Key
C | Covered - No restrictions |
Q | Has quantity limits |
S | Has step therapy |
P | Has prior authorization |
N | Not Covered |
| Cigna Secure Rx (PDP) S5617-013 | Humana Basic Rx Plan (PDP) S5552-004 | SilverScript Choice (PDP) S5601-006 | Wellcare Classic (PDP) S4802-077 | AgeWell New York CareWell (HMO I-SNP) H4922-004 | ArchCare Advantage (HMO I-SNP) H1777-007 | Centers Plan for Nursing Home Care (HMO I-SNP) H6988-003 | Elderplan Advantage For Nursing Home Residents (HMO I-SNP) H3347-003 | Elderplan Assist (HMO I-SNP) H3347-015 | Independent Health's Medicare Family Choice (HMO I-SNP) H3362-020 | Longevity Health Plan (HMO I-SNP) H8457-001 | Nascentia Skilled Nursing Facility (HMO I-SNP) H9066-002 | RiverSpring Star (HMO I-SNP) H6776-001 | UnitedHealthcare Assisted Living Plan (PPO I-SNP) H2292-003 | UnitedHealthcare Nursing Home Plan (HMO-POS I-SNP) H3379-022 | UnitedHealthcare Nursing Home Plan 1 (PPO I-SNP) H2292-001 | UnitedHealthcare Nursing Home Plan 1 (PPO I-SNP) H2292-002 | UnitedHealthcare Nursing Home Plan 2 (HMO I-SNP) H3379-002 | UnitedHealthcare Nursing Home Plan 2 (HMO I-SNP) H3379-042 |
| N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N |
| N | P | N | P | P | N | N | N | N | P | P | P | P | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N |
| N | N | N | Q | C | N | N | N | N | N | Q | Q | Q | N | N | N | N | N | N |
| N | N | N | Q | C | N | N | N | N | C | Q | Q | Q | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N |
| N | Q | N | C | C | N | N | N | N | C | C | C | C | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | N | Q | N | Q | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | P | P | N | N | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | P | P | N | P | N | N | N | N | N | N |
| N | Q | N | Q | Q | N | N | N | N | Q | Q | Q | Q | N | N | N | N | N | N |
| N | Q | N | Q | Q | N | N | N | N | Q | Q | Q | Q | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N |
| N | N | N | QP | QP | N | N | N | N | C | P | QP | QP | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N |
| Cigna Secure Rx (PDP) S5617-013 | Humana Basic Rx Plan (PDP) S5552-004 | SilverScript Choice (PDP) S5601-006 | Wellcare Classic (PDP) S4802-077 | AgeWell New York CareWell (HMO I-SNP) H4922-004 | ArchCare Advantage (HMO I-SNP) H1777-007 | Centers Plan for Nursing Home Care (HMO I-SNP) H6988-003 | Elderplan Advantage For Nursing Home Residents (HMO I-SNP) H3347-003 | Elderplan Assist (HMO I-SNP) H3347-015 | Independent Health's Medicare Family Choice (HMO I-SNP) H3362-020 | Longevity Health Plan (HMO I-SNP) H8457-001 | Nascentia Skilled Nursing Facility (HMO I-SNP) H9066-002 | RiverSpring Star (HMO I-SNP) H6776-001 | UnitedHealthcare Assisted Living Plan (PPO I-SNP) H2292-003 | UnitedHealthcare Nursing Home Plan (HMO-POS I-SNP) H3379-022 | UnitedHealthcare Nursing Home Plan 1 (PPO I-SNP) H2292-001 | UnitedHealthcare Nursing Home Plan 1 (PPO I-SNP) H2292-002 | UnitedHealthcare Nursing Home Plan 2 (HMO I-SNP) H3379-002 | UnitedHealthcare Nursing Home Plan 2 (HMO I-SNP) H3379-042 |
| N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N |
| N | QP | N | QP | P | N | N | N | N | N | QP | P | QP | N | N | N | N | N | N |
| N | N | N | N | C | N | N | N | N | C | N | N | N | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | N | N | N | P | N | N | N | N | N | N |
| N | N | N | Q | N | N | N | N | N | N | QP | N | Q | N | N | N | N | N | N |
| N | N | N | Q | C | N | N | N | N | N | C | N | Q | N | N | N | N | N | N |
| N | Q | N | N | C | N | N | N | N | C | C | Q | C | N | N | N | N | N | N |
