Brklyn/Manhat/Queen/Richmon/Westche

LLLL. GHI HMO Select – Std – Brnx/Brklyn/Manhat/Queen/Richmon/Westche

MMMM. GHI HMO Select – High – Capital/Hudson Valley

NNNN. GHI HMO Select – Std – Capital/Hudson Valley

OOOO. HMOBlue – CNY

PPPP. Aetna HealthFund CDHP

QQQQ. Aetna HealthFund HDHP

RRRR. Capital District Physician’s Health Plan

 

 

CARD IN-2A

State TANF Program
New York

Family Assistance Program (FA)

 

 

CARD PR-1

Medicare Managed Care Plans
Ohio

T. Hometown Securecare (Hometown Health Plan)

GG. Advantra PPO (Advantra PPO)

MM. MediGold (MediGold)

NN. Prime Time Health Plan (Prime Time Health Plan)

SS. United Healthcare Medicare Complete (United Healthcare of Ohio, Inc.)

UU. Medicare Plus (Kaiser Foundation HP of Ohio)

BBB. QualChoice Medicare Prime (QualChoice Health Plan, Inc.)

CCC. Health Plan SecureCare (The Health Plan)

DDD. Humana Choice PPO (Humana Insurance Company)

EEE. Paramount Elite (Paramount Elite)

FFF. SummaCare Secure (SummaCare Health Plan)

GGG. Aetna Golden (Aetna Medicare

HHH. Blue Medicare Access/Anthem Sr Advantage (Anthem Blue Cross and Blue Shield)

III. SecureHorizons Direct

 

 

CARD PR-2

Plan Names
Ohio

S. Paramount Care, Inc.

T. QualChoice Health Plan

V. Care Source

Z. Buckeye Community Health Plan

AB. Amerigroup Ohio Inc.

AC. Amerigroup Community Care

AD. Gateway Health Plan of Ohio

AE. McKinley Life Insurance Company

AF. Moline Healthcare of Ohio

AG. Unison

 

 

CARD HX-3 A

Sample Medicaid Card – Ohio

Sample of Medicaid Card for the state of Ohio

 

 

CARD HX-5

Medicare Managed Care Plans
Ohio

T. Hometown Securecare (Hometown Health Plan)

GG. Advantra PPO (Advantra PPO)

MM. MediGold (MediGold)

NN. Prime Time Health Plan (Prime Time Health Plan)

SS. United Healthcare Medicare Complete (United Healthcare of Ohio, Inc.)

UU. Medicare Plus (Kaiser Foundation HP of Ohio)

BBB. QualChoice Medicare Prime (QualChoice Health Plan, Inc.)

CCC. Health Plan SecureCare (The Health Plan)

DDD. Humana Choice PPO (Humana Insurance Company)

EEE. Paramount Elite (Paramount Elite)

FFF. SummaCare Secure (SummaCare Health Plan)

GGG. Aetna Golden (Aetna Medicare

HHH. Blue Medicare Access/Anthem Sr Advantage (Anthem Blue Cross and Blue Shield)

III. SecureHorizons Direct

 

 

CARD HX-6

Plan Names
Ohio

S. Paramount Care, Inc.

T. QualChoice Health Plan

V. Care Source

Z. Buckeye Community Health Plan

AB. Amerigroup Ohio Inc.

AC. Amerigroup Community Care

AD. Gateway Health Plan of Ohio

AE. McKinley Life Insurance Company

AF. Moline Healthcare of Ohio

AG. Unison

 

 

CARD HX-8

PLAN NAMES (FOR FEDERAL CIVILIAN EMPLOYEES)
OHIO

F. NALC

H. Association Benefit Plan

J. Foreign Service Benefit Plan

L. Panama Canal Area Benefit Plan

M. Rural Carrier Benefit Plan

BB. HMO Health Ohio

DD. Kaiser Permanente

GG. Paramount Health Care

RR. GEHA Benefit Plan – High

SS. GEHA Benefit Plan – Standard

TT. Mail Handlers – High

UU. Mail Handlers – Standard

VV. PBP Health Plan – High

WW. PBP Health Plan – Standard

ZZ. SummaCare Health Plan

AAA. SuperMed HMO

CCC. APWU Health Plan – High

DDD. APWU Health Plan – Consumer Driven

EEE. Blue Cross Blue Shield Service Benefit Plan – Standard

FFF. Blue Cross Blue Shield Service Benefit Plan – Basic

III. SAMBA – High

JJJ. SAMBA – Standard

KKK. GEHA High Deductible Health Plan

LLL. Mail Handlers High Deductible Plan

MMM. Aetna – Cleveland and Toledo Areas

NNN. Aetna – Columbus Area

OOO. Aetna – Greater Cincinnati Area

PPP. AultCare HMO – High

QQQ. Blue HMO

RRR. Hometown Health Plan

SSS. The Health Plan of the Upper Ohio Valley

TTT. United Healthcare of Ohio, Inc. – High

UUU. United Healthcare of Ohio, Inc. – Std

VVV. Aetna HealthFund CDHP

WWW. Aetna HealthFund HDHP

XXX. AultCare HMO – HDHP

YYY. Humana CDHP

 

 

CARD IN-2A

State TANF Program
Ohio

Ohio Works First (OWF)

 

 

CARD PR-1

Medicare Managed Care Plans
Oklahoma

G. Senior Health Plan (Community Care HMO, Inc.)

H. Generations Healthcare (Generations Healthcare)

I. Secure Horizons Standard Plan (Secure Horizons Medicare Advantage Plan)

J. Humana Gold Choice/Humana Choice PPO (Humana Insurance Company)

L. Medicare Blue PPO (Blue Cross/Blue Shield of Oklahoma)

M. SecureHorizons Direct

 

 

CARD PR-2

Plan Names
Oklahoma

J. SoonerCare (PCCM)

 

 

CARD HX-3

Sample Medicaid Card
Oklahoma

Sample of Medicaid Card for the state of Oklahoma front side

Sample of Medicaid Card for the state of Oklahoma back side

 

 

CARD HX-5

Medicare Managed Care Plans
Oklahoma

G. Senior Health Plan (Community Care HMO, Inc.)

H. Generations Healthcare (Generations Healthcare)

I. Secure Horizons Standard Plan (Secure Horizons Medicare Advantage Plan)

J. Humana Gold Choice/Humana Choice PPO (Humana Insurance Company)

L. Medicare Blue PPO (Blue Cross/Blue Shield of Oklahoma)

M. SecureHorizons Direct

 

 

CARD HX-6

Plan Names
Oklahoma

J. SoonerCare (PCCM)

 

 

CARD HX-8

PLAN NAMES (FOR FEDERAL CIVILIAN EMPLOYEES)
OKLAHOMA

F. NALC

H. Association Benefit Plan

J. Foreign Service Benefit Plan

L. Panama Canal Area Benefit Plan

M. Rural Carrier Benefit Plan

V. GEHA Benefit Plan – High

W. GEHA Benefit Plan – Standard

X. Mail Handlers – High

Y. Mail Handlers – Standard

Z. PBP Health Plan – High

AA. PBP Health Plan – Standard

DD. APWU Health Plan – High

EE. APWU Health Plan – Consumer Driven

FF. Blue Cross and Blue Shield Service Benefit Plan – Standard

GG. Blue Cross and Blue Shield Service Benefit Plan – Basic

HH. SAMBA – High

II. SAMBA – Standard

JJ. GEHA High Deductible Health Plan

KK. Mail Handlers High Deductible Plan

LL. Aetna

MM. Globalhealth, Inc.

