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Chart of 2020 BIN and PCN values for each Medicare Part D prescription drug plan Part 1 of 5 (E0654 through H2334)

Category: Your Formulary (Drug List)
Published on 2019-07-31 14:11:31


The Centers for Medicare & Medicaid Services (CMS) released a compilation of the BIN and PCN values for each 2020 Medicare Part D plan sponsor.  Please note, the data below is Part 1 of 5 (E0654 - H2334) with links to Parts 2 through 5.

In addition, CMS included the following disclaimer in regards to this data:

"DISCLAIMER: The Centers for Medicare & Medicaid Services (CMS) has made a reasonable effort to ensure that the provided data are a true and accurate representation of the data on file at CMS at the time of disclosure. This information reflects data as reported by the Medicare Part D sponsors and has not been validated. CMS is not responsible for data that is misrepresented, misinterpreted or altered in any way."

You may also wish to read more at: "What is the BIN, PCN, and RxGROUP number for my Medicare Part D prescription drug plan?."

The chart below is the first page of the 2020 Medicare Part D pharmacy BIN and PCN list covering prescription drug plans from contracts E0654 through H2334.

Click here for the second page (H2354 - H4093), third page (H4094 - H6293) , fourth page (H6306 - H9431) and fifth page (H9438 - S9701).

2020 Medicare Prescription Drug Plan Pharmacy BIN and PCN Numbers
Contract ID Contract Name Plan ID BIN PCN
E0654 IBT VOLUNTARY EMPLOYEE BENEFITS TRUST all plans 015574 ASPROD1
E3014   all plans 610097 9999
E4744 MODOT/MSHP MEDICAL AND LIFE INSURANCE PLAN all plans 015574 ASPROD1
H0022 BUCKEYE COMMUNITY HEALTH PLAN, INC. all plans 004336 MEDDMCDOH
H0028 CHA HMO, INC. 001, 004, 007, 011, 013, 014, 015, 016, 017, 018, 019, 020, 021, 022, 023, 024, 025, 026, 027, 028, 029, 030, 031, 032, 033, 034, 035, 036, 038, 039, 040, 041, 042, 043, 044, 045, 046, 801, 804 015581 03200000
H0028 CHA HMO, INC. 037 03200000 015581
H0029   all plans 004336 MEDDADV
H0034 HAMASPIK, INC. all plans 00000000 018927
H0062 SUPERIOR HEALTHPLAN COMMUNITY SOLUTIONS, INC. all plans 004336 MEDDADV
H0088 WELLCARE HEALTH INSURANCE OF NEW YORK, INC. all plans 004336 MEDDADV
H0104 BLUE CROSS AND BLUE SHIELD OF ALABAMA all plans 014897 MBG
H0105 THE METHODIST OAKS all plans 510999 GPP
H0107 HEALTH CARE SERVICE CORPORATION 003,004 011552 MAPDMT
H0107 HEALTH CARE SERVICE CORPORATION 801,802 011552 MAPDMTG
H0111 WELLCARE OF GEORGIA, INC. all plans 004336 MEDDADV
H0112   all plans 016110 PACE
H0137 COMMONWEALTH CARE ALLIANCE, INC. all plans 610602 NVTD
H0148 BLUE SHIELD OF CALIFORNIA PROMISE HEALTH PLAN all plans 012353 07820000