| N | Q | N | C | C | N | N | N | N | C | C | C | C | N | N | N | N | N | N |
| N | N | N | N | C | N | N | N | N | Q | N | N | N | N | N | N | N | N | N |
| N | C | N | C | C | N | N | N | N | C | C | C | C | N | N | N | N | N | N |
| N | C | N | C | C | N | N | N | N | C | C | C | C | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N |
| N | Q | N | Q | C | N | N | N | N | C | C | C | Q | N | N | N | N | N | N |
| N | P | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | N | N | N | Q | N | N | N | N | N | N |
| N | QP | N | N | P | N | N | N | N | C | N | P | N | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N |
| N | N | N | N | C | N | N | N | N | Q | N | C | C | N | N | N | N | N | N |
| N | C | N | C | P | N | N | N | N | C | C | P | P | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N |
| N | C | N | C | C | N | N | N | N | C | C | C | C | N | N | N | N | N | N |
| N | Q | N | Q | C | N | N | N | N | C | C | Q | Q | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | P | N | N | N | N | N | N | N | N | N |
| Cigna Secure Rx (PDP) S5617-013 | Humana Basic Rx Plan (PDP) S5552-004 | SilverScript Choice (PDP) S5601-006 | Wellcare Classic (PDP) S4802-077 | AgeWell New York CareWell (HMO I-SNP) H4922-004 | ArchCare Advantage (HMO I-SNP) H1777-007 | Centers Plan for Nursing Home Care (HMO I-SNP) H6988-003 | Elderplan Advantage For Nursing Home Residents (HMO I-SNP) H3347-003 | Elderplan Assist (HMO I-SNP) H3347-015 | Independent Health's Medicare Family Choice (HMO I-SNP) H3362-020 | Longevity Health Plan (HMO I-SNP) H8457-001 | Nascentia Skilled Nursing Facility (HMO I-SNP) H9066-002 | RiverSpring Star (HMO I-SNP) H6776-001 | UnitedHealthcare Assisted Living Plan (PPO I-SNP) H2292-003 | UnitedHealthcare Nursing Home Plan (HMO-POS I-SNP) H3379-022 | UnitedHealthcare Nursing Home Plan 1 (PPO I-SNP) H2292-001 | UnitedHealthcare Nursing Home Plan 1 (PPO I-SNP) H2292-002 | UnitedHealthcare Nursing Home Plan 2 (HMO I-SNP) H3379-002 | UnitedHealthcare Nursing Home Plan 2 (HMO I-SNP) H3379-042 |
| N | Q | N | C | C | N | N | N | N | C | Q | Q | C | N | N | N | N | N | N |
| N | N | N | C S | C | N | N | N | N | C | C | C | C S | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | P | N | N | N | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N |
| N | Q | N | C | C | N | N | N | N | C | C | Q | C | N | N | N | N | N | N |
| N | Q | N | N | C | N | N | N | N | P | Q | N | C | N | N | N | N | N | N |
| N | N | N | N | C | N | N | N | N | C S | C | P | N | N | N | N | N | N | N |
| N | N | N | N | C | N | N | N | N | C | C | Q | C | N | N | N | N | N | N |
| N | Q | N | QP | QP | N | N | N | N | Q | QP | QP | QP | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N |
| N | QP | N | P | N | N | N | N | N | P | QP | N | P | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | C | N | N | C | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | N | C | N | Q | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | N | C | N | Q | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | C | C | N | N | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | C | C | N | N | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | C | C | N | N | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | C | C | N | N | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | C | C | N | N | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | C | C | N | N | N | N | N | N | N | N |
| N | N | N | P | C | N | N | N | N | C | Q | Q | P | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N |
| N | N | N | N | C | N | N | N | N | N | N | N | C | N | N | N | N | N | N |
