2022 Medicare Advantage And Prescription Drug Plans Offered By Blue .

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SENIOR MARKETS2022Medicare Advantageand Prescription Drug PlansOffered by Blue Crossand Blue Shield CompaniesUpdated December 2021

2022 Medicare Advantage PlansOffered by Blue Cross and Blue Shield CompaniesKey:PPO Preferred Provider OrganizationHMO Health Maintenance OrganizationPFFS Private Fee-For-ServiceCost Cost ContractSNP Special Needs PlanMSA Medical Savings AccountHMO-POS HMO with Point-Of-Service OptionStateRegionalPPOMedicare Advantage plans must include the Medicare prescriptiondrug coverage in at least one of their MA benefit options (except forprivate fee for service and cost plans where it is optional). RegionalPPOs and SNPs must offer drug coverage in all of their options.LocalHMOHMOPFFS CostPPOPOSSNPBlue Cross and BlueShield Plan SponsorProduct Name Blue Cross and BlueShield of AlabamaBlue Advantage Complete(Local PPO) Blue Cross and BlueShield of AlabamaBlue Advantage Premier(Local PPO) Blue Cross and BlueShield of ArizonaBlue Medicare AdvantageClassic (HMO) Blue Cross and BlueShield of ArizonaBlue Medicare AdvantagePlus (HMO) Blue Cross and BlueShield of ArizonaBlue Medicare AdvantageStandard (HMO)Blue Cross and BlueShield of ArizonaBlueJourney (PPO) Blue Cross and BlueShield of ArizonaBluePathway Plan 1 (HMO) Blue Cross and BlueShield of ArizonaBluePathway Plan 2 (HMO) Blue Cross and BlueShield of ArizonaBluePathway Plan 3 (HMO) Arkansas Blue Crossand Blue ShieldBlueMedicare Premier (HMO) Arkansas Blue Crossand Blue ShieldHealth AdvantageBlue Classic (HMO) Arkansas Blue Crossand Blue ShieldHealth AdvantageBlue Premier (HMO) Arkansas Blue Crossand Blue ShieldBlueMedicarePremier Choice (PPO) Arkansas Blue Crossand Blue ShieldBlueMedicare SaverChoice (PPO) Arkansas Blue Crossand Blue ShieldBlueMedicare ValueChoice (PPO)Arkansas Blue Crossand Blue ShieldBlueMedicarePreferred (PFFS)AlabamaArizonaArkansas 2

2022 Medicare Advantage Plans Offered by Blue Cross and Blue Shield CompaniesStateRegionalPPOLocalHMOHMOPFFS CostPPOPOSArkansas(cont.)SNP Blue Cross and BlueShield Plan SponsorProduct NameArkansas Blue Crossand Blue ShieldBlueMedicareValue (PFFS)Anthem Blue CrossAnthem MediBlueAccess (PPO) Anthem Blue CrossAnthem MediBlue CareOn Site (HMO I-SNP) Anthem Blue CrossAnthem MediBlue CareTo You (HMO I-SNP) Anthem Blue CrossAnthem MediBlue Connect(HMO D-SNP) Anthem Blue CrossAnthem MediBlue ConnectPlus (HMO) Anthem Blue CrossAnthem MediBlueCoordination Plus (HMO) Anthem Blue CrossAnthem MediBlue Diabetes(HMO C-SNP) Anthem Blue CrossAnthem MediBlue DiabetesCare (HMO C-SNP) Anthem Blue CrossAnthem MediBlue DiabetesCare Plus (HMO C-SNP) Anthem Blue CrossAnthem MediBlue DualAccess (PPO D-SNP) Anthem Blue CrossAnthem MediBlue DualAdvantage (HMO D-SNP) Anthem Blue CrossAnthem MediBlue DualPlus (HMO D-SNP) Anthem Blue CrossAnthem MediBlue ESRDCare (HMO C-SNP) Anthem Blue CrossAnthem MediBlue ESRDCare (PPO C-SNP) Anthem Blue CrossAnthem MediBlue Heart(HMO C-SNP) Anthem Blue CrossAnthem MediBlue HeartCare (HMO C-SNP) Anthem Blue CrossAnthem MediBlue Lung(HMO C-SNP) Anthem Blue CrossAnthem MediBlue LungCare (HMO C-SNP) Anthem Blue CrossAnthem MediBlueExtra (HMO) Anthem Blue CrossAnthem MediBluePlus (HMO) California 3