H0154 VIVA HEALTH, INC. all plans 004336 MEDDADV
H0169 UNITEDHEALTHCARE OF THE MIDWEST, INC. all plans 610097 9999
H0174 WELLCARE OF TEXAS, INC. all plans 004336 MEDDADV
H0192 AMERIHEALTH MICHIGAN, INC. all plans 012353 06500000
H0216   all plans 000000 PACE
H0251 UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC. 004 610097 8500
H0251 UNITEDHEALTHCARE PLAN OF THE RIVER VALLEY, INC. 002, 005 610097 9999
H0270 WELLCARE HEALTH INSURANCE COMPANY OF AMERICA all plans 004336 MEDDADV
H0271 SYMPHONIX HEALTH INSURANCE, INC. all plans 610097 9999
H0281 ILLINICARE HEALTH PLAN all plans 004336 MEDDADV
H0292 HUMANA HEALTH PLAN OF OHIO, INC. all plans 015581 03200000
H0294 CARE IMPROVEMENT PLUS WISCONSIN INSURANCE COMPANY all plans 610097 9999
H0302 MEDISUN, INC. all plans 015574 ASPR0D1
H0321 ARIZONA PHYSICIANS IPA, INC. all plans 610097 9999
H0332 KS PLAN ADMINISTRATORS, LLC all plans 015789 05900000
H0336 HUMANA HEALTH PLAN, INC. all plans 015581 03200000
H0351 HEALTH NET OF ARIZONA, INC. all plans 004336 MEDDADV
H0354 CIGNA HEALTHCARE OF ARIZONA, INC. all plans 017010 CIHSCARE
H0390   all plans 018091 PRSMEDD
H0422 UCARE HEALTH, INC. all plans 003858 MD
H0423 METROPLUS HEALTH PLAN, INC. all plans 004336 MEDDADV
H0432 UNITEDHEALTHCARE OF ALABAMA, INC. all plans 610097 9999
H0439 CIGNA HEALTHCARE OF GEORGIA, INC. all plans 017010 CIHSCARE
H0473 HUMANA INSURANCE COMPANY OF KENTUCKY all plans 015581 03200000
H0477   all plans 018091 PRSMEDD
H0480 MERIDIAN HEALTH PLAN OF MICHIGAN, INC. all plans 610241 MHPMICOMP
H0504 CALIFORNIA PHYSICIANS' SERVICE 038, 039, 040 012353 0192000
H0504 CALIFORNIA PHYSICIANS' SERVICE 015, 017, 021, 026, 028, 029, 031, 037, 041, 042, 043, 044, 045, 803, 804 012353 01920000
H0523 AETNA HEALTH OF CALIFORNIA INC. all plans 610502 MEDDAET
H0524 KAISER FOUNDATION HP, INC. 002, 003, 015, 029, 034, 035, 036, 037, 805, 807, 809, 811 011172 SCCMS
H0524 KAISER FOUNDATION HP, INC. 008, 010, 013, 030, 031, 032, 033, 038, 039, 040, 041, 042, 043, 046, 051, 054, 806, 808, 810, 812 011842 NCCMS
H0542 ALTAMED HEALTH SERVICES CORPORATION all plans 015284 CRX
H0543 UHC OF CALIFORNIA all plans 610097 9999
H0544 BLUE CROSS OF CALIFORNIA 070 020015 IS
H0544 BLUE CROSS OF CALIFORNIA 002, 003, 004, 005, 007, 008, 010, 012, 013, 014, 015, 019, 020, 021, 024, 025, 027, 031, 032, 036, 037, 038, 041, 049, 050, 052, 053, 054, 055, 056, 057, 058, 059, 060, 061, 062, 063, 064, 065, 066, 067, 069, 071, 072, 074, 081, 087, 088, 089, 090, 091, 093, 094, 095, 096, 097, 098, 099, 100, 802, 804, 805, 807, 808, 811 020115 IS
H0545 INTER VALLEY HEALTH PLAN, INC. 001, 012, 014, 801, 802 004758 DNPS
H0545 INTER VALLEY HEALTH PLAN, INC. 015 610602 NVTD