| N | N | N | N | C | N | N | N | N | N | N | N | C | N | N | N | N | N | N |
| N | N | N | N | C | N | N | N | N | N | N | N | C | N | N | N | N | N | N |
| N | Q | N | Q | C | N | N | N | N | P | Q | C | Q | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N |
| N | Q | N | C | C | N | N | N | N | C | Q | Q | C | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N |
| N | Q | N | Q | C | N | N | N | N | C | C | Q | C | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | N | N | N | C | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | C | Q | N | N | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N |
| Cigna Secure Rx (PDP) S5617-013 | Humana Basic Rx Plan (PDP) S5552-004 | SilverScript Choice (PDP) S5601-006 | Wellcare Classic (PDP) S4802-077 | AgeWell New York CareWell (HMO I-SNP) H4922-004 | ArchCare Advantage (HMO I-SNP) H1777-007 | Centers Plan for Nursing Home Care (HMO I-SNP) H6988-003 | Elderplan Advantage For Nursing Home Residents (HMO I-SNP) H3347-003 | Elderplan Assist (HMO I-SNP) H3347-015 | Independent Health's Medicare Family Choice (HMO I-SNP) H3362-020 | Longevity Health Plan (HMO I-SNP) H8457-001 | Nascentia Skilled Nursing Facility (HMO I-SNP) H9066-002 | RiverSpring Star (HMO I-SNP) H6776-001 | UnitedHealthcare Assisted Living Plan (PPO I-SNP) H2292-003 | UnitedHealthcare Nursing Home Plan (HMO-POS I-SNP) H3379-022 | UnitedHealthcare Nursing Home Plan 1 (PPO I-SNP) H2292-001 | UnitedHealthcare Nursing Home Plan 1 (PPO I-SNP) H2292-002 | UnitedHealthcare Nursing Home Plan 2 (HMO I-SNP) H3379-002 | UnitedHealthcare Nursing Home Plan 2 (HMO I-SNP) H3379-042 |
| N | C | N | C | C | N | N | N | N | C | C S | C | C | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N |
| N | Q | N | Q | P | N | N | N | N | C | C | P | C | N | N | N | N | N | N |
| N | C | N | C | N | N | N | N | N | C | C | N | C | N | N | N | N | N | N |
| N | N | N | N | C | N | N | N | N | C | C | C | C | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N |
| N | N | N | N | C | N | N | N | N | Q | Q | Q | Q | N | N | N | N | N | N |
| N | Q | N | C | C | N | N | N | N | C | C | C | C | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N |
| N | QP | N | P | P | N | N | N | N | P | P | P | P | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N |
| N | Q | N | C | C | N | N | N | N | C | C | C | C | N | N | N | N | N | N |
| N | QP | N | P | C | N | N | N | N | C | P | Q | P | N | N | N | N | N | N |
| N | QP | N | N | C | N | N | N | N | C | P | Q | N | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N |
| N | N | N | N | Q | N | N | N | N | C | N | N | N | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N |
| N | Q | N | Q | C | N | N | N | N | C | C | C | C | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | P | P | N | N | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N |
| N | N | N | C | C | N | N | N | N | C | C | C | C | N | N | N | N | N | N |
| N | C | N | C | C | N | N | N | N | N | N | C | C | N | N | N | N | N | N |
| N | C | N | C | C | N | N | N | N | N | N | C | C | N | N | N | N | N | N |
| N | C | N | C | C | N | N | N | N | N | N | C | C | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N |