2022 Medicare Advantage Plans Offered by Blue Cross and Blue Shield CompaniesStateRegionalPPOLocalHMOHMOPFFS CostPPOPOSCalifornia(cont.)Blue Cross and BlueShield Plan SponsorProduct Name Anthem Blue CrossAnthem MediBlueSelect (HMO) Anthem Blue CrossAnthem MediBlue StartSmartPlus (HMO) Anthem Blue CrossAnthem MediBlueValue (HMO) Anthem Blue CrossAnthem MediBlueValue Plus (HMO) Blue Shield of CaliforniaBlue Shield 65 Plus (HMO) Blue Shield of CaliforniaBlue Shield 65 PlusChoice Plan (HMO) Blue Shield of CaliforniaBlue Shield 65 PlusPlan 2 (HMO) Blue Shield of CaliforniaBlue ShieldAdvantageOptimumPlan (HMO) Blue Shield of CaliforniaBlue ShieldAdvantageOptimumPlan 1 (HMO) Blue Shield of CaliforniaBlue ShieldAdvantageOptimumPlan 2 (HMO) Blue Shield of CaliforniaBlue Shield Balance (HMO) Blue Shield of CaliforniaBlue Shield CoordinatedChoice Plan (HMO) Blue Shield of CaliforniaBlue Shield Inspire (HMO)Blue Shield of CaliforniaBlue Shield Inspire (PPO)Blue Shield of CaliforniaBlue Shield Vital (HMO)SNP Blue Shield of CaliforniaBlue Shield Inspire(HMO D-SNP) Blue Shield of CaliforniaBlue Shield Total DualPlan (HMO D-SNP) Anthem Blue Crossand Blue ShieldAnthem MediBlue CareOn Site (HMO I-SNP) Anthem Blue Crossand Blue ShieldAnthem MediBlue DiabetesCare (HMO C-SNP) Anthem Blue Crossand Blue ShieldAnthem MediBlue DualAdvantage (HMO D-SNP) Anthem Blue Crossand Blue ShieldAnthem MediBlue ESRD Care(HMO C-SNP)Colorado4

2022 Medicare Advantage Plans Offered by Blue Cross and Blue Shield OPFFS CostPPOPOSBlue Cross and BlueShield Plan SponsorProduct NameAnthem Blue Crossand Blue ShieldAnthem MediBluePlus (HMO)Anthem Blue Crossand Blue ShieldAnthem MediBlueAccess (PPO) Anthem Blue Crossand Blue ShieldAnthem MediBlue CareTo You (HMO I-SNP) Anthem Blue Crossand Blue ShieldAnthem MediBlue Dual Access(PPO D-SNP) Anthem Blue Crossand Blue ShieldAnthem MediBlue DualAdvantage (HMO D-SNP) Anthem Blue Crossand Blue ShieldAnthem MediBlue DualAdvantage Select(HMO D-SNP) Anthem Blue Crossand Blue ShieldAnthem MediBlue ESRD Care(HMO-POS C-SNP) Anthem Blue Crossand Blue ShieldAnthem MediBlueExtra (HMO) Anthem Blue Crossand Blue ShieldAnthem MediBluePlus (HMO) Anthem Blue Crossand Blue ShieldAnthem MediBluePrime (HMO) Anthem Blue Crossand Blue ShieldAnthem MediBlueSelect (HMO) Anthem Blue Crossand Blue ShieldAnthem MediBlueAccess Select (PPO) HighmarkFreedom Blue PPODistinct (PPO) HighmarkFreedom Blue PPOSignature (PPO) Florida BlueBlueMedicareClassic (HMO) Florida BlueBlueMedicare ClassicPlus (HMO) Florida BlueBlueMedicare Premier (HMO) Florida BlueBlueMedicare Saver (HMO) Florida Blue(Capital Health Plan)Capital Health Plan AdvantagePlus (HMO) Florida Blue(Capital Health Plan)Capital Health PlanPreferred Advantage (HMO) Florida Blue(Capital Health Plan)Capital Health PlanSilver Advantage (HMO) Florida Blue(Florida Health Care Plans)FCHP Medicare FlaglerAdvantage (HMO) Florida Blue(Florida Health Care Plans)FCHP Medicare PremierAdvantage (HMO)SNP ConnecticutDelawareFlorida5

2022 Medicare Advantage Plans Offered by Blue Cross and Blue Shield CompaniesStateRegionalPPOLocalHMOHMOPFFS CostPPOPOSBlue Cross and BlueShield Plan SponsorProduct Name Florida Blue(Florida Health Care Plans)FCHP Medicare PremierPlus (HMO) Florida Blue(Florida Health Care Plans)FCHP Medicare Rx (HMO) Florida Blue(Florida Health Care Plans)FHCP Medicare Valor (HMO) Florida Blue(Florida Health Care Plans)FCHP Medicare RxSavings (HMO)Florida Blue(Florida Health Care Plans)FHCP Medicare RxPlus (HMO-POS) Florida BlueBlueMedicare Select (PPO) Florida BlueBlueMedicare Value (PPO) Florida BlueBlueMedicare Patriot (PPO)Florida BlueBlueMedicare Choice(Regional PPO)Florida BlueBlueMedicare Complete(HMO D-SNP) Anthem Blue Crossand Blue ShieldAnthem MediBlueEssential (HMO) Anthem Blue Crossand Blue ShieldAnthem MediBlueExtra (HMO) Anthem Blue Crossand Blue ShieldAnthem MediBluePlus (HMO) Anthem Blue Crossand Blue ShieldAnthem MediBlueService (HMO) Anthem Blue Crossand Blue ShieldAnthem MediBlue Kroger (HMO) Anthem Blue Crossand Blue ShieldAnthem MediBlue Kroger Access (PPO) Anthem Blue Crossand Blue ShieldAnthem MediBlueAccess (PPO) Anthem Blue Crossand Blue ShieldAnthem MediBlueAccess Basic (PPO) Anthem Blue Crossand Blue ShieldAnthem MediBlue Kroger Dual Advantage(HMO D-SNP) Anthem Blue Crossand Blue ShieldAnthem MediBlue DualAccess (PPO D-SNP) Anthem Blue Crossand Blue ShieldAnthem MediBlue DualAdvantage (HMO D-SNP) Anthem Blue Crossand Blue ShieldAnthem MediBlue ESRDCare (HMO C-SNP) HMSAHMSA Akamai AdvantageComplete (PPO) HMSAHMSA Akamai AdvantageComplete Plus (PPO) HMSAHMSA Akamai AdvantageStandard (PPO)SNP Florida(cont.) Georgia Hawaii6