H0562 HEALTH NET OF CALIFORNIA,INC. all plans 004336 MEDDADV
H0571 CHINESE COMMUNITY HEALTH PLAN all plans 015574 ASPROD1
H0609 PACIFICARE OF COLORADO, INC. all plans 610097 9999
H0613   all plans 018091 PRSMEDD
H0624 UNITEDHEALTHCARE INSURANCE COMPANY all plans 610097 9999
H0628 AETNA HEALTH OF OHIO INC. all plans 610502 MEDDAET
H0630 KAISER FOUNDATION HP OF CO 013, 014, 015, 016, 022, 805, 807, 809, 810 011255 COCMS
H0630 KAISER FOUNDATION HP OF CO 020, 021, 817, 819, 821, 822 011255 COCMSN
H0630 KAISER FOUNDATION HP OF CO 017, 018, 811, 813, 815, 816 011255 COCMSS
H0672 CIGNA HEALTHCARE OF COLORADO, INC. all plans 017010 CIHSCARE
H0710 SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. all plans 610097 9999
H0712 WELLCARE OF CONNECTICUT, INC. all plans 004336 MEDDADV
H0724 BUCKEYE HEALTH PLAN COMMUNITY SOLUTIONS all plans 004336 MEDDADV
H0755 OXFORD HEALTH PLANS (CT), INC. all plans 610097 9999
H0798 MEDICA COMMUNITY HEALTH PLAN all plans 003858 MD
H0809 MERCY LIFE, INC. all plans 018091 PRSMEDD
H0819 SENIOR LIFE YORK, INC. all plans 013519 N/A
H0838 UNIVERSAL CARE, INC. all plans 015574 ASPROD1
H0839 VOANS SENIOR COMMUNITY CARE OF NORTH CAROLINA, INC all plans 018091 PRSMEDD
H0908 BUCKEYE COMMUNITY HEALTH PLAN, INC. all plans 004336 MEDDADV
H0913 WELLCARE HEALTH PLANS OF NEW JERSEY, INC. all plans 004336 MEDDADV
H0927 HEALTH CARE SERVICE CORPORATION all plans 011552 ILDEMD
H0969 WELLCARE HEALTH INSURANCE COMPANY OF NEW HAMPSHIRE all plans 004336 MEDDADV
H0982 SOLIS HEALTH PLANS, INC. all plans 610602 NVTD
H1016 AVMED, INC. all plans 004336 MEDDADV
H1019 CAREPLUS HEALTH PLANS, INC. all plans 015581 03200000
H1032 WELLCARE OF FLORIDA, INC. all plans 004336 MEDDADV
H1035 FLORIDA BLUE MEDICARE, INC. 017, 018, 019, 020, 021, 022, 023, 024, 025, 026, 027, 028, 029, 030, 031, 032, 033, 034, 035, 036, 037, 038, 039, 042 012833 MedDPrime
H1035 FLORIDA BLUE MEDICARE, INC. 002, 006, 011, 014, 016, 040, 041, 801, 802 610593 SXCFLH
H1036 HUMANA MEDICAL PLAN, INC. all plans 015581 03200000
H1043 FLORIDA PACE CENTERS, INC. all plans 000000 PACE
H1045 PREFERRED CARE PARTNERS, INC. all plans 610097 9999
H1099 HEALTH FIRST HEALTH PLANS all plans 003858 MD
H1100 INNOVATION HEALTH INSURANCE COMPANY all plans 610502 MEDDAET
H1109 AETNA HEALTH INC.(GA) all plans 610502 MEDDAET
H1111 UNITEDHEALTHCARE OF GEORGIA, INC. all plans 610097 9999
H1112 WELLCARE OF GEORGIA, INC. all plans 004336 MEDDADV
H1119 TSG GUARD, INC. all plans 012312 PARTD
H1142 BRIGHT HEALTH INSURANCE COMPANY OF OHIO, INC. all plans 012312 PARTD
H1170 KAISER FOUNDATION HP OF GA, INC. all plans 011222 GACMS
H1175   all plans 012312 PARTD
H1189 CHRISTUS HEALTH PLAN all plans 003858 MD
H1205 INTEGRA MLTC, INC. all plans 012312 PARTD