NN. PacifiCare Southwest Region (OK & TX)

OO. Aetna HealthFund CDHP

PP. Aetna HealthFund HDHP

 

 

CARD PR-1

Medicare Managed Care Plans Oregon

L. Providence Medicare Extra (Providence Health Plan)

P. Clear Choice (Clear Choice Health Plan)

U. Senior Advantage (Kaiser Foundation Health Plan of the Northwest)

V. First Choice/Preferred Choice Sixty-Five (Regence Blue Cross Blue Shield of Oregon)

W. Health Net Options Plus (Health Net Options Plus)

X. Secure Horizons (Secure Horizons Medicare Advantage Plan)

Y. CareSource

Z. MyAdvantage PPO (ATRIO Health Plans)

AA. ODS Advantage PPO (ODS Advantage)

BB. Preferred Choice Sixty-Five (Regence Blue Cross/Blue Shield of Oregon)

CC. Premier Care (Familycare Health Plans, Inc.)

DD. SecureHorizons Direct

EE. The Conventional /Premier Plan (Samaritan Advantage Health Plan)

FF. Today’s Options

GG. United Healthcare Medicare Complete (United Healthcare Insurance Company)

 

 

CARD PR-2

Plan Names
Oregon

J. InterCommunity Health Network

EE. Mid-Rogue IPA

GG. Oregon Health Management Services

OO. Douglas County IPA

YY. CareOregon

ZZ. Cascade Comprehensive Care

DDD. FamilyCare

HHH. Lane Individual Practice Association (LIPA)

III. Marion Polk Community Health Plan

OOO. Quality Health Alliance (Mental Health)

SSS. Doctors of the Oregon Coast South

UUU. Central Oregon Individual Health Solutions (COIHS)

WWW. Providence Health Assurance

XXX. ODS Community Health, Inc.

YYY. Kaiser Permanente Oregon Plus, LLC

 

 

CARD HX-3

Sample Medicaid Card – Oregon

Sample Medicaid Card for the state of Oregon

 

 

CARD HX-5

Medicare Managed Care Plans
Oregon

L. Providence Medicare Extra (Providence Health Plan)

P. Clear Choice (Clear Choice Health Plan)

U. Senior Advantage (Kaiser Foundation Health Plan of the Northwest)

V. First Choice/Preferred Choice Sixty-Five (Regence Blue Cross Blue Shield of Oregon)

W. Health Net Options Plus (Health Net Options Plus)

X. Secure Horizons (Secure Horizons Medicare Advantage Plan)

Y. CareSource

Z. MyAdvantage PPO (ATRIO Health Plans)

AA. ODS Advantage PPO (ODS Advantage)

BB. Preferred Choice Sixty-Five (Regence Blue Cross/Blue Shield of Oregon)

CC. Premier Care (Familycare Health Plans, Inc.)

DD. SecureHorizons Direct

FF. The Conventional /Premier Plan (Samaritan Advantage Health Plan)

FG. Today’s Options

GG. United Healthcare Medicare Complete (United Healthcare Insurance Company)

 

 

CARD HX-6

Plan Names
Oregon

J. InterCommunity Health Network

EE. Mid-Rogue IPA

GG. Oregon Health Management Services

OO. Douglas County IPA

YY. CareOregon

ZZ. Cascade Comprehensive Care

DDD. FamilyCare

HHH. Lane Individual Practice Association (LIPA)

III. Marion Polk Community Health Plan

OOO. Quality Health Alliance (Mental Health)

SSS. Doctors of the Oregon Coast South

UUU. Central Oregon Individual Health Solutions (COIHS)

WWW. Providence Health Assurance

XXX. ODS Community Health, Inc.

YYY. Kaiser Permanente Oregon Plus, LLC

 

 

CARD HX-8

PLAN NAMES (FOR FEDERAL CIVILIAN EMPLOYEES)
OREGON

F. NALC

H. Association Benefit Plan

J. Foreign Service Benefit Plan

L. Panama Canal Area Benefit Plan

M. Rural Carrier Benefit Plan

P. Kaiser Permanente – High

Q. Kaiser Permanente – Standard

X. GEHA Benefit Plan – High

Y. GEHA Benefit Plan – Standard

Z. Mail Handlers – High

AA. Mail Handlers – Standard

BB. PBP Health Plan – High

CC. PBP Health Plan – Standard

EE. APWU Health Plan – High

FF. APWU Health Plan – Consumer Driven

GG. Blue Cross and Blue Shield Service Benefit Plan – Standard

HH. Blue Cross and Blue Shield Service Benefit Plan – Basic

II. SAMBA – High

JJ. SAMBA – Standard

KK. GEHA High Deductible Health Plan

LL. Mail Handlers High Deductible Plan

MM. PacifiCare Northwest Region (Oregon/Washington)

NN. PacifiCare of Oregon

 

 

CARD PR-1

Medicare Managed Care Plans
Pennsylvania

G. Security Blue (Keystone Health Plan West, Inc.)

N. Senior Blue (Keystone Health Plan Central, Inc.)

GG. Geisinger Health Plan Gold (Geisinger Health Plan Gold)

LL. Keystone 65 (Keystone 65)

SS. FreedomBlue PPO (Highmark, Inc.)

TT. Health Assurance Advantra PPO (Health Assurance Pennsylvania, Inc.)

UU. Personal Choice 65 (Personal Choice 65)

VV. Senior Partners Gold/Silver (Health Partners)

WW. Smart Choice (Elder Health of PA, Inc.)

XX. UPMC For Life (UMPC For Life)

ZZ. AmeriChoice Personal Care Plus (AmeriChoice Personal Care Plus)

BBB. AmeriHealth 65 (Amerihealth 65)

CCC. Elder Health (Elder Health of PA, Inc.)

EEE. Today’s Options (American Progressive Life/Hlth Ins.)

FFF. Advantra Silver/Gold (HealthAmerica Advantra)

GGG. Advantra PPO

HHH. Aetna Golden (Aetna Medicare)

III. Fresenius Medical Care Health Plan, Inc.

JJJ. Humana Gold Choice/Humana Choice PPO (Humana Insurance Company)

KKK. SecureHorizons Direct

MMM. Sterling Partners (Sterling Partners – Pennsylvania)

NNN. Unison Advantage (Unison Health Plan)

OOO. United HealthCare Medicare Complete (Erickson Advantage, United Healthcare Insurance)

 

 

CARD PR-2

Plan Names
Pennsylvania

DD. AmeriChoice of Pennsylvania

EE. AmeriHealth HMO, Inc./AmeriHealth Mercy Health Plan

HH. Community Care Behavioral Health Care Organization

II. Gateway Health Plan, Inc.

JJ. Health Partners of Philadelphia, Inc.