2022 Medicare Advantage Plans Offered by Blue Cross and Blue Shield FFS CostPPOPOSBlue Cross and BlueShield Plan SponsorProduct NameHMSAHMSA Akamai AdvantageStandard Plus (PPO)HMSAHMSA Akamai AdvantageDual Care (PPO D-SNP) The Regence GroupRegence St. Luke's HealthPartners Align (HMO) The Regence GroupRegence St. Luke's HealthPartners Align Plus (HMO) The Regence GroupRegence Blue MedAdvantageHMO (HMO) The Regence GroupRegence Blue MedAdvantageHMO Plus (HMO) The Regence GroupRegence St. Luke's HealthPartners Align No Rx (HMO) The Regence GroupRegence MedAdvantage Rx Classic (PPO) The Regence GroupRegence MedAdvantage Rx Enhanced (PPO) The Regence GroupRegence MedAdvantage Rx Primary (PPO) The Regence GroupRegence Valiance (PPO) Blue Cross of IdahoTrue Blue Rx (HMO) Blue Cross of IdahoTrue Blue Rx St. Luke'sHealth Partners (HMO) Blue Cross of IdahoTrue Blue RxEssentials (HMO) Blue Cross of IdahoTrue Blue RxGem (HMO) Blue Cross of IdahoTrue Blue RxOption I (HMO) Blue Cross of IdahoTrue Blue RxOption II (HMO) Blue Cross of IdahoTrue Blue RxPreferred (HMO) Blue Cross of IdahoTrue Blue Valor (HMO)Blue Cross of IdahoTrue Blue Special Needs Plan(HMO D-SNP)Blue Cross of IdahoSecure Blue Courage (PPO)Blue Cross andBlue Shield of IllinoisBlue Cross Medicare AdvantageBasic (HMO) Blue Cross andBlue Shield of IllinoisBlue Cross Medicare AdvantageBasic Plus (HMO-POS) Blue Cross andBlue Shield of IllinoisBlue Cross Medicare AdvantagePremier Plus (HMO-POS)Blue Cross andBlue Shield of IllinoisBlue Medicare AdvocateHealth (HMO)SNP Idaho Illinois 7

2022 Medicare Advantage Plans Offered by Blue Cross and Blue Shield OPFFS CostPPOPOSBlue Cross and BlueShield Plan SponsorProduct Name Blue Cross andBlue Shield of IllinoisBlue Cross Medicare AdvantageChoice Plus (PPO) Blue Cross andBlue Shield of IllinoisBlue Cross Medicare AdvantageChoice Premier (PPO) Blue Cross andBlue Shield of IllinoisBlue Cross Medicare AdvantageClassic (PPO) Blue Cross andBlue Shield of IllinoisBlue Cross Medicare AdvantageElite (PPO) Blue Cross andBlue Shield of IllinoisBlue Cross Medicare AdvantageFlex (PPO) Anthem Blue Crossand Blue ShieldAnthem MediBlueExtra (HMO) Anthem Blue Crossand Blue ShieldAnthem MediBluePlus (HMO) Anthem Blue Crossand Blue ShieldAnthem MediBlueAccess (PPO) Anthem Blue Crossand Blue ShieldAnthem MediBlueAccess Plus (PPO) Anthem Blue Crossand Blue ShieldAnthem MediBlueAccess Preferred (PPO) Anthem Blue Crossand Blue ShieldAnthem MediBlueService (PPO)Anthem Blue Crossand Blue ShieldAnthem MediBlue AccessBasic (Regional PPO)Anthem Blue Crossand Blue ShieldAnthem MediBlue DualAdvantage (HMO D-SNP)WellmarkBlue Medicare AdvantageHMO (HMO) WellmarkBlue Medicare AdvantageEnhanced PPO (PPO) WellmarkBlue MedicareAdvantage PPO (PPO) Blue Cross andBlue Shield of KansasBlue MedicareAdvantage (PPO) Blue Cross andBlue Shield of KansasBlue MedicareAdvantage Choice (PPO) Blue Cross andBlue Shield of KansasBlue Medicare AdvantageComprehensive (PPO) Blue Cross and Blue Shieldof Kansas CityBlue Medicare AdvantageSecure (HMO) Blue Cross and Blue Shieldof Kansas CityBlue Medicare AdvantageSpira Care (HMO) Blue Cross and Blue Shieldof Kansas CityBlue Medicare AdvantageEssential (PPO) Blue Cross and Blue Shieldof Kansas CitySimply Blue (PPO) Blue Cross and Blue Shieldof Kansas CitySimply Blue Advantage (PPO)SNPIndiana IowaKansas8

