Transcription
Michigan Medicine Participation Status2021 Medicare Advantage PlansPlan NameAARP (UHC) Medicare Advantage (HMO) Medicare Advantage (HMO-POS) Medicare Advantage Access (HMO) Medicare Advantage Focus (HMO) Medicare Advantage Freedom Plus (HMO-POS) Medicare Advantage Mosaic Choice (HMO) Medicare Advantage Plan (HMO) Medicare Advantage Plan (HMO-POS) Medicare Advantage Plus (HMO-POS) Medicare Advantage Prime (HMO) Medicare Advantage SecureHorizons Focus (HMO) Medicare Advantage SecureHorizons Plan (HMO-POS) Medicare Advantage SecureHorizons Premier (HMO) Medicare Advantage SecureHorizons Value (HMO) Medicare Advantage Walgreens Plan (HMO)AARP (UHC) Medicare Advantage Choice (PPO) Medicare Advantage Choice Premier (PPO) Medicare Advantage Headwaters (PPO) Medicare Advantage Lakeshore (PPO) Medicare Advantage Mosaic Choice (PPO) Medicare Advantage Open (PPO) Medicare Advantage Open Premier (PPO) Medicare Advantage Patriot (Local PPO) Medicare Advantage Premier (PPO) Medicare Advantage Riverbank (PPO) Medicare Advantage Walgreens (PPO)1TypeNetwork StatusHMOPrior AuthorizationRequired (Notsold in Michigan)PPOIn-Network(Effective1/1/21)October 15, 2020
Michigan Medicine Participation Status2021 Medicare Advantage PlansPlan NameAetna (Out-of-State Plans) Medicare Advantra Gold (HMO) Medicare Advantra (HMO) Medicare Advantra (HMO-POS) Medicare Advantra Premier (HMO) Medicare Advantra Silver (HMO) Medicare Advantra Value (HMO) Medicare Choice (HMO-POS) Medicare Connect Plus (HMO) Medicare Credit (HMO) Medicare Advantra Elite (HMO) Medicare Elite Plan (HMO) Medicare Elite Prime (HMO) Medicare Explorer Elite (HMO) Medicare Explorer Premier Plus (HMO) Medicare Gold Advantage Prime (HMO) Medicare Platinum Plan (HMO) Medicare Platinum Plus Plan (HMO) Medicare Plus Plan (HMO) Medicare Premier Plan (HMO) Medicare Premier Plus (HMO) Medicare Prime PCP Elite (HMO) Medicare Prime Plan (HMO) Medicare Prime Plus Plan (HMO) Medicare Prime Value (HMO) Medicare Select Plan (HMO) Medicare Silver (HMO) Medicare Value Plan (HMO) Medicare Value Plus Plan (HMO)Aetna (Out-of-State Plans) Medicare Advantra Cares (HMO D-SNP) Medicare Assure (HMO D-SNP) Medicare Assure Plus (HMO D-SNP) Medicare Assure Premier Plus (HMO D-SNP) Medicare Dual Complete Plan (HMO D-SNP)Aetna (Michigan Plans) Medicare Premier (HMO) Medicare Assure Premier (HMO D-SNP)2TypeNetwork StatusHMOPrior AuthorizationRequired (Notsold in MichiganHMO D-SNPOut-of-NetworkHMOIn-NetworkOctober 15, 2020
Michigan Medicine Participation Status2021 Medicare Advantage PlansPlan NameAetna Medicare Advantra Credit Value (PPO) Medicare Advantra Preferred Plan (PPO) Medicare Advantra Premier (PPO) Medicare Advantra Premier Plus (PPO) Medicare Advantra Silver (PPO) Medicare Choice Plan (PPO) Medicare Credit Plan (PPO) Medicare Eagle (PPO) Medicare Elite Plan (PPO) Medicare Essential Plan (PPO) Medicare Explorer Plan (PPO) Medicare Explorer Premier (PPO) Medicare Explorer Premier Plus (PPO) Medicare Explorer Value (PPO) Medicare Freedom Plan (PPO) Medicare Gold Plan (PPO) Medicare Platinum Plan (PPO) Medicare Plus Plan (PPO) Medicare Preferred Premium Plan (PPO) Medicare Premier Advantra (PPO) Medicare Premier Plan (PPO) Medicare Premier Plus (Regional PPO) Medicare Prime Credit (PPO) Medicare Prime Plan (PPO) Medicare Prime Premier (PPO) Medicare Select Plan (PPO) Medicare Value Advantra (PPO) Medicare Value Plan (PPO) Medicare Value Plus Plan (PPO)Aetna Better Health of Michigan Premier Plan (Medicare-Medicaid)Aetna Better Health of Ohio Dual Preferred (HMO SNP)Aetna Better Health of Ohio MyCare Ohio (Medicare-Medicaid)Align Senior Care Align Connect (HMO C-SNP) Align Thrive (HMO I-SNP)Allwell Dual Medicare (HMO D-SNP) Medicare (HMO) Medicare Boost (HMO) Medicare Complement (HMO) Medicare Essentials (HMO)Allwell Medicare (PPO)AmeriHealth Caritas VIP Care Plus (Medicare-Medicaid)3TypeNetwork StatusPPOIn-NetworkMI Health LinkIn-NetworkHMO SNPOut-of-NetworkMyCare etworkPPOOut-of-NetworkMI Health LinkIn-NetworkOctober 15, 2020