KK. Magellan Behavioral Health

MM. Value Behavioral Health of PA

NN. Community Behavioral Healthcare Network of Pennsylvania (CBHNP)

OO. UPMC Health Plan, Inc./UPMC For You

PP. Southwest Behavioral Health Management, Inc.

SS. Unison Health Plan/MedPLUS+

TT. Bucks County Behavioral Health System

UU. Behavioral Health collaborative, Inc.

 

 

CARD HX-3

Sample Medicaid Card
Pennsylvania

Sample Medicaid Card for the state of Pennsylvania image 1

Sample Medicaid Card for the state of Pennsylvania image2

 

 

CARD HX-5

Medicare Managed Care Plans
Pennsylvania

G. Security Blue (Keystone Health Plan West, Inc.)

N. Senior Blue (Keystone Health Plan Central, Inc.)

GG. Geisinger Health Plan Gold (Geisinger Health Plan Gold)

LL. Keystone 65 (Keystone 65)

SS. FreedomBlue PPO (Highmark, Inc.)

TT. Health Assurance Advantra PPO (Health Assurance Pennsylvania, Inc.)

UU. Personal Choice 65 (Personal Choice 65)

VV. Senior Partners Gold/Silver (Health Partners)

WW. Smart Choice (Elder Health of PA, Inc.)

XX. UPMC For Life (UMPC For Life)

ZZ. AmeriChoice Personal Care Plus (AmeriChoice Personal Care Plus)

BBB. AmeriHealth 65 (Amerihealth 65)

CCC. Elder Health (Elder Health of PA, Inc.)

EEE. Today’s Options (American Progressive Life/Health Ins.)

FFF. Advantra Silver/Gold (HealthAmerica Advantra)

GGG. Advantra PPO

HHH. Aetna Golden (Aetna Medicare)

III. Fresenius Medical Care Health Plan, Inc.

JJJ. Humana Gold Choice/Humana Choice PPO (Humana Insurance Company)

KKK. SecureHorizons Direct

MMM. Sterling Partners (Sterling Partners – Pennsylvania)

NNN. Unison Advantage (Unison Health Plan)

OOO. United HealthCare Medicare Complete (Erickson Advantage, United Healthcare Insurance)

 

 

CARD HX-6

Pennsylvania
Plan Names

DD. AmeriChoice of Pennsylvania

EE. AmeriHealth HMO, Inc./AmeriHealth Mercy Health Plan

HH. Community Care Behavioral Health Care Organization

II. Gateway Health Plan, Inc.

JJ. Health Partners of Philadelphia, Inc.

KK. Magellan Behavioral Health

MM. Value Behavioral Health of PA

NN. Community Behavioral Healthcare Network of Pennsylvania (CBHNP)

OO. UPMC Health Plan, Inc./UPMC For You

PP. Southwest Behavioral Health Management, Inc.

SS. Unison Health Plan/MedPLUS+

TT. Bucks County Behavioral Health System

UU. Behavioral Health collaborative, Inc.

 

 

CARD HX-8

PLAN NAMES (FOR FEDERAL CIVILIAN EMPLOYEES)
PENNSYLVANIA

F. NALC

H. Association Benefit Plan

J. Foreign Service Benefit Plan

L. Panama Canal Area Benefit Plan

M. Rural Carrier Benefit Plan

CC. Keystone Health Plan Central

DD. Keystone Health Plan East

LL. GEHA Benefit Plan – High

MM. GEHA Benefit Plan – Standard

NN. Mail Handlers – High

OO. Mail Handlers – Standard

PP. PBP Health Plan – High

QQ. PBP Health Plan – Standard

YY. UPMC Health Plan

ZZ. APWU Health Plan High

AAA. APWU Health Plan – Consumer Driven

BBB. Blue Cross and Blue Shield Service Benefit Plan – Standard

CCC. Blue Cross and Blue Shield Service Benefit Plan – Basic

FFF. SAMBA – High

GGG. SAMBA – Standard

HHH. GEHA High Deductible Health Plan

III. Mail Handlers High Deductible Plan

JJJ. Aetna – Philadelphia and Southeastern PA

KKK. Aetna – Pittsburgh Area

MMM. HealthAmerica Pennsylvania High – Greater Pittsburgh area

NNN. HealthAmerica Pennsylvania – Std – Greater Pittsburgh area

OOO. HealthAmerica Pennsylvania – High – Northeast Pennsylvania

PPP. HealthAmerica Pennsylvania – Std – Northeast Pennsylvania

SSS. HealthAmerica Pennsylvania – High – Central Pennsylvania

TTT. HealthAmerica Pennsylvania – Std – Central Pennsylvania

UUU. Aetna HealthFund CDHP

VVV. Aetna HealthFund HDHP

WWW. Coventry Health Care of Delaware HDHP

XXX. HealthAmerica Pennsylvania HDHP – Southeastern Pennsylvania

YYY. HealthAmerica Pennsylvania HDHP – Greater Pittsburgh Area

ZZZ. HealthAmerica Pennsylvania HDHP – Northeast Pennsylvania

AAAA. HealthAmerica Pennsylvania HDHP – Central Pennsylvania

 

 

CARD PR-1

Medicare Managed Care Plans
Rhode Island

J. United Healthcare Medicare Complete (United Healthcare of New England, Inc.)

K. BlueCHIP for Medicare (BlueCross and Blue Shield of Rhode Island)

M. SecureHorizons Direct

 

 

CARD PR-2

Plan Names
Rhode Island

C. Neighborhood Health Plan of Rhode Island

H. United Healthcare of New England

J. Rite Care

K. Blue Cross and Blue Shield of RI

 

 

CARD HX-3

Sample Medicaid Card
Rhode Island

Sample Medicaid Card for the state of Rhode Island front side

Sample Medicaid Card for the state of Rhode Island back side

 

 

CARD HX-5

Medicare Managed Care Plans
Rhode Island

J. United Healthcare Medicare Complete (United Healthcare of New England, Inc.)

K. BlueCHIP for Medicare (BlueCross and Blue Shield of Rhode Island)

M. SecureHorizons Direct

 

 

CARD HX-6

Plan Names
Rhode Island

C. Neighborhood Health Plan of Rhode Island

H. United Healthcare of New England

J. Rite Care

K. Blue Cross and Blue Shield of RI

 

 