H1225 HOPKINS HEALTH ADVANTAGE, INC. all plans 004336 MEDDADV
H1230 KAISER FOUNDATION HP, INC. all plans 011214 HICMS
H1234 LIFE ST. FRANCIS all plans 018091 PRSMEDD
H1239 KISSITO PACE OF ROANOKE, INC. all plans 018091 PRSMEDD
H1248 LOUISIANA HEALTH SERVICE & INDEMNITY COMPANY all plans 003858 MD
H1277 ALIGN SENIOR CARE, INC. all plans 610602 NVTD
H1278 HARKEN HEALTH INSURANCE COMPANY all plans 610097 9999
H1286 UNITEDHEALTHCARE INSURANCE COMPANY all plans 610097 9999
H1290 DEVOTED HEALTH PLAN OF FLORIDA, INC. all plans 004336 MEDDADV
H1304 REGENCE BLUESHIELD OF IDAHO all plans 610623 2100000
H1310 COMPREHENSIVE SENIOR CARE CORPORATION all plans 013170 CLAIMCR
H1350 BLUE CROSS OF IDAHO CARE PLUS, INC. all plans 004336 MEDDADV
H1352 BLUE-ADVANTAGE PLUS OF KANSAS CITY, INC. all plans 015574 ASPROD1
H1353 WELLCARE OF WASHINGTON, INC. all plans 004336 MEDDADV
H1357 CAROLINA SENIORCARE all plans 004410 SCI
H1365 MARTIN'S POINT GENERATIONS ADVANTAGE, INC. all plans 004336 MEDDADV
H1372 MARQUIS ADVANTAGE, INC. all plans 610602 NVTD
H1375 UNITEDHEALTHCARE COMMUNITY PLAN OF CALIFORNIA, INC all plans 610097 9999
H1393 BRIGHT HEALTH INSURANCE COMPANY OF TENNESSEE all plans 012312 PARTD
H1415 HEALTHSPRING LIFE & HEALTH INSURANCE COMPANY, INC. all plans 017010 CIHSCARE
H1416 HARMONY HEALTH PLAN, INC. all plans 004336 MEDDADV
H1426 VITALITY HEALTH PLAN OF CALIFORNIA, INC. all plans 015574 ASPROD1
H1436 ABSOLUTE TOTAL CARE, INC. all plans 004336 MEDDADV
H1463 HEALTH ALLIANCE CONNECT, INC. all plans 015789 CTRXMEDD
H1468 HUMANA BENEFIT PLAN OF ILLINOIS, INC. all plans 015581 03200000
H1475 ILLINICARE HEALTH PLAN all plans 004336 MEDDADV
H1500 LIFE ST. JOSEPH OF THE PINES, INC. all plans 018091 PRSMEDD
H1518 CATHOLIC HEALTH SYSTEM BUFFALO PACE all plans 018091 PRSMEDD
H1533 STAYWELL SENIOR CARE, INC. all plans 018091 PRSMEDD
H1537 CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE CO all plans 610097 9999
H1587 ARKANSAS SUPERIOR SELECT, INC. all plans 012312 PartD
H1607 ANTHEM INSURANCE COMPANIES, INC. all plans 020115 IS
H1608 COVENTRY HEALTH AND LIFE INSURANCE COMPANY all plans 610502 MEDDAET
H1609 AETNA HEALTH INC. (FL) all plans 610502 MEDDAET
H1610 COVENTRY HEALTH CARE OF VIRGINIA all plans 610591 MEDDADV
H1644 LONGEVITY HEALTH PLAN OF FLORIDA INC. all plans 610602 NVTD
H1659 PIEDMONT COMMUNITY HEALTHCARE, INC. all plans 004336 MEDDADV
H1660 HARVARD PILGRIM HEALTH CARE INC. all plans 610011 HPHCMEDD
H1664 HOME STATE HEALTH PLAN, INC. all plans 004336 MEDDADV
H1666 HCSC INSURANCE SERVICES COMPANY 001, 002, 003, 004, 005, 006, 008 011552 MAPDTX
H1666 HCSC INSURANCE SERVICES COMPANY 801, 803 011552 MAPDTXG
H1666 HCSC INSURANCE SERVICES COMPANY 807 011552 PARTBG