Michigan Medicine Participation Status2021 Medicare Advantage PlansPlan NameAnthem MediBlue Dual Advantage (HMO D-SNP) MediBlue Essential (HMO) MediBlue Extra (HMO) MediBlue Plus (HMO) MediBlue Preferred (HMO) MediBlue Preferred Plus (HMO)Anthem MediBlue Access (PPO) MediBlue Access Basic (Regional PPO) MediBlue Access Core (Regional PPO)AultCare’s PrimeTime Health Plan Aultimate (HMO-POS) Basic MA Only (HMO-POS) Classic (HMO-POS) Plus (HMO-POS)Blue Care Network BCN Advantage HMO ConnectedCareBlue Care Network BCN Advantage HMO-POS Classic BCN Advantage HMO-POS Community Value BCN Advantage HMO-POS Elements BCN Advantage HMO-POS Prestige BCN Advantage HMO-POS Prime Value PlanBlue Cross Blue Shield of Michigan Medicare Plus Blue PPO Assure Medicare Plus Blue PPO Essential Medicare Plus Blue PPO Signature Medicare Plus Blue PPO VitalityBright Health Bright Advantage (HMO) Bright Advantage Assist (HMO) Bright Advantage Choice (HMO-POS) Bright Advantage Plus (HMO) Bright Advantage University Hospitals (HMO)Bright Health Bright Advantage Choice (PPO) Bright Advantage Choice Plus (PPO) Bright Advantage Flex (PPO) Bright Advantage Flex Choice (PPO) Bright Advantage University Hospitals Choice (PPO) Bright Advantage University Hospitals Choice Plus (PPO)Buckeye Health Plan MyCare Ohio (Medicare-Medicaid)CareSource Advantage (HMO) Advantage Zero Premium (HMO) Dual Advantage (HMO D-SNP)4TypeNetwork HMOOut-of-NetworkPPOOut-of-NetworkMyCare OhioOut-of-NetworkHMOOut-of-NetworkOctober 15, 2020
Michigan Medicine Participation Status2021 Medicare Advantage PlansPlan NameCigna Fundamental Medicare (HMO) Preferred Medicare (HMO)Cigna True Choice Medicare (PPO)CommuniCare Advantage CommuniCare Advantage ISNP (HMO I-SNP)Devoted Health Core (HMO) Prime (HMO) Saver (HMO)Erickson Advantage Champion (HMO-POS C-SNP) Guardian (HMO-POS I-SNP)Erickson Advantage Freedom (HMO-POS) Liberty with Drugs (HMO-POS) Liberty without Drugs (HMO) Signature with Drugs (HMO-POS)Gateway Health Medicare Assured Diamond (HMO SNP) Medicare Assured Ruby (HMO SNP)Health Alliance (Illinois) Medicare HMO 20 Rx (HMO) Medicare HMO 40 Rx (HMO) Medicare HMO Basic (HMO) Medicare HMO Basic Rx (HMO) Medicare POS 10 Rx (HMO-POS) Medicare POS 30 Rx (HMO-POS) Medicare POS Basic (HMO-POS) Medicare POS Basic Rx (HMO-POS)Health Alliance Plan (HAP) HAP Senior Plus (HMO) HAP Senior Plus (HMO-POS) HAP Senior Plus Medical Only (HMO)Health Alliance Plan (HAP) HAP Primary Choice Medicare (HMO)Health Alliance Plan (HAP) HAP Senior Plus Henry Ford Tiered Access (HMO)Health Alliance Plan (HAP) HAP Choice Medicare - West Michigan Option 1 (HMO)Health Alliance Plan (HAP) HAP Senior Plus (PPO)HAP Empowered (Midwest Health Plan) HAP Empowered Duals (HMO D-SNP)HAP Empowered (Midwest Health Plan) HAP Empowered MI Health Link (Medicare-Medicaid)5TypeNetwork HMOIn-NetworkHMOReferral Required,Specialty CareOnlyHMOTier I Health LinkIn-NetworkOctober 15, 2020