CARD HX-8

PLAN NAMES (FOR FEDERAL CIVILIAN EMPLOYEES)
RHODE ISLAND

F. NALC

H. Association Benefit Plan

J. Foreign Service Benefit Plan

L. Panama Canal Area Benefit Plan

M. Rural Carrier Benefit Plan

W. GEHA Benefit Plan – High

X. GEHA Benefit Plan – Standard

Y. Mail Handlers – High

Z. Mail Handlers – Standard

AA. PBP Health Plan – High

BB. PBP Health Plan – Standard

CC. Blue Chip, Coord Health Partners, Inc.

DD. APWU Health Plan – High

EE. APWU Health Plan - Consumer Driven

FF. Blue Cross and Blue Shield Service Benefit Plan - Standard

GG. Blue Cross and Blue Shield Service Benefit Plan – Basic

HH. SAMBA – High

II. SAMBA – Standard

JJ. GEHA High Deductible Health Plan

KK. Mail Handlers High Deductible Plan

 

 

CARD IN-2A

State TANF Program
Rhode Island

Family Independence Program (FIP)

 

 

CARD PR-1

Medicare Managed Care Plans
South Carolina

A. Humana Gold Choice (Humana Insurance Company)

D. Carolina Medicare Prime

E. InStil InCare/InChoice (InStil Health Insurance Company)

F. Medicare Blue (Blue Cross and Blue Shield of SC)

G. Platinum Advantage (BlueChoice Health Plan)

H. SecureHorizons Direct

I. Today’s Options

 

 

CARD PR-2

Plan Names
South Carolina

G. Select Health of South Carolina, Inc.

H. Unison Health Plan of South Carolina

I. First Choice/Select Health

J. Upstate Carolina Best Care

K. PhysTrust of SCF

L. Community Health Solutions – SC Solutions

 

 

CARD HX-3

Sample Medicaid Card - South Carolina

Sample Medicaid Card for the state of South Carolina front side

Sample Medicaid Card for the state of South Carolina back side

 

 

CARD HX-5

Medicare Managed Care Plans
South Carolina

A. Humana Gold Choice (Humana Insurance Company)

D. Carolina Medicare Prime

E. InStil InCare/InChoice (InStil Health Insurance Company)

F. Medicare Blue (Blue Cross and Blue Shield of SC)

G. Platinum Advantage (BlueChoice Health Plan)

H. SecureHorizons Direct

I. Today’s Options

 

 

CARD HX-6

Plan Names
South Carolina

G. Select Health of South Carolina, Inc.

H. Unison Health Plan of South Carolina

I. First Choice/Select Health

J. Upstate Carolina Best Care

K. PhysTrust of SCF

L. Community Health Solutions – SC Solutions

 

 

CARD HX-8

PLAN NAMES (FOR FEDERAL CIVILIAN EMPLOYEES)
SOUTH CAROLINA

F. NALC

H. Association Benefit Plan

J. Foreign Service Benefit Plan

L. Panama Canal Area Benefit Plan

M. Rural Carrier Benefit Plan

Z. Mail Handlers – High

AA. Mail Handlers – Standard

BB. PBP Health Plan – High

CC. PBP Health Plan – Standard

DD. APWU Health Plan – High

EE. APWU Health Plan – Consumer Driven

FF. Blue Cross and Blue Shield Service Benefit Plan – Standard

GG. Blue Cross and Blue Shield Service Benefit Plan – Basic

HH. GEHA Benefit Plan – High

II. GEHA Benefit Plan – Std

JJ. GEHA High Deductible Health Plan

KK. Mail Handlers High Deductible Plan

LL. Carolina Care

MM. Aetna HealthFund CDHP

NN. Aetna HealthFund HDHP

OO. SAMBA – High

PP. SAMBA – Standard

 

 

CARD IN-2A

State TANF Program
South Carolina

Family Independence

 

 

CARD PR-1

Medicare Managed Care Plans
South Dakota

B. Humana Gold Choice (Humana Insurance Company)

C. Prime Solution (Medica Insurance Company)

D. United Healthcare Medicare Complete Essential (United Healthcare Insurance Company)

E. MedicareBlue PPO (Wellmark Blue Cross Blue Shield of SD)

F. SecureHorizons Direct

 

 

CARD PR-2

Plan Names
South Dakota

C. Primary Care Case Management Program

 

 

CARD HX-3

Sample Medicaid Card
South Dakota

Sample Medicaid Card for the state of South Dakota front side

Sample Medicaid Card for the state of South Dakota back side

 

 

CARD HX-5

Medicare Managed Care Plans
South Dakota

B. Humana Gold Choice (Humana Insurance Company)

C. Prime Solution (Medica Insurance Company)

D. United Healthcare Medicare Complete Essential (United Healthcare Insurance Company)

E. MedicareBlue PPO (Wellmark Blue Cross Blue Shield of SD)

F. SecureHorizons Direct

 

 

CARD HX-6

Plan Names
South Dakota

C. Primary Care Case Management Program

 

 

CARD HX-8

PLAN NAMES (FOR FEDERAL CIVILIAN EMPLOYEES)
SOUTH DAKOTA

F. NALC

H. Association Benefit Plan

J. Foreign Service Benefit Plan

L. Panama Canal Area Benefit Plan

M. Rural Carrier Benefit Plan

S. GEHA Benefit Plan – High

T. GEHA Benefit Plan – Standard

U. Mail Handlers – High

V. Mail Handlers – Standard

W. PBP Health Plan – High

X. PBP Health Plan – Standard

Y. Avera Health Plan

AA. APWU Health Plan – High

BB. APWU Health Plan – Consumer Driven

CC. Blue Cross and Blue Shield Service Benefit Plan - Standard

DD. Blue Cross and Blue Shield Service Benefit Plan – Basic

EE. SAMBA – High

FF. SAMBA – Standard

GG. GEHA High Deductible Health Plan

HH. Mail Handlers High Deductible Plan

II. Sioux Valley Health Plan – High

JJ. Sioux Valley Health Plan – Standard

KK. HealthPartners Classic/Open Access Deductible

 

 

CARD IN-2A

State TANF Program
South Dakota

TANF

 

 

CARD PR-1

Medicare Managed Care Plans
Tennessee

N. Secure Plus (John Deere Health Plan, Inc.)

Q. Cariten Senior Health [Cariten Senior Health/(PPO)]

R. HealthSpring (HealthSpring, Inc.)

T. United Healthcare Medicare Complete (United Healthcare of Tennessee, Inc.)

U. BlueAdvantage (Blue Cross Blue Shield of Tennessee)

V. HumanaChoice PPO/Humana Gold Choice (Humana Insurance Company)

W. SecureHorizons Direct

X. Windson Medicare Extra

 

 

CARD PR-2

Plan Names
Tennessee

U. Better Health Plans, Inc.

V. Bluecare (Volunteer State Health Plan)

W. Preferred Health Partnership/PHP

DD. TLC Family Care (Memphis Managed Care)

EE. TennCare Select

GG. John Deere Health Care

HH. UAHC (Omnicare)

II. Windsor Health Plan of TN, Inc.

 

 