| Cigna Secure Rx (PDP) S5617-013 | Humana Basic Rx Plan (PDP) S5552-004 | SilverScript Choice (PDP) S5601-006 | Wellcare Classic (PDP) S4802-077 | AgeWell New York CareWell (HMO I-SNP) H4922-004 | ArchCare Advantage (HMO I-SNP) H1777-007 | Centers Plan for Nursing Home Care (HMO I-SNP) H6988-003 | Elderplan Advantage For Nursing Home Residents (HMO I-SNP) H3347-003 | Elderplan Assist (HMO I-SNP) H3347-015 | Independent Health's Medicare Family Choice (HMO I-SNP) H3362-020 | Longevity Health Plan (HMO I-SNP) H8457-001 | Nascentia Skilled Nursing Facility (HMO I-SNP) H9066-002 | RiverSpring Star (HMO I-SNP) H6776-001 | UnitedHealthcare Assisted Living Plan (PPO I-SNP) H2292-003 | UnitedHealthcare Nursing Home Plan (HMO-POS I-SNP) H3379-022 | UnitedHealthcare Nursing Home Plan 1 (PPO I-SNP) H2292-001 | UnitedHealthcare Nursing Home Plan 1 (PPO I-SNP) H2292-002 | UnitedHealthcare Nursing Home Plan 2 (HMO I-SNP) H3379-002 | UnitedHealthcare Nursing Home Plan 2 (HMO I-SNP) H3379-042 |
| N | Q | N | Q | C | N | N | N | N | C | C | Q | C | N | N | N | N | N | N |
| N | N | N | N | C | N | N | N | N | C | C | C | N | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N |
| N | QP | N | C | P | N | N | N | N | P | C | P | P | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N |
| N | Q | N | Q | C | N | N | N | N | C | C | C | Q | N | N | N | N | N | N |
| N | N | N | QP | N | N | N | N | N | C | N | N | N | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N |
| N | Q | N | C | C | N | N | N | N | C | C | C | C | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N |
| N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N | N |
| N | QP | N | N | C | N | N | N | N | C | QP | C | N | N | N | N | N | N | N |
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| N | Q | N | Q | N | N | N | N | N | C | N | N | Q | N | N | N | N | N | N |
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| Cigna Secure Rx (PDP) S5617-013 | Humana Basic Rx Plan (PDP) S5552-004 | SilverScript Choice (PDP) S5601-006 | Wellcare Classic (PDP) S4802-077 | AgeWell New York CareWell (HMO I-SNP) H4922-004 | ArchCare Advantage (HMO I-SNP) H1777-007 | Centers Plan for Nursing Home Care (HMO I-SNP) H6988-003 | Elderplan Advantage For Nursing Home Residents (HMO I-SNP) H3347-003 | Elderplan Assist (HMO I-SNP) H3347-015 | Independent Health's Medicare Family Choice (HMO I-SNP) H3362-020 | Longevity Health Plan (HMO I-SNP) H8457-001 | Nascentia Skilled Nursing Facility (HMO I-SNP) H9066-002 | RiverSpring Star (HMO I-SNP) H6776-001 | UnitedHealthcare Assisted Living Plan (PPO I-SNP) H2292-003 | UnitedHealthcare Nursing Home Plan (HMO-POS I-SNP) H3379-022 | UnitedHealthcare Nursing Home Plan 1 (PPO I-SNP) H2292-001 | UnitedHealthcare Nursing Home Plan 1 (PPO I-SNP) H2292-002 | UnitedHealthcare Nursing Home Plan 2 (HMO I-SNP) H3379-002 | UnitedHealthcare Nursing Home Plan 2 (HMO I-SNP) H3379-042 |
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| Cigna Secure Rx (PDP) S5617-013 | Humana Basic Rx Plan (PDP) S5552-004 | SilverScript Choice (PDP) S5601-006 | Wellcare Classic (PDP) S4802-077 | AgeWell New York CareWell (HMO I-SNP) H4922-004 | ArchCare Advantage (HMO I-SNP) H1777-007 | Centers Plan for Nursing Home Care (HMO I-SNP) H6988-003 | Elderplan Advantage For Nursing Home Residents (HMO I-SNP) H3347-003 | Elderplan Assist (HMO I-SNP) H3347-015 | Independent Health's Medicare Family Choice (HMO I-SNP) H3362-020 | Longevity Health Plan (HMO I-SNP) H8457-001 | Nascentia Skilled Nursing Facility (HMO I-SNP) H9066-002 | RiverSpring Star (HMO I-SNP) H6776-001 | UnitedHealthcare Assisted Living Plan (PPO I-SNP) H2292-003 | UnitedHealthcare Nursing Home Plan (HMO-POS I-SNP) H3379-022 | UnitedHealthcare Nursing Home Plan 1 (PPO I-SNP) H2292-001 | UnitedHealthcare Nursing Home Plan 1 (PPO I-SNP) H2292-002 | UnitedHealthcare Nursing Home Plan 2 (HMO I-SNP) H3379-002 | UnitedHealthcare Nursing Home Plan 2 (HMO I-SNP) H3379-042 |
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