Michigan Medicine Participation Status2021 Medicare Advantage PlansPlan NameThe Health Plan SecureCare (HMO) SecureCare SNP (HMO SNP)The Health Plan SecureChoice (PPO)Humana Gold Choice PFFSHumana Cleveland Clinic Preferred (HMO)Gold Plus (HMO) Gold Plus SNP (HMO-SNP-DE) Gold Plus – Diabetes and Heart (HMO C-SNP)Humana Community HMO Diabetes and Heart (HMO C-SNP) Together in Health (HMO I-SNP)Humana Honor (PPO) HumanaChoice (PPO) Value Plus (PPO)Humana HumanaChoice SNP-DE (PPO D-SNP)Indiana University Health Plans – Medicare Medicare Choice (HMO-POS) Medicare Select Plus (HMO)Longevity Health Plan Longevity Health Plan (HMO I-SNP)Medica HealthCare MedicareMax (HMO)Medical Mutual of Ohio Advantage Choice (HMO) Advantage Classic (HMO) Advantage Plus (HMO) Advantage Secure (HMO) Advantage Signature (HMO)Medical Mutual of Ohio Advantage Preferred (PPO) Advantage Premium (PPO) Advantage Select (PPO)MediGold Essential Care (HMO) Medical Only (HMO) Southeast OH Classic Preferred (HMO) Southeast OH Essential Care (HMO) Southwest OH Classic Preferred (HMO) Southwest OH Essential Care (HMO) True Advantage (HMO)MediGold Flexible Choice (PPO)Meridian Health Plan of Michigan MeridianComplete (Medicare-Medicaid)6TypeNetwork StatusHMOOut-of-NetworkPPOOut-of-NetworkPFFSNo etworkHMOOut-of-NetworkPPOOut-of-NetworkMI Health LinkIn-NetworkOctober 15, 2020
Michigan Medicine Participation Status2021 Medicare Advantage PlansPlan NameMeridian Health Plan of Michigan (WellCare) See WellCare further down.Meridian Health Plan (WellCare) (Out-of-State) See WellCare further down.Michigan Complete Health Medicare-Medicaid Plan (Medicare-Medicaid)Molina Healthcare of Michigan Dual Options (Medicare-Medicaid)Molina Healthcare of Michigan Medicare Complete Care (HMO D-SNP) (new name, same plan)Molina Healthcare (Out-of-State) Medicare Complete Care (HMO D-SNP)Mutual of Omaha CareAdvantage Complete (HMO) CareAdvantage Plus (HMO)MyTrueAdvantage Select (HMO)MyTrueAdvantage Choice (PPO)Paramount Paramount Elite - Enhanced Medical Only (HMO) Paramount Elite - Enhanced Medical and Drug (HMO) Paramount Elite - Prime Medical and Drug (HMO) Paramount Elite - Standard Medical and Drug (HMO)Paramount Paramount Elite – Preferred PPOPerennial Advantage Concierge (HMO C-SNP) Strive (HMO I-SNP)Physicians Health Plan (PHP) Covenant Advantage (HMO-POS) Covenant Advantage Plus (HMO-POS) PHP Advantage (HMO-POS) PHP Advantage Plus (HMO-POS) Sparrow Advantage (HMO-POS) Sparrow Advantage Plus (HMO-POS)Priority Health PriorityMedicare (HMO-POS) PriorityMedicare Key (HMO-POS) PriorityMedicare Value (HMO-POS)Priority Health PriorityMedicare D-SNP (HMO D-SNP)Priority Health PriorityMedicare Edge (PPO) PriorityMedicare Ideal (PPO) PriorityMedicare Merit (PPO) PriorityMedicare Select (PPO) PriorityMedicare Vital (PPO)Provider Partners Health Plan Ohio Advantage Plan (HMO I-SNP)7TypeNetwork StatusHMOIn-NetworkHMOOut-of-NetworkMI Health LinkOut-of-NetworkMI Health etworkPPOIn-NetworkHMO/SNPOut-of-NetworkOctober 15, 2020
Michigan Medicine Participation Status2021 Medicare Advantage PlansPlan NameReliance Medicare Advantage Cardinal Plan (HMO) Dual Care Plus (D-SNP HMO) Principle Plan (HMO)SummaCare Medicare Amber (HMO) Medicare Emerald (HMO-POS) Medicare Garnet (HMO) Medicare Ruby (HMO) Medicare Sapphire (HMO-POS) Medicare Topaz (HMO)UnitedHealthcare Canopy Health Medicare Advantage (HMO) Medicare Advantage Assure (HMO)TypeNetwork ealthcare Assisted Living Plan (HMO-POS I-SNP) Medicare Advantage Assist (HMO C-SNP) Nursing Home Plan (HMO-POS I-SNP)UnitedHealthcare Medicare Advantage Assure (PPO) Medicare Advantage Choice Plan (PPO) Medicare Advantage Patriot (Regional PPO) Medicare Gold (PPO C-SNP) Medicare Silver (PPO C-SNP) Nursing Home Plan (PPO I-SNP)UnitedHealthcare MedicareDirect Rx (PFFS)UnitedHealthcare Community Plan (Michigan) Dual Complete (HMO D-SNP)UnitedHealthcare (Out-of-State) Dual Complete ONE (HMO D-SNP) Dual Complete ONE Plus (HMO D-SNP)HMO/SNPPPOIn-Network(Effective1/1/21)PFFSNo