CARD HX-3

Sample Medicaid Card
Tennessee

Sample Medicaid Card for the state of Tennessee front side

Sample Medicaid Card for the state of Tennessee back side

 

 

CARD HX-5

Medicare Managed Care Plans
Tennessee

N. Secure Plus (John Deere Health Plan, Inc.)

Q. Cariten Senior Health [Cariten Senior Health/(PPO)]

R. HealthSpring (HealthSpring, Inc.)

T. United Healthcare Medicare Complete (United Healthcare of Tennessee, Inc.)

U. BlueAdvantage (Blue Cross Blue Shield of Tennessee)

V. HumanaChoice PPO/Humana Gold Choice (Humana Insurance Company)

W. SecureHorizons Direct

X. Windson Medicare Extra

 

 

CARD HX-6

Plan Names
Tennessee

U. Better Health Plans, Inc.

V. Bluecare (Volunteer State Health Plan)

W. Preferred Health Partnership/PHP

DD. TLC Family Care (Memphis Managed Care)

EE. TennCare Select

GG. John Deere Health Care

HH. UAHC (Omnicare)

II. Windsor Health Plan of TN, Inc.

 

 

CARD HX-8

PLAN NAMES (FOR FEDERAL CIVILIAN EMPLOYEES)
TENNESSEE

F. NALC

H. Association Benefit Plan

J. Foreign Service Benefit Plan

L. Panama Canal Area Benefit Plan

M. Rural Carrier Benefit Plan

Y. GEHA Benefit Plan – High

Z. GEHA Benefit Plan – Standard

AA. Mail Handlers – High

BB. Mail Handlers – Standard

CC. PBP Health Plan – High

DD. PBP Health Plan – Standard

HH. APWU Health Plan – High

II. APWU Health Plan – Consumer Driven

NN. Blue Cross and Blue Shield Service Benefit Plan – Standard

OO. Blue Cross and Blue Shield Service Benefit Plan – Basic

PP. SAMBA – High

QQ. SAMBA – Standard

RR. GEHA High Deductible Health Plan

SS. Mail Handlers High Deductible Plan

TT. Aetna – Nashville Area

UU. Aetna – Memphis Area

VV. Aetna HealthFund CDHP

WW. Aetna HealthFund HDHP

XX. Humana CDHP

 

 

CARD IN-2A

State TANF Program
Tennessee

Families First

 

 

CARD PR-1

Medicare Managed Care Plans
Texas

KK. SeniorCare Senior (Scott and White Health Plan)

NN. Secure Horizons (Secure Horizons Medicare Advantage Plan)

PP. Texan (SelectCare of Texas, LLC)

QQ. Texas HealthSpring (Texas Healthspring, LLC)

RR. Humana Choice PPO (Humana Insurance Company)

SS. Aetna Golden (Aetna Medicare)

TT. Blue Medicare PPO (HISC – Blue Cross Blue Shield of Texas)

UU. Elder Health (Elder Health Texas, Inc.)

VV. FIRSTCARE Advantage

WW. Fresenius Medical Care Health Plan, Inc.

XX. Physicians Health Choice

YY. Premier Advantage

ZZ. SecureHorizons Direct

AAA. Texas Community Care

BBB. Valley Advantage (Valley Baptist Health Plan, Inc.)

CCC. United HealthCare Medicare Complete (United HealthCare Insurance Company)

 

 

CARD PR-2

Plan Names
Texas

U. Community First

X. First Care

JJ. AMERIGROUP STAR+PLUS

KK. Evercare

LL. Aetna

MM. Community Health Choice

NN. Cook Children’s Hospital

OO. Molina

PP. Parkland Health First

QQ. Mercy, Superior Health Plan

RR. Texas Children’s Health Plan

SS. Unicare

TT. NorthSTAR

UU. STAR+PLUS

VV. Primary Care Case Management

 

 

CARD HX-3 A

Sample Medicaid Card – Texas

Sample Medicaid Card for the state of Texas

 

 

CARD HX-5

Medicare Managed Care Plans
Texas

KK. SeniorCare Senior (Scott and White Health Plan)

NN. Secure Horizons (Secure Horizons Medicare Advantage Plan)

PP. Texan (SelectCare of Texas, LLC)

QQ. Texas HealthSpring (Texas Healthspring, LLC)

RR. Humana Choice PPO (Humana Insurance Company)

SS. Aetna Golden (Aetna Medicare)

TT. Blue Medicare PPO (HISC – Blue Cross Blue Shield of Texas)

UU. Elder Health (Elder Health Texas, Inc.)

VV. FIRSTCARE Advantage

WW. Fresenius Medical Care Health Plan, Inc.

XX. Physicians Health Choice

YY. Premier Advantage

ZZ. SecureHorizons Direct

AAA. Texas Community Care

BBB. Valley Advantage (Valley Baptist Health Plan, Inc.)

CCC. United HealthCare Medicare Complete (United HealthCare Insurance Company)

 

 

CARD HX-6

Plan Names
Texas

U. Community First

X. First Care

JJ. AMERIGROUP STAR+PLUS

KK. Evercare

LL. Aetna

MM. Community Health Choice

NN. Cook Children’s Hospital

OO. Molina

PP. Parkland Health First

QQ. Mercy, Superior Health Plan

RR. Texas Children’s Health Plan

SS. Unicare

TT. NorthSTAR

UU. STAR+PLUS

VV. Primary Care Case Management

 

 

CARD HX-8

PLAN NAMES (FOR FEDERAL CIVILIAN EMPLOYEES)
TEXAS

F. NALC

H. Association Benefit Plan

J. Foreign Service Benefit Plan

L. Panama Canal Area Benefit Plan

M. Rural Carrier Benefit Plan

LL. GEHA Benefit Plan – High

MM. GEHA Benefit Plan – Standard

NN. Mail Handlers – High

OO. Mail Handlers – Standard

PP. PBP Health Plan – High

QQ. PBP Health Plan – Standard

TT. FIRSTCARE - Waco

UU. FIRSTCARE – West Texas

XX. Mercy Health Plans/Premier Health Plans

ZZ. APWU Health Plan – High

AAA. APWU Health Plan – Consumer Driven

BBB. Blue Cross and Blue Shield Service Benefit Plan - Standard

CCC. Blue Cross and Blue Shield Service Benefit Plan – Basic

FFF. Humana Health Plan of Texas - High

GGG. Humana Health Plan of Texas – Standard

HHH. SAMBA – High

III. SAMBA – Standard

JJJ. GEHA High Deductible Health Plan

KKK. Mail Handlers High Deductible Plan

LLL. Aetna – Houston Area

MMM. Aetna – Austin/San Antonio Areas

NNN. Aetna – Dallas/Ft. Worth Areas

OOO. HMO Blue Texas

PPP. PacifiCare Southwest Region (OK & TX)