2022 Medicare Advantage Plans Offered by Blue Cross and Blue Shield FFS CostPPOPOSBlue Cross and BlueShield Plan SponsorProduct NameBlue Cross and Blue Shieldof Kansas CityBlue Medicare Advantage Flex(no Part D) (PPO)Anthem Blue Crossand Blue ShieldAnthem MediBluePlus (HMO) Anthem Blue Crossand Blue ShieldAnthem MediBlueAccess (PPO) Anthem Blue Crossand Blue ShieldAnthem MediBlue Kroger Access (PPO) Anthem Blue Crossand Blue ShieldAnthem MediBlueAccess Plus (PPO) Anthem Blue Crossand Blue ShieldAnthem MediBlueAccess Preferred (PPO) Anthem Blue Crossand Blue ShieldAnthem MediBlueService (PPO)Anthem Blue Crossand Blue ShieldAnthem MediBlue AccessBasic (Regional PPO)SNP Kentucky Anthem Blue Crossand Blue ShieldAnthem MediBlue KrogerDual Advantage (HMO D-SNP) Anthem Blue Crossand Blue ShieldAnthem MediBlue DualAdvantage (HMO D-SNP) Anthem Blue Crossand Blue ShieldAnthem MediBlue ESRDCare (HMO C-SNP)Blue Cross Blue Shieldof LouisianaBlue Advantage (HMO)Blue Cross Blue Shieldof LouisianaBlue Advantage (PPO)Blue Cross Blue Shieldof LouisianaHealthy Blue DualAdvantage (HMO D-SNP)Anthem Blue Crossand Blue ShieldAnthem l MaineHealthAdvantage Choice(HMO-POS) Anthem Blue Crossand Blue ShieldAnthem l MaineHealthAdvantage Extra (HMO) Anthem Blue Crossand Blue ShieldAnthem l MaineHealthAdvantage Plus (HMO)Anthem Blue Crossand Blue ShieldAnthem l MaineHealthAdvantage Access (PPO)Anthem Blue Crossand Blue ShieldAnthem l MaineHealthAdvantage Dual Plus(HMO D-SNP) CareFirst Blue CrossBlue ShieldCareFirst BlueCross BlueShieldAdvantage Core (HMO) CareFirst Blue CrossBlue ShieldCareFirst BlueCross BlueShieldAdvantage Enhanced (HMO)Blue Cross Blue Shieldof MassachusettsMedicare HMO BlueFlexRx (HMO-POS) Blue Cross Blue Shieldof MassachusettsMedicare HMO BluePlusRx (HMO) Blue Cross Blue Shieldof MassachusettsMedicare HMO BlueSaverRx (HMO) Louisiana Maine Maryland Massachusetts9

2022 Medicare Advantage Plans Offered by Blue Cross and Blue Shield CompaniesStateRegionalPPOLocalHMOHMOPFFS CostPPOPOSBlue Cross and BlueShield Plan SponsorProduct NameBlue Cross Blue Shieldof MassachusettsMedicare HMO BlueValueRx (HMO) Blue Cross Blue Shieldof MassachusettsMedicare PPO BluePlusRx (PPO) Blue Cross Blue Shieldof MassachusettsMedicare PPO BlueSaverRx (PPO) Blue Cross Blue Shieldof MassachusettsMedicare PPO BlueValueRx (PPO)Blue Care Network(Blue Cross Blue Shieldof Michigan)BCN Advantage CommunityValue (HMO-POS)Blue Care Network(Blue Cross Blue Shieldof Michigan)BCN Advantage HMOConnectedCare (HMO) Blue Care Network(Blue Cross Blue Shieldof Michigan)BCN Advantage HMO-POSClassic (HMO-POS) Blue Care Network(Blue Cross Blue Shieldof Michigan)BCN Advantage HMO-POSPrestige (HMO-POS) Blue Care Network(Blue Cross Blue Shieldof Michigan)BCN Advantage PrimeValue (HMO-POS) Blue Care Network(Blue Cross Blue Shieldof Michigan)BCN Advantage HMO-POSElements (HMO-POS) Blue Cross Blue Shieldof MichiganMedicare Plus Blue PPOAssure (PPO) Blue Cross Blue Shieldof MichiganMedicare Plus Blue PPOEssential (PPO) Blue Cross Blue Shieldof MichiganMedicare Plus Blue PPOSignature (PPO) Blue Cross Blue Shieldof MichiganMedicare Plus Blue PPOVitality (PPO) Blue Cross and Blue Shieldof MinnesotaPlatinum Blue ChoicePlan with Rx (Cost) Blue Cross and Blue Shieldof MinnesotaPlatinum Blue CompletePlan with Rx (Cost) Blue Cross and Blue Shieldof MinnesotaPlatinum Blue CorePlan with Rx (Cost) Blue Cross and Blue Shieldof MinnesotaPlatinum Blue ChoicePlan (Cost) Blue Cross and Blue Shieldof MinnesotaPlatinum Blue CompletePlan (Cost) Blue Cross and Blue Shieldof MinnesotaPlatinum Blue CorePlan (Cost) Blue Cross and Blue Shieldof MinnesotaBlue Cross MedicareAdvantage Choice (PPO) Blue Cross and Blue Shieldof MinnesotaBlue Cross MedicareAdvantage Complete (PPO) Blue Cross and Blue Shieldof MinnesotaBlue Cross MedicareAdvantage Core (PPO) Blue Cross and Blue Shieldof MinnesotaBlue Cross Medicare AdvantageChoice MA Only (PPO) Massachusetts(cont.) MichiganMinnesota10SNP