H1692 COVENTRY HEALTH CARE OF WEST VIRGINIA, INC. all plans 610502 MEDDAET
H1714 VIA CHRISTI HEALTHCARE OUTREACH FOR ELDERS, INC. all plans 018091 PRSMEDD
H1722 HEALTH POINTE OF NEW YORK, LLC all plans 610602 NVTD
H1723 ABSOLUTE TOTAL CARE, INC. all plans 004336 MEDDADV
H1737 HEALTH ALLIANCE - MIDWEST, INC. all plans 015789 CTRXMEDD
H1777 CATHOLIC SPECIAL NEEDS PLAN, LLC all plans 004336 MEDDADV
H1787 GOOD SAMARITAN INSURANCE PLAN OF SOUTH DAKOTA, INC all plans 610602 NVTD
H1846 MOUNT CARMEL HEALTH INSURANCE COMPANY all plans 004336 MEDDADV
H1889 UNITEDHEALTHCARE OF FLORIDA, INC. all plans 610097 9999
H1894 AMERIGROUP WASHINGTON, INC. all plans 020115 IS
H1904 PACE GREATER NEW ORLEANS all plans 000000 000000
H1914 WELLCARE HEALTH INSURANCE OF CONNECTICUT all plans 004336 MEDDADV
H1926   all plans 012312 PARTD
H1944 UNITEDHEALTHCARE OF NEW ENGLAND, INC. all plans 610097 9999
H1947 COMMUNITY CARE HEALTH PLAN OF LOUISIANA, INC. all plans 020115 IS
H1951 HUMANA HEALTH BENEFIT PLAN OF LOUISIANA, INC. 050 015577 03200000
H1951 HUMANA HEALTH BENEFIT PLAN OF LOUISIANA, INC. 013, 024, 028, 032, 033, 034, 038, 039, 041, 044, 047, 048, 049, 801, 807 015581 03200000
H1961 PEOPLES HEALTH, INC. all plans 004336 MEDDADV
H1969 REGENCE BLUESHIELD OF IDAHO all plans 610623 2100000
H1970   all plans 012312 PartD
H1977 UPPER PENINSULA HEALTH PLAN, LLC all plans 012353 06766761
H1994 SELECTHEALTH, INC. all plans 015938 7463
H1997 REGENCE BLUESHIELD all plans 610623 2100000
H2001 SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. all plans 610097 9999
H2011 BRIGHT HEALTH INSURANCE COMPANY OF TENNESSEE all plans 012312 PARTD
H2020 DELAWARE LIFE INSURANCE COMPANY all plans 012312 PARTD
H2029 HUMANA INSURANCE OF PUERTO RICO, INC. all plans 015581 03200000
H2032 INSURANCE COMPANY OF SCOTT AND WHITE 002, 003 012353 07650000
H2032 INSURANCE COMPANY OF SCOTT AND WHITE 001, 801, 803 012353 07660000
H2034 COMMUNITY CARE HEALTH PLAN, INC. all plans 018091 PRSMEDD
H2056 AETNA BETTER HEALTH OF MICHIGAN INC. all plans 610502 MEDDAET
H2064 GEISINGER COMMUNITY HEALTH SERVICES all plans 015574 ASPROD1
H2108 BRAVO HEALTH MID-ATLANTIC, INC. all plans 017010 CIHSCARE
H2109 THE JOHNS HOPKINS HEALTH SYSTEM CORPORATION all plans 004336 MEDDADV
H2120 SECURITYCARE OF TENNESSEE, INC. all plans 610014 MEDDPRIME
H2134 WESTERN SKY COMMUNITY CARE, INC. all plans 004336 MEDDADV
H2150 KAISER FNDN HP OF THE MID-ATLANTIC STS all plans 011859 MACMS
H2161 UPPER PENINSULA HEALTH PLAN, LLC all plans 012353 07187182
H2162 WELLCARE OF NEW HAMPSHIRE, INC. all plans 004336 MEDDADV
H2168 VILLAGE SENIOR SERVICES CORPORATION all plans 015574 ASPROD1
H2171 CARE N' CARE INSURANCE COMPANY, INC. all plans 012312 PARTD