QQQ. Aetna HealthFund CDHP

RRR. Aetna HealthFund HDHP

SSS. Humana CoverageFirst CDHP – Houston

TTT. Humana CoverageFirst CDHP – Dallas/Ft. Worth

UUU. Humana CoverageFirst CDHP – Corpus Christi

VVV. Humana CoverageFirst CDHP – San Antonio

WWW. Humana CoverageFirst CDHP – Austin

 

 

CARD IN-2A

State TANF Program
Texas

Texas Works

Choices

 

 

CARD PR-1

Medicare Managed Care Plans
Utah

A. Humana Gold Choice (Humana Insurance Company)

B. Security Choice (Unicare Life & Health Ins. Company)

C. UnitedHealthcare Medicare Complete (UnitedHealthcare of Utah, Inc.)

L. HumanaChoice PPO/Humana Gold Choice (Humana Insurance Company)

M. MedAvantage (Regence Blue Cross Blue Shield of Utah)

N. SecureHorizons Direct

O. Sierra Spectrum

P. Today’s Options

Q. United Healthcare Medicare Complete (United Healthcare of Utah, Inc.)

 

 

CARD PR-2

Plan Names
Utah

H. IHC Health Plans

M. Bear River Mental Health

P. Four Corners Mental Health

Q. Healthy U

S. Molina Healthcare of Utah

U. Valley Mental Health

V. Wasatch Mental Health

W. Weber Mental Health

X. Molina Plus

Y. Davis Behavioral Health

Z. Central Utah Counseling

AA. Northeastern Counseling

BB. Southwest Center

 

 

CARD HX-3

Sample Medicaid Card
Utah

Sample Medicaid Card for the state of Utah

 

 

CARD HX-5

Medicare Managed Care Plans
Utah

A. Humana Gold Choice (Humana Insurance Company)

B. Security Choice (Unicare Life & Health Ins. Company)

C. UnitedHealthcare Medicare Complete (UnitedHealthcare of Utah, Inc.)

L. HumanaChoice PPO/Humana Gold Choice (Humana Insurance Company)

M. MedAvantage (Regence Blue Cross Blue Shield of Utah)

N. SecureHorizons Direct

O. Sierra Spectrum

P. Today’s Options

Q. United Healthcare Medicare Complete (United Healthcare of Utah, Inc.)

 

 

CARD HX-6

Plan Names
Utah

H. IHC Health Plans

M. Bear River Mental Health

P. Four Corners Mental Health

Q. Healthy U

S. Molina Healthcare of Utah

U. Valley Mental Health

V. Wasatch Mental Health

W. Weber Mental Health

X. Molina Plus

Y. Davis Behavioral Health

Z. Central Utah Counseling

AA. Northeastern Counseling

BB. Southwest Center

 

 

CARD HX-8

PLAN NAMES (FOR FEDERAL CIVILIAN EMPLOYEES)
UTAH

F. NALC

H. Association Benefit Plan

J. Foreign Service Benefit Plan

L. Panama Canal Area Benefit Plan

M. Rural Carrier Benefit Plan

V. GEHA Benefit Plan – High

W. GEHA Benefit Plan – Standard

X. Mail Handlers – High

Y. Mail Handlers – Standard

Z. PBP Health Plan – High

AA. PBP Health Plan – Standard

BB. Altius Health Plans

CC. APWU Health Plan - High

DD. APWU Health Plan – Consumer Driven

EE. Blue Cross and Blue Shield Service Benefit Plan – Standard

FF. Blue Cross and Blue Shield Service Benefit Plan – Basic

GG. SAMBA – High

HH. SAMBA – Standard

II. GEHA High Deductible Health Plan

JJ. Mail Handlers High Deductible Plan

 

 

CARD IN-2A

State TANF Program
Utah

Family Employment Program (FEP)

 

 

CARD PR-1

Medicare Managed Care Plans
Vermont

C. SecureHorizons Direct

D. Today’s Options

 

 

CARD PR-2

Plan Names
Vermont

F. Vermont Health Access

 

 

CARD HX-3

Sample Medicaid Card
Vermont

Sample Medicaid Card for the state of Vermont

 

 

CARD HX-5

Medicare Managed Care Plans
Vermont

C. SecureHorizons Direct

D. Today’s Options

 

 

CARD HX-6

Plan Names
Vermont

F. Vermont Health Access

 

 

CARD HX-8

PLAN NAMES (FOR FEDERAL CIVILIAN EMPLOYEES)
VERMONT

F. NALC

H. Association Benefit Plan

J. Foreign Service Benefit Plan

L. Panama Canal Area Benefit Plan

M. Rural Carrier Benefit Plan

S. MVP Health Plan

V. GEHA Benefit Plan – High

W. GEHA Benefit Plan – Standard

X. Mail Handlers – High

Y. Mail Handlers – Standard

Z. PBP Health Plan – High

AA. PBP Health Plan – Standard

BB. APWU Health Plan - High

CC. APWU Health Plan – Consumer Driven

EE. Blue Cross and Blue Shield Service Benefit Plan – Standard

FF. Blue Cross and Blue Shield Service Benefit Plan – Basic

GG. SAMBA – High

HH. SAMBA – Standard

II. GEHA High Deductible Health Plan

JJ. Mail Handlers High Deductible Plan

 

 

CARD IN-2A

State TANF Program
Vermont

Aid to Needy Families with Children (ANFC)

Reach Up

 

 

CARD PR-1

Medicare Managed Care Plans Virginia

J. Secure Plus (John Deere Health Plan, Inc.)

K. Kaiser Permanente Medicare Plus (Kaiser Permanente Medicare Plus)

L. Security Choice (Unicare Life and Health Insurance Company)

M. Aetna Golden (Aetna Medicare)

N. Anthem Medicare Preferred (Anthem Blue Cross and Blue Shield)

O. Humana Gold choice/Humana Choice PPO (Humana Insurance Company)

P. Optima Medicare Preferred

Q. SecureHorizons Direct

R. Today’s Options

S. United HealthCare Medicare Complete (Erickcson Advantage, United Healthcare Insurance Co.)

 

 

CARD PR-2

Plan Names
Virginia

L. CareNet by Southern Health Services, Inc.

P. Virginia Premier Health Plan

Q. UNICARE Health Plan of Virginia

R. Anthem HealthKeepers Plus

S. Amerigroup Virginia

 

 

CARD HX-3

Sample Medicaid Card
Virginia

Sample Medicaid Card for the state of Virginia

 

 

CARD HX-5

Medicare Managed Care Plans Virginia

J. Secure Plus (John Deere Health Plan, Inc.)

K. Kaiser Permanente Medicare Plus (Kaiser Permanente Medicare Plus)

L. Security Choice (Unicare Life and Health Insurance Company)

M. Aetna Golden (Aetna Medicare)

N. Anthem Medicare Preferred (Anthem Blue Cross and Blue Shield)

O. Humana Gold choice/Humana Choice PPO (Humana Insurance Company)

P. Optima Medicare Preferred

Q. SecureHorizons Direct

R. Today’s Options

S. United HealthCare Medicare Complete (Erickcson Advantage, United Healthcare Insurance Co.)

 