2022 Medicare Advantage Plans Offered by Blue Cross and Blue Shield CompaniesStateRegionalPPOLocalHMOHMOPFFS CostPPOPOSBlue Cross and BlueShield Plan SponsorProduct NameBlue Cross and Blue Shieldof MinnesotaSecureBlue(HMO D-SNP) Anthem Blue Crossand Blue ShieldAnthem MediBluePlus (HMO) Anthem Blue Crossand Blue ShieldHealthy BlueEssential (HMO) Anthem Blue Crossand Blue ShieldAnthem MediBlueAccess (PPO) Anthem Blue Crossand Blue ShieldAnthem MediBlueAccess Basic (PPO) Anthem Blue Crossand Blue ShieldAnthem MediBlueAccess Service (PPO)Minnesota(cont.) SNP Anthem Blue Crossand Blue ShieldAnthem MediBlue DualAdvantage (HMO D-SNP) Anthem Blue Crossand Blue ShieldHealthy Blue Dual(HMO D-SNP)Blue Cross and Blue Shieldof Kansas CityBlue Secure (HMO) Blue Cross and Blue Shieldof Kansas CityBlue Medicare AdvantageEssential (PPO) Blue Cross and Blue Shieldof Kansas CitySimply Blue (PPO) Blue Cross and Blue Shieldof Kansas CitySimply Blue Advantage (PPO) Blue Cross and Blue Shieldof Kansas CityBlue Medicare AdvantageFlex (no Part D) (PPO) Blue Cross and BlueShield of MontanaBlue Cross MedicareAdvantage Choice Plus (PPO) Blue Cross and BlueShield of MontanaBlue Cross MedicareAdvantage Classic (PPO) Blue Cross and BlueShield of MontanaBlue Cross MedicareAdvantage Flex (PPO) Blue Cross and BlueShield of MontanaBlue Cross MedicareAdvantage Optimum (PPO) Blue Cross and BlueShield of NebraskaBlue Cross Blue ShieldNebraska MA Access (PPO) Blue Cross and BlueShield of NebraskaBlue Cross Blue ShieldNebraska MA Core (HMO) Anthem Blue Crossand Blue ShieldAnthem MediBlueConnect Plus (HMO) Anthem Blue Crossand Blue ShieldAnthem MediBlueStartSmart Plus (HMO) Anthem Blue Crossand Blue ShieldAnthem MediBlue ValuePlus (HMO)Anthem Blue Crossand Blue ShieldAnthem MediBlue CareOn Site (HMO I-SNP)Missouri MontanaNebraskaNevada 11

2022 Medicare Advantage Plans Offered by Blue Cross and Blue Shield CompaniesStateRegionalPPOLocalHMOHMOPFFS CostPPOPOSBlue Cross and BlueShield Plan SponsorProduct Name Anthem Blue Crossand Blue ShieldAnthem MediBlueConnect (HMO D-SNP) Anthem Blue Crossand Blue ShieldAnthem MediBlue DiabetesCare (HMO C-SNP) Anthem Blue Crossand Blue ShieldAnthem MediBlue DualAdvantage (HMO D-SNP) Anthem Blue Crossand Blue ShieldAnthem MediBlueHeart Care (HMO C-SNP) Anthem Blue Crossand Blue ShieldAnthem MediBlueLung Care (HMO C-SNP) Anthem Blue Crossand Blue ShieldAnthem MediBlueCoordination Plus (HMO) Anthem Blue Crossand Blue ShieldAnthem MediBluePlus (HMO) Anthem Blue Crossand Blue ShieldAnthem MediBlueSelect (HMO) Anthem Blue Crossand Blue ShieldAnthem MediBlueSelect Plus (HMO) Anthem Blue Crossand Blue ShieldAnthem MediBlueAccess (PPO) Anthem Blue Crossand Blue ShieldAnthem MediBlueAccess Select Plus (PPO) Horizon Blue Cross BlueShield of New JerseyBraven Medicare Plus (HMO) Horizon Blue Cross BlueShield of New JerseyHorizon MedicareBlue Advantage (HMO) Horizon Blue Cross BlueShield of New JerseyHorizon MedicareBlue Choice w/Rx (HMO) Horizon Blue Cross BlueShield of New JerseyHorizon MedicareBlue Value w/Rx (HMO) Horizon Blue Cross BlueShield of New JerseyHorizon MedicareBlue Value (HMO) Horizon Blue Cross BlueShield of New JerseyBraven MedicareChoice (PPO) Horizon Blue Cross BlueShield of New JerseyBraven MedicareFreedom (PPO) Horizon Blue Cross BlueShield of New JerseyHorizon MedicareBlue Access (PPO)Horizon Blue Cross BlueShield of New JerseyHorizon NJ TotalCare(HMO D-SNP) Blue Cross and Blue Shieldof New MexicoBlue Cross Medicare AdvantageBasic (HMO) Blue Cross and Blue Shieldof New MexicoBlue Cross Medicare AdvantageSelect (HMO) Blue Cross and Blue Shieldof New MexicoBlue Cross Medicare AdvantageChoice Plus (PPO) Blue Cross and Blue Shieldof New MexicoBlue Cross Medicare AdvantageClassic (PPO) Blue Cross and Blue Shieldof New MexicoBlue Cross Medicare AdvantageFlex (PPO)Nevada(cont.)NewHampshireNew Jersey New MexicoSNP 12