NetworkHMO/SNPIn-NetworkHMO/SNPUnitedHealthcare (Out-of-State) Dual Complete (PPO D-SNP) Dual Complete RP (PPO D-SNP) Dual Complete Choice (PPO D-SNP)Upper Peninsula Health Plan Advantage ChoiceUpper Peninsula Health Plan MI Health Link (Medicare-Medicaid)Valor Health Plan Valor Health Plan (HMO I-SNP)PPO/SNP8Prior AuthorizationRequired (Notsold in MichiganPrior AuthorizationRequired (Notsold in MichiganPrior AuthorizationRequired (Notsold in MichiganPrior AuthorizationRequired (Notsold in MichiganHMOOut-of-NetworkMI Health LinkOut-of-NetworkHMO/SNPOut-of-NetworkOctober 15, 2020
Michigan Medicine Participation Status2021 Medicare Advantage PlansPlan NameWellCare (Meridian Health Plan of Michigan MeridianCare) – Michigan Dividend (HMO) Elite (HMO-POS) Elite Smile (HMO-POS) Essential (HMO-POS) Exclusive (HMO) Explore (HMO-POS) Extra Plus (HMO-POS D-SNP) Guardian (HMO-POS C-SNP)WellCare – Out-of-State WellCare Access (HMO D-SNP) WellCare Best (HMO) WellCare Choice (HMO-POS) WellCare Compass (HMO) WellCare Dividend (HMO) WellCare Edge (HMO) WellCare Element (HMO) WellCare Essential (HMO-POS) WellCare Exclusive (HMO) WellCare Extra Plus (HMO-POS) WellCare Guardian (HMO C-SNP) WellCare Liberty (HMO D-SNP) WellCare Patriot (HMO-POS) WellCare Plus (HMO) WellCare Plus (HMO-POS D-SNP) WellCare Preferred (HMO) WellCare Value (HMO-POS)WellCare – Out-of-State WellCare Absolute (PPO) WellCare Endurance (PPO) WellCare Flex Complete (PPO) WellCare Imperial (PPO D-SNP) WellCare Premier (PPO) WellCare Summit (PPO) WellCare Today’s Options Advantage Plus 150A (PPO) WellCare Today’s Options Advantage Plus 550B (PPO)WellCare – Out-of-State WellCare Today’s Options Premier 200 (PFFS) WellCare Today’s Options Premier 300 (PFFS) WellCare Today’s Options Premier Plus 250A (PFFS) WellCare Today’s Options Premier Plus 650B (PFFS)Zing Health Choice IL (HMO) Choice IN (HMO) Choice MI (HMO) Essential Wellness IL (HMO D-SNP) Essential Wellness MI (HMO D-SNP) Open Access IL (HMO-POS) Open Access MI (HMO-POS)9TypeNetwork StatusHMOIn-Network(Meridian hastransitioned itsMeridianCare MAplans to WellCarefor all states. Onlythe plans offeredin Michigan FSOut-of-NetworkHMOOut-of-NetworkOctober 15, 2020
Michigan Medicine Participation Status2021 Medicare Advantage PlansMedicare Advantage Plans are offered with different plan designs. HMO – Members are required to select a participating PCP and referrals may be required forspecialty care (varies by plan). All out-of-network care requires prior plan authorization.MI Health Link – Special Medicare-Medicaid Demonstration plan available on in certain regionsof Michigan. Similar to an HMO, members are required to select a participating PCP andreferrals may be required for specialty care (varies by plan). All out-of-network care requiresprior plan authorization.POS – Members are often required to select a participating PCP. Referrals may be required forspecialty care (varies by plan).PPO – Members are not required to select a PCP. No referral required for specialty care. Out-ofnetwork care will incur higher out-of-pocket costs but does not need plan approval.PFFS – Most plans do not have a network of providers. No referral required for specialty care.SNP – Members are required to select a participating PCP and referrals may be required forspecialty care (varies by plan). All out-of-network care requires prior plan authorization.10October 15, 2020
Blue Care Network BCN Advantage HMO ConnectedCare HMO Out-of-Network Blue Care Network BCN Advantage HMO-POS Classic BCN Advantage HMO-POS Community Value BCN Advantage HMO-POS Elements BCN Advantage HMO-POS Prestige BCN Advantage HMO-POS Prime Val