 

CARD HX-6

Plan Names
Virginia

L. CareNet by Southern Health Services, Inc.

P. Virginia Premier Health Plan

Q. UNICARE Health Plan of Virginia

R. Anthem HealthKeepers Plus

S. Amerigroup Virginia

 

 

CARD HX-8

PLAN NAMES (FOR FEDERAL CIVILIAN EMPLOYEES)
VIRGINIA

F. NALC

H. Association Benefit Plan

J. Foreign Service Benefit Plan

L. Panama Canal Area Benefit Plan

M. Rural Carrier Benefit Plan

BB. M.D. IPA

NN. GEHA Benefit Plan – High

OO. GEHA Benefit Plan – Standard

PP. Mail Handlers – High

QQ. Mail Handlers – Standard

RR. PBP Health Plan – High

SS. PBP Health Plan – Standard

VV. CareFirst Blue Choice

WW. Piedmont Community Healthcare

XX. APWU Health Plan – High

YY. APWU Health Plan – Consumer Driven

ZZ. Blue Cross and Blue Shield Service Benefit Plan –Standard

AAA. Blue Cross and Blue Shield Service Benefit Plan – Basic

DDD. SAMBA – High

EEE. SAMBA – Standard

FFF. GEHA High Deductible Health Plan

GGG. Mail Handlers High Deductible Plan

HHH. Aetna Open Access – High

III. Aetna Open Access – Basic

JJJ. Kaiser Permanente – High

KKK. Kaiser Permanente – Standard

LLL. Optima Health Plan

MMM. Aetna HealthFund CDHP

NNN. Aetna HealthFund HDHP

 

 

CARD PR-1

Medicare Managed Care Plans
Washington

W. GHC Medicare Plan (Group Health Cooperative)

Z. Senior Advantage (Kaiser Foundation Health Plan of the Northwest)

BB. Health Net Options Plus (Health Net Options Plus)

DD. Secure Horizons (Secure Horizons Medicare Advantage Plan)

FF. Columbia Community Care (Spokane Community Care)

GG. MedAvantage (Asuris Northwest Health)

HH. MedAdvantage/First Choice Sixty-Five (Regence Blue Shield/Blue Cross Blue Shield of OR)

II. Providence Medicare Extra (Providence Health Plan)

JJ. SecureHorizons Direct

KK. United Healthcare Medicare Complete (United Healthcare Insurance Company)

 

 

CARD PR-2

Plan Names
Washington

KK. BHP Plus

SS. WA Medicaid Integration Partnership (WMIP)

TT. Medicaid – Medicare Integration Program (MMIP)

 

 

CARD HX-3

Sample Medicaid Card
Washington

Sample Medicaid Card for the state of Washington

 

 

CARD HX-5

Medicare Managed Care Plans
Washington

W. GHC Medicare Plan (Group Health Cooperative)

Z. Senior Advantage (Kaiser Foundation Health Plan of the Northwest)

BB. Health Net Options Plus (Health Net Options Plus)

DD. Secure Horizons (Secure Horizons Medicare Advantage Plan)

FF. Columbia Community Care (Spokane Community Care)

GG. MedAvantage (Asuris Northwest Health)

HH. MedAdvantage/First Choice Sixty-Five (Regence Blue Shield/Blue Cross Blue Shield of OR)

II. Providence Medicare Extra (Providence Health Plan)

JJ. SecureHorizons Direct

KK. United Healthcare Medicare Complete (United Healthcare Insurance Company)

 

 

CARD HX-6

Plan Names
Washington

KK. BHP Plus

SS. WA Medicaid Integration Partnership (WMIP)

TT. Medicaid – Medicare Integration Program (MMIP)

 

 

CARD HX-8

PLAN NAMES (FOR FEDERAL CIVILIAN EMPLOYEES)
WASHINGTON

F. NALC

H. Association Benefit Plan

J. Foreign Service Benefit Plan

L. Panama Canal Area Benefit Plan

M. Rural Carrier Benefit Plan

S. Kaiser Permanente – High

T. Kaiser Permanente – Standard

EE. GEHA Benefit Plan – High

FF. GEHA Benefit Plan – Standard

GG. Mail Handlers – High

HH. Mail Handlers – Standard

II. PBP Health Plan – High

JJ. PBP Health Plan – Standard

PP. APWU Health Plan –High

QQ. APWU Health Plan – Consumer Driven

RR. Blue Cross and Blue Shield Service Benefit Plan – Standard

SS. Blue Cross and Blue Shield Service Benefit Plan – Basic

UU. KPS Health Plans – High

VV. KPS Health Plans – Standard

WW. SAMBA – High XX. SAMBA – Standard

YY. GEHA High Deductible Health Plan

ZZ. Mail Handlers High Deductible Plan

AAA. Aetna

BBB. Group Health Cooperative – High – Western WA

CCC. Group Health Cooperative – Std – Western WA

DDD. Group Health Cooperative – High – Central WA/Spokane/Pullman

EEE. Group Health Cooperative – Std – Central WA/Spokane/Pullman

GGG. PacifiCare Northwest Region (Oregon/Washington) – Washington

HHH. Aetna HealthFund CDHP

III. Aetna HealthFund HDHP

JJJ. PacifiCare of Oregon

 

 

CARD IN-2A

State TANF Program
Washington

WorkFirst

 

 

CARD PR-1

Medicare Managed Care Plans
West Virginia

H. Advantra PPO

J. Health Plan SecureCare (The Health Plan)

L. 2006 FreedomBlue (Mountain State Blue Cross Blue Shield)

M. Humana Gold Choice/Humana Choice PPO (Humana Insurance Company)

N. SecureHorizons Direct

 

 

CARD PR-2

Plan Names
West Virginia

A. CareLink

C. The Health Plan of the Upper Ohio Valley

D. Mountain Health Trust

E. Physician Assured Access System (PAAS)

F. Unicare

 

 

CARD HX-3

Sample Medicaid Card
West Virginia

Sample Medicaid Card for the state of West Virginia front side

Sample Medicaid Card for the state of West Virginia back side

 

 

CARD HX-5

Medicare Managed Care Plans
West Virginia

H. Advantra PPO

J. Health Plan SecureCare (The Health Plan)

L. 2006 FreedomBlue (Mountain State Blue Cross Blue Shield)

M. Humana Gold Choice/Humana Choice PPO (Humana Insurance Company)

N. SecureHorizons Direct

 

 

CARD HX-6

Plan Names
West Virginia

A. CareLink

C. The Health Plan of the Upper Ohio Valley

D. Mountain Health Trust

E. Physician Assured Access System (PAAS)

F. Unicare

 

 