2022 Medicare Advantage Plans Offered by Blue Cross and Blue Shield CompaniesStateNew Mexico(cont.)RegionalPPOLocalHMOHMOPFFS CostPPOPOSBlue Cross and BlueShield Plan SponsorProduct Name Blue Cross and Blue Shieldof New MexicoBlue Cross MA Dual Care PlusPreferred (PPO D-SNP) Blue Cross and Blue Shieldof New MexicoBlue Cross Medicare AdvantageDual Care Plus (HMO D-SNP)Empire BlueCross BlueShieldEmpire MediBlueChoice (HMO-POS) Empire BlueCross BlueShieldEmpire MediBlueExtra Select (HMO) Empire BlueCross BlueShieldEmpire MediBlueHealthPlus (HMO) Empire BlueCross BlueShieldEmpire MediBlueHealthPlus Select (HMO) Empire BlueCross BlueShieldEmpire MediBluePlus (HMO) Empire BlueCross BlueShieldEmpire MediBlueSelect (HMO) Empire BlueCross BlueShieldEmpire MediBlueService (HMO) Empire BlueCross BlueShieldEmpire MediBlueService Select (HMO)Empire BlueCross BlueShieldEmpire MediBlueAccess (PPO)Empire MediBlue DualAdvantage (HMO D-SNP) SNP New York Empire BlueCross BlueShield Empire MediBlue DualEmpire BlueCross BlueShield Advantage Select(HMO D-SNP) Empire BlueCross BlueShieldEmpire MediBlue HealthPlusDual Connect (HMO D-SNP) Empire BlueCross BlueShieldEmpire MediBlue HealthPlusDual Plus (HMO D-SNP) ExcellusBlueCross BlueShieldMedicare Bassett(HMO-POS) ExcellusBlueCross BlueShieldMedicare Blue ChoiceAdvanced (HMO-POS) ExcellusBlueCross BlueShieldMedicare Blue Choice Optimum(HMO-POS) ExcellusBlueCross BlueShieldMedicare Blue ChoiceSelect (HMO) ExcellusBlueCross BlueShieldMedicare Blue ChoiceValue (HMO) ExcellusBlueCross BlueShieldMedicare Blue ChoiceValue Plus (HMO-POS) ExcellusBlueCross BlueShieldMedicare Blue Choice Platinum(HMO-POS)ExcellusBlueCross BlueShieldMedicare Blue Basic (PPO) HighmarkHighmark Blue Cross BlueShield BlueSaver (HMO) HighmarkHighmark Blue CrossBlue Shield Senior Blue651 (HMO) 13

2022 Medicare Advantage Plans Offered by Blue Cross and Blue Shield CompaniesStateRegionalPPOLocalHMOHMOPFFS CostPPOPOSBlue Cross and BlueShield Plan SponsorProduct Name HighmarkHighmark Blue CrossBlue Shield Senior BlueBasic (HMO) HighmarkHighmark Blue CrossBlue Shield Senior BlueSelect (HMO) HighmarkHighmark Blue ShieldFreedom Plus (HMO) HighmarkHighmark Blue ShieldFreedom Value (HMO) HighmarkHighmark Blue ShieldSenior Blue 652 (HMO) HighmarkHighmark Blue Cross BlueShield Senior Blue 601 (HMO) HighmarkHighmark Blue ShieldFreedom (HMO) HighmarkHighmark Blue Cross BlueShield Forever Blue 751 (PPO) HighmarkHighmark Blue CrossBlue Shield Forever BlueValue (PPO) HighmarkHighmark Blue Cross BlueShield Freedom Nation (PPO) HighmarkHighmark Blue ShieldForever Blue 770 (PPO) HighmarkHighmark Blue ShieldFreedom Basic (PPO) HighmarkHighmark Blue ShieldFreedom Nation (PPO) Blue Cross and BlueShield of North CarolinaBlue MedicareChoice (HMO) Blue Cross and BlueShield of North CarolinaBlue MedicareEnhanced (HMO) Blue Cross and BlueShield of North CarolinaBlue MedicareEssential (HMO) Blue Cross and BlueShield of North CarolinaBlue MedicareEssential Plus (HMO) Blue Cross and BlueShield of North CarolinaExperience Health MedicareAdvantage (HMO) Blue Cross and BlueShield of North CarolinaBlue MedicareMedical Only (HMO)Blue Cross and BlueShield of North CarolinaHealthy Blue Medicare(HMO D-SNP) Blue Cross and BlueShield of North CarolinaBlue Medicare PPOEnhanced (PPO) Blue Cross and BlueShield of North CarolinaBlue MedicareFreedom (PPO) Blue Cross Blue Shieldof North DakotaNextBlue ClassicPPO (PPO) Blue Cross Blue Shieldof North DakotaNextBlue PremiumPPO (PPO)New York(cont.)NorthCarolina SNP North Dakota14