H2172 KAISER FDTN HLTH PLAN OF THE MID-ATLANTIC STATES 001, 002, 004, 006, 008, 009, 010, 801, 803, 804 011859 MACMSA
H2172 KAISER FDTN HLTH PLAN OF THE MID-ATLANTIC STATES 003 011859 MASMSA
H2174 TRILLIUM COMMUNITY HEALTH PLAN all plans 004336 MEDDADV
H2185 LIFEWORKS ADVANTAGE, LLC all plans 610602 NVTD
H2218 HARBOR HEALTH SERVICES, INC. all plans 999999 9999999999
H2219 FALLON COMMUNITY HEALTH PLAN all plans 004336 MEDDADV
H2220 UPHAMS CORNER HEALTH COMMITTEE, INC. all plans 000000 000000
H2221 CAMBRIDGE PUBLIC HEALTH COMMISSION all plans 018091 018091
H2222 ELEMENT CARE, INC. all plans 000000 000000
H2223 ELDER SVC PLN/E BOSTON HEALTH CENTER all plans 000000 000000
H2224 SENIOR WHOLE HEALTH, LLC all plans 003858 MD
H2225 COMMONWEALTH CARE ALLIANCE, INC. all plans 610602 NVTD
H2226 UNITEDHEALTHCARE INSURANCE COMPANY all plans 610097 9999
H2228 UNITEDHEALTHCARE INSURANCE COMPANY 022 610097 999
H2228 UNITEDHEALTHCARE INSURANCE COMPANY 001, 002, 010, 011, 013, 016, 017, 018, 019, 020, 021, 023, 024, 029, 030, 031, 032, 035, 036, 037, 039, 041, 042, 043, 044, 045, 046, 047, 048, 049, 064, 065, 066, 067, 068, 071, 074, 075, 076, 077, 078, 079, 080, 081, 082, 083, 084, 085, 086, 805, 808, 809, 811, 812, 813, 814, 816, 817, 819, 820, 821, 823, 824, 825, 826, 827, 828, 829, 831, 832, 833, 834, 835 610097 9999
H2230 BCBS OF MASSACHUSETTS HMO BLUE, INC. all plans 003858 MD
H2235 BAYCARE SELECT HEALTH PLANS, INC. all plans 015574 ASPROD1
H2237 INDEPENDENT CARE HEALTH PLAN, INC. all plans 015574 ASPROD1
H2241 GOLDEN STATE MEDICARE HEALTH PLAN all plans 610097 9999
H2247 UNITEDHEALTHCARE COMMUNITY PLAN, INC. all plans 610097 9999
H2256 TUFTS ASSOCIATED HEALTH MAINTENANCE ORGANIZATION all plans 004336 MEDDADV
H2261 BCBS OF MASSACHUSETTS HMO BLUE, INC. all plans 003858 MD
H2288 BRIGHT HEALTH INSURANCE COMPANY OF NEW YORK all plans 012312 PARTD
H2292 OXFORD HEALTH INSURANCE, INC. all plans 610097 9999
H2318 PACE SOUTHEAST MICHIGAN all plans 018091 PRSMEDD
H2320 PRIORITY HEALTH all plans 003858 MD
H2322 ALLIANCE HEALTH AND LIFE INSURANCE COMPANY all plans 610014 MEDDPRIME
H2334 EON HEALTH, INC. (SC) all plans 610011 CTRXMEDD


The above chart is the first page of the 2020 Medicare Part D pharmacy BIN and PCN list (E0654 - H2334).

Click here for the second page (H2354 - H4093), third page (H4094 - H6293) , fourth page (H6306 - H9431) and fifth page (H9438 - S9701).






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Tips & Disclaimers
  • The Medicare Advantage and Medicare Part D prescription drug plan data on our site comes directly from Medicare and is subject to change.
  • Medicare has neither reviewed nor endorsed the information on our site.