CARD HX-8

PLAN NAMES (FOR FEDERAL CIVILIAN EMPLOYEES)
WEST VIRGINIA

F. NALC

H. Association Benefit Plan

J. Foreign Service Benefit Plan

L. Panama Canal Area Benefit Plan

M. Rural Carrier Benefit Plan

W. GEHA Benefit Plan – High

X. GEHA Benefit Plan – Standard

Y. Mail Handlers – High

Z. Mail Handlers – Standard

AA. PBP Health Plan – High

BB. PBP Health Plan – Standard

CC. APWU Health Plan – High

DD APWU Health Plan – Consumer Driven

GG. Blue Cross and Blue Shield Service Benefit Plan – Standard

HH. Blue Cross and Blue Shield Service Benefit Plan – Basic

II. SAMBA – High

JJ. SAMBA – Standard

KK. GEHA High Deductible Health Plan

LL. Mail Handlers High Deductible Plan

MM. The Health Plan of the Upper Ohio Valley

NN. Aetna HealthFund CDHP

OO. Aetna HealthFund HDHP

 

 

CARD IN-2A

State TANF Program
West Virginia

West Virginia Works

 

 

CARD PR-1

Medicare Managed Care Plans Wisconsin

N. DeanCare Gold (Dean Health Plan, Inc.)

O. Gundersen Lutheran Senior Preferred (Gundersen Lutheran Health Plan, Inc.)

P. Medical Associates Advantage Plan (Medical Associates Clinic Health Plan of Wisconsin)

R. United Healthcare Medicare Complete (United Healthcare of Wisconsin, Inc.)

T. Network Senior Plus (Network Senior Plus)

U. Security Choice (Unicare Life and Health Insurance Company)

V. Advocare (Security Health Plan of Wisconsin, Inc.)

W. Humana Gold Choice (Humana Insurance Company)

X. Network PlatinumPlus (Network Health Insurance Corporation)

Y. Humana Choice PPO/Humana Gold choice (Humana Insurance Plan)

Z. Medica Advantage Solution/Prime Solution (Medica Health Plans of Wisconsin)

AA. Secure Horizons Direct

BB. SmartValue (Blue Cross Blue Shield of Wisconsin)

CC. Today’s Options

 

 

CARD PR-2

Plan Names
Wisconsin

AA. Badger Care

HH. WrapAround Milwaukee

II. Children Come First

JJ. Wisconsin Partnership Plan

KK. Program of All – Inclusive Care/Elderly (PACE)

LL. Family Care

 

 

CARD HX-3

Sample Medicaid Card – Wisconsin

Sample Medicaid Card for the state of Wisconsin

 

 

CARD HX-5

Medicare Managed Care Plans Wisconsin

N. DeanCare Gold (Dean Health Plan, Inc.)

O. Gundersen Lutheran Senior Preferred (Gundersen Lutheran Health Plan, Inc.)

P. Medical Associates Advantage Plan (Medical Associates Clinic Health Plan of Wisconsin)

R. United Healthcare Medicare Complete (United Healthcare of Wisconsin, Inc.)

T. Network Senior Plus (Network Senior Plus)

U. Security Choice (Unicare Life and Health Insurance Company)

V. Advocare (Security Health Plan of Wisconsin, Inc.)

W. Humana Gold Choice (Humana Insurance Company)

X. Network PlatinumPlus (Network Health Insurance Corporation)

Y. Humana Choice PPO/Humana Gold choice (Humana Insurance Plan)

Z. Medica Advantage Solution/Prime Solution (Medica Health Plans of Wisconsin)

AA. Secure Horizons Direct

BB. SmartValue (Blue Cross Blue Shield of Wisconsin)

CC. Today’s Options

 

 

CARD HX-6

Plan Names
Wisconsin

AA. Badger Care

HH. WrapAround Milwaukee

II. Children Come First

JJ. Wisconsin Partnership Plan

KK. Program of All – Inclusive Care/Elderly (PACE)

LL. Family Care

 

 

CARD HX-8

PLAN NAMES (FOR FEDERAL CIVILIAN EMPLOYEES)
WISCONSIN

F. NALC

H. Association Benefit Plan

J. Foreign Service Benefit Plan

L. Panama Canal Area Benefit Plan

M. Rural Carrier Benefit Plan

LL. GEHA Benefit Plan – High

MM. GEHA Benefit Plan – Standard

NN. Mail Handlers – High

OO. Mail Handlers – Standard

PP. PBP Health Plan – High

QQ. PBP Health Plan – Standard

RR. Dean Health Plan

VV. APWU Health Plan - High

WW. APWU Health Plan – Consumer Driven

XX. Blue Cross Blue Shield Service Benefit Plan – Standard

YY. Blue Cross Blue Shield Service Benefit Plan – Basic

AAA. Group Health Cooperative – S. Central WI

DDD. SAMBA – High

EEE. SAMBA – Standard

FFF. GEHA High Deductible Health Plan

GGG. Mail Handlers High Deductible Plan

HHH. HealthPartners Classic – High

JJJ. HealthPartners Primary Clinic Plan

LLL. Humana CoverageFirst CDHP

MMM. Group Health Cooperative

 

 

CARD IN-2A

State TANF Program
Wisconsin

Wisconsin Works (W-2)

 

 

CARD PR-1

Medicare Managed Care Plans
Wyoming

A. Humana Gold Choice (Humana Insurance Company)

B. MedicareBlue PPO (BlueCross Blue Shield Of Wyoming)

C. RMHP AB Basic/WINHEALTH (WINHealth Partners)

D. SecureHorizons Direct

 

 

CARD PR-2

Plan Names
Wyoming

None Available

 

 

CARD HX-3

Sample Medicaid Card – Wyoming

Sample Medicaid Card for the state of Wyoming

 

 

CARD HX-5

Medicare Managed Care Plans
Wyoming

A. Humana Gold Choice (Humana Insurance Company)

B. MedicareBlue PPO (BlueCross Blue Shield Of Wyoming)

C. RMHP AB Basic/WINHEALTH (WINHealth Partners)

D. SecureHorizons Direct

 

 

CARD HX-6

Plan Names
Wyoming

None Available

 

 

CARD HX-8

PLAN NAMES (FOR FEDERAL CIVILIAN EMPLOYEES)
WYOMING

F. NALC

H. Association Benefit Plan

J. Foreign Service Benefit Plan

L. Panama Canal Area Benefit Plan

M. Rural Carrier Benefit Plan

R. GEHA Benefit Plan – High

S. GEHA Benefit Plan – Standard

T. Mail Handlers – High

U. Mail Handlers – Standard

V. PBP Health Plan – High

W. PBP Health Plan – Standard

X. WINhealth Partners

Y. APWU Health Plan – High

Z. APWU Health Plan – Consumer Driven

AA. Blue Cross and Blue Shield Service Benefit Plan – Standard

BB. Blue Cross and Blue Shield Service Benefit Plan – Basic

CC. SAMBA – High DD. SAMBA – Standard

EE. GEHA High Deductible Health Plan

FF. Mail Handlers High Deductible Plan

 

 

CARD IN-2A

State TANF Program
Wyoming

Personal Opportunities with Employment Responsibility (POWER) Spring 2007