2022 Medicare Advantage Plans Offered by Blue Cross and Blue Shield CompaniesStateRegionalPPOBlue Cross and BlueShield Plan SponsorProduct Name Anthem Blue Crossand Blue ShieldAnthem MediBlueExtra (HMO) Anthem Blue Crossand Blue ShieldAnthem MediBluePlus (HMO) Anthem Blue Crossand Blue ShieldAnthem MediBluePreferred (HMO) Anthem Blue Crossand Blue ShieldAnthem MediBluePreferred Plus (HMO) Anthem Blue Crossand Blue ShieldAnthem MediBluePrime Select (HMO) Anthem Blue Crossand Blue ShieldAnthem MediBlue Access Kroger Access (PPO) Anthem Blue Crossand Blue ShieldAnthem MediBlueAccess (PPO) Anthem Blue Crossand Blue ShieldAnthem MediBlueAccess Plus (PPO) Anthem Blue Crossand Blue ShieldAnthem MediBlueService (PPO) Anthem Blue Crossand Blue ShieldAnthem MediBlue AccessBasic (Regional PPO) Anthem Blue Crossand Blue ShieldAnthem MediBlue AccessCore (Regional PPO)OhioLocalHMOHMOPFFS CostPPOPOS Anthem Blue Crossand Blue ShieldAnthem MediBlue KrogerDual Advantage (HMO D-SNP) Anthem Blue Crossand Blue ShieldAnthem MediBlue DualAdvantage (HMO D-SNP)Blue Cross and Blue Shieldof OklahomaBlue Cross MedicareAdvantage Basic (HMO) Blue Cross and Blue Shieldof OklahomaBlue Cross MedicareAdvantage Classic (PPO) Blue Cross and Blue Shieldof OklahomaBlue Cross MedicareAdvantage Flex (PPO) Regence BlueCrossBlueShield of OregonRegence MedAdvantage Rx Primary (PPO) Regence BlueCrossBlueShield of OregonRegence MedAdvantage Rx Enhanced (PPO) Regence BlueCrossBlueShield of OregonRegence MedAdvantage Rx Classic (PPO) Regence BlueCrossBlueShield of OregonRegence Valiance,(PPO) Regence BlueCrossBlueShield of OregonRegence BlueAdvantageHMO (HMO) Regence BlueCrossBlueShield of OregonRegence BlueAdvantageHMO Plus (HMO) Regence BlueCrossBlueShield of OregonRegence Valiance,(HMO) OklahomaOregonSNP15

2022 Medicare Advantage Plans Offered by Blue Cross and Blue Shield CompaniesStateRegionalPPOLocalHMOHMOPFFS CostPPOPOSBlue Cross and BlueShield Plan SponsorProduct Name Capital Blue CrossBlueJourney Essential (HMO) Capital Blue CrossBlueJourney Premier (HMO) Capital Blue CrossBlueJourney Value (HMO) Capital Blue CrossCapital Blue Cross WellSpanHealth Inspire (HMO) Capital Blue CrossBlueJourney Classic (PPO) Capital Blue CrossBlueJourney Prime (PPO) Capital Blue CrossBlueJourney Select (PPO) Capital Blue CrossCapital Blue Cross WellspanHealth Advantage (PPO) Capital Blue CrossCapital Blue Cross WellspanHealth AdvantagePlus (PPO) HighmarkCommunity Blue MedicareHMO Prestige (HMO) HighmarkCommunity Blue MedicareHMO Signature (HMO) HighmarkSecurity Blue HMO-POSDeluxe (HMO-POS) HighmarkSecurity Blue HMO-POSStandard (HMO-POS) HighmarkSecurity Blue HMO-POSValueRx (HMO-POS) HighmarkSecurity Blue HMO-POSBasic (HMO-POS) Highmark .Community Blue MedicarePlus PPO Distinct (PPO) HighmarkCommunity Blue MedicarePlus PPO Signature (PPO) HighmarkCommunity Blue MedicarePPO Distinct (PPO) HighmarkCommunity Blue MedicarePPO Signature (PPO) HighmarkComplete Blue PPODistinct (PPO) HighmarkComplete Blue PPOSignature (PPO) HighmarkFreedom Blue PPOClassic (PPO) HighmarkFreedom Blue PPODeluxe (PPO) HighmarkFreedom Blue PPOSelect (PPO) HighmarkFreedom Blue PPOStandard (PPO) HighmarkFreedom Blue PPOValueRx (PPO)SNPPennsylvania16