  • We provide our Q1Medicare.com site for educational purposes and strive to present unbiased and accurate information. However, Q1Medicare is not intended as a substitute for your lawyer, doctor, healthcare provider, financial advisor, or pharmacist. For more information on your Medicare coverage, please be sure to seek legal, medical, pharmaceutical, or financial advice from a licensed professional or telephone Medicare at 1-800-633-4227.
  • We are an independent education, research, and technology company. We are not affiliated with any Medicare plan, plan carrier, healthcare provider, or insurance company. We are not compensated for Medicare plan enrollments. We do not sell leads or share your personal information.
  • Benefits, formulary, pharmacy network, provider network, premium and/or co-payments/co-insurance may change on January 1 of each year. Our PDP-Compare.com and MA-Compare.com provide highlights of annual plan benefit changes.
  • The benefit information provided is a brief summary, not a complete description of benefits. For more information contact the plan.
  • Limitations, copayments, and restrictions may apply.
  • We make every effort to show all available Medicare Part D or Medicare Advantage plans in your service area. However, since our data is provided by Medicare, it is possible that this may not be a complete listing of plans available in your service area. For a complete listing please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.
  • When enrolling in a Medicare Advantage plan, you must continue to pay your Medicare Part B premium.
  • Medicare beneficiaries with higher incomes may be required to pay both a Medicare Part B and Medicare Part D Income Related Monthly Adjustment Amount (IRMAA). Read more on IRMAA.
  • Medicare Advantage plans that include prescription drug coverage (MAPDs) are considered Medicare Part D plans and members with higher incomes may be subject to the Medicare Part D Income Related Monthly Adjustment Amount (IRMAA), just as members in stand-alone Part D plans. In certain situations, you can appeal IRMAA.
  • You must be enrolled in both Medicare Part A and Part B to enroll in a Medicare Advantage plan. Members may enroll in a Medicare Advantage plan only during specific times of the year. Contact the Medicare plan for more information.
  • If you are enrolled in a Medicare plan with Part D prescription drug coverage, you may be eligible for financial Extra Help to assist with the payment of your prescription drug premiums and drug purchases. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week or consult www.medicare.gov; the Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call, 1-800-325-0778; or your state Medicaid Office.
  • Medicare evaluates plans based on a 5-Star rating system. Star Ratings are calculated each year and may change from one year to the next.
  • A Medicare Advantage Private Fee-for-Service plan (PFFS) is not a Medicare supplement plan. Providers who do not contract with the plan are not required to see you except in an emergency.
  • Disclaimer for Institutional Special Needs Plan (SNP): This plan is available to anyone with Medicare who meets the Skilled Nursing Facility (SNF) level of care and resides in a nursing home.
  • Disclaimer for Dual Eligible (Medicare/Medicaid) Special Needs Plan (SNP): This plan is available to anyone who has both Medical Assistance from the State and Medicare. Premiums, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for further details.
  • Disclaimer for Chronic Condition Special Needs Plan (SNP): This plan is available to anyone with Medicare who has been diagnosed with the plan specific Chronic Condition.
  • Medicare MSA Plans combine a high deductible Medicare Advantage Plan and a trust or custodial savings account (as defined and/or approved by the IRS). The plan deposits money from Medicare into the account. You can use this money to pay for your health care costs, but only Medicare-covered expenses count toward your deductible. The amount deposited is usually less than your deductible amount, so you generally have to pay out-of-pocket before your coverage begins.
  • Medicare MSA Plans do not cover prescription drugs. If you join a Medicare MSA Plan, you can also join any separate (stand-alone) Medicare Part D prescription drug plan
  • There are additional restrictions to join an MSA plan, and enrollment is generally for a full calendar year unless you meet certain exceptions. Those who disenroll during the calendar year will owe a portion of the account deposit back to the plan. Contact the plan provider for additional information.
  • Medicare beneficiaries may enroll through the CMS Medicare Online Enrollment Center located at www.medicare.gov.
  • Medicare beneficiaries can file a complaint with the Centers for Medicare & Medicaid Services by calling 1-800-MEDICARE 24 hours a day/7 days or using the medicare.gov site. Beneficiaries can appoint a representative by submitting CMS Form-1696.