2022 Medicare Advantage Plans Offered by Blue Cross and Blue Shield CompaniesStateRegionalPPOLocalHMOHMOPFFS CostPPOPOSBlue Cross and BlueShield Plan SponsorProduct NameHighmarkFreedom Blue PPOBasic (PPO)Independence Blue CrossKeystone 65 BasicRx (HMO)Independence Blue CrossKeystone 65 FocusRx (HMO-POS) Independence Blue CrossKeystone 65 PreferredRx (HMO) Independence Blue CrossKeystone 65 SelectRx (HMO) Independence Blue CrossKeystone 65 PreferredMedical Only (HMO) Independence Blue CrossKeystone 65 SelectMedical Only (HMO) Independence Blue CrossPersonal Choice 65Elite Rx (PPO) Independence Blue CrossPersonal Choice 65Prime Rx (PPO) Independence Blue CrossPersonal Choice 65Rx (PPO) Independence Blue CrossPersonal Choice 65Saver Rx (PPO) Independence Blue CrossPersonal Choice 65Medical Only (PPO)Independence Blue CrossKeystone First VIP Choice(HMO D-SNP) Triple-S AdvantageBrillante (HMO-POS) Triple-S AdvantageMagno (HMO-POS) Triple-S AdvantageReal (HMO) Triple-S AdvantageBasic (HMO) Triple-S AdvantageƓptimo Plus (PPO) Triple-S AdvantageƓptimo (PPO)SNP Pennsylvania(cont.) Puerto Rico Triple-S AdvantageContigo Plus (HMO C-SNP) Triple-S AdvantagePlatino Advance (HMO D-SNP) Triple-S AdvantagePlatino Alcance (HMO D-SNP) Triple-S AdvantagePlatino Blindao (HMO D-SNP) Triple-S AdvantagePlatino Plus (HMO D-SNP) Triple-S AdvantagePlatino Ultra (HMO D-SNP)17

2022 Medicare Advantage Plans Offered by Blue Cross and Blue Shield CompaniesStateRegionalPPOLocalHMOHMOPFFS CostPPOPOSBlue Cross and BlueShield Plan SponsorProduct NameBlue Cross & Blue Shieldof Rhode IslandBlueCHiP for MedicareAdvance (HMO)Blue Cross & Blue Shieldof Rhode IslandBlueCHiP for MedicareExtra (HMO-POS)Blue Cross & Blue Shieldof Rhode IslandBlueCHiP for MedicarePlus (HMO)Blue Cross & Blue Shieldof Rhode IslandBlueCHiP for MedicarePreferred (HMO-POS)Blue Cross & Blue Shieldof Rhode IslandBlueCHiP for MedicareStandard with Drugs (HMO)Blue Cross & Blue Shieldof Rhode IslandBlueCHiP for MedicareValue (HMO-POS)Blue Cross & Blue Shieldof Rhode IslandBlueCHiP for MedicareCore (HMO)Blue Cross & Blue Shieldof Rhode IslandHealthMate for Medicare (PPO)Blue Cross & Blue Shieldof Rhode IslandBlueRI for Duals (HMO D-SNP)BlueCross BlueShieldof South CarolinaBlueCross Secure (HMO) BlueCross BlueShieldof South CarolinaBlueCross Total (PPO) BlueCross BlueShieldof South CarolinaBlueCross Total Value (PPO) BlueCross BlueShieldof South CarolinaBlueCross Blue Basic (PPO) WellmarkBlue Medicare AdvantageEnhanced PPO (PPO) WellmarkBlue Medicare AdvantagePPO (PPO) BlueCross BlueShieldof TennesseeBlueAdvantage Diamond (PPO) BlueCross BlueShieldof TennesseeBlueAdvantage Emerald (PPO) BlueCross BlueShieldof TennesseeBlueAdvantage Garnet (PPO) BlueCross BlueShieldof TennesseeBlueAdvantage Ruby (PPO) BlueCross BlueShieldof TennesseeBlueAdvantage Sapphire (PPO) BlueCross BlueShieldof TennesseeBlueAdvantage Freedom (PPO)SNP Rhode Island South CarolinaSouth DakotaTennessee BlueCross BlueShieldof TennesseeBlueCare Plus (HMO D-SNP) BlueCross BlueShieldof TennesseeBlueCare Plus Choice(HMO D-SNP) Blue Cross and Blue Shieldof TexasBlue Cross Medicare AdvantageBasic (HMO) Blue Cross and Blue Shieldof TexasBlue Cross Medicare AdvantageValue (HMO)Texas18

2022 Medicare Advantage Plans Offered by Blue Cross and Blue Shield FS CostPPOPOSBlue Cross and BlueShield Plan SponsorProduct Name Blue Cross and Blue Shieldof TexasBlue Cross Medicare AdvantageChoice Plus (PPO) Blue Cross and Blue Shieldof TexasBlue Cross Medicare AdvantageChoice Premier (PPO) Blue Cross and Blue Shieldof TexasBlue Cross Medicare AdvantageClassic (PPO) Blue Cross and Blue Shieldof TexasBlue Cross Medicare AdvantageFlex (PPO)Blue Cross and Blue Shieldof TexasBlue Cross Medicare AdvantageDual

2022 Medicare Advantage Plans Offered by Blue Cross and Blue Shield Companies 5 State Regional PPO Local PPO HMO HMO- POS PFFS Cost SNP Blue Cross and Blue