2016 Medicare Advantage and Prescription Drug Plans Offered by Blue Cross and Blue Shield Companies

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1 S E N I O R M A R K E T S 2016 Medicare Advantage and Prescription Drug Plans Offered by Blue Cross Companies Updated November 2015 Association is an association of independent Blue Cross companies. W /14

2 2016 Medicare Advantage Plans Offered by Blue Cross Companies Key: = Preferred Provider Organization = Health Maintenance Organization PFFS = Private Fee-For-Service Cost = Cost Contract SNP = Special Needs Plan MSA = Medical Savings Account with Point-Of-Service Option Medicare Advantage plans must include the Medicare prescription drug coverage in at least one of their MA benefit options (except for private fee for service and cost plans where it is optional). s and SNPs must offer drug coverage in all of their options. Blue Cross Blue Shield of Alabama Blue Advantage Complete Alabama Blue Shield of Alabama Blue Advantage Premier of Arizona Advantage Blue Medicare Advantage Classic Arizona of Arizona Advantage Blue Medicare Advantage Plus of Arizona Advantage Blue Medicare Advantage Premier Arkansas Blue Cross Medi-Pak Advantage Arkansas Arkansas Blue Cross Medi-Pak Advantage Arkansas Blue Cross Medi-Pak Advantage (PFFS) Anthem MediBlue Access () Anthem MediBlue Plus California Anthem MediBlue Select Anthem MediBlue Dual Advantage 2/14

3 2016 Medicare Advantage Plans Offered by Blue Cross Companies (continued) Blue Cross California (cont.) Anthem MediBlue Corrdination Plus Blue Shield of California Blue Shield 65 Plus Blue Shield of California Blue Shield 65 Plus Choice Plan Colorado and Blue Shield and Blue Shield Anthem MediBlue Plus Anthem MediBlue Plus Connecticut Anthem MediBlue Select Anthem Dual Advantage BlueMedicare ( ) BlueMedicare (Health Options, Inc.) BlueMedicare ( Preferred ) BlueMedicare Preferred ( Preferred ) BlueMedicare Preferred (SNP) Florida (Capital Health Plan) (Capital Health Plan) Capital Health Plan Advantage Plus Capital Health Plan Preferred Advantage (Florida Health Care Plans) Medvantage Rx (Florida Health Care Plans) Medvantage (Florida Health Care Plans) Medvantage Rx Plus (Florida Health Care Plans) Premier (Florida Health Care Plans) Premier Plus of Georgia BCBSHP MediBlue Plus Georgia of Georgia of Georgia BCBSHP MediBlue Prime Select BCBSGA MediBlue Access () of Georgia BCBSHP Dual Advantage 3/14

4 2016 Medicare Advantage Plans Offered by Blue Cross Companies (continued) Blue Cross Hawaii Blue Cross of Hawaii (Hawaii Medical Service Association) Blue Cross of Hawaii (Hawaii Medical Service Association) Blue Cross of Hawaii Akamai Advantage Standard Akamai Advantage Standard Plus Akamai Advantage Complete Blue Cross of Hawaii Akamai Advantage Complete Plus Blue Cross of Hawaii Akamai Advantage Dual Care (-SNP) Blue Cross of Idaho Secure Blue Blue Cross of Idaho True Blue Blue Cross of Idaho True Blue Special Needs Plan Blue Cross of Idaho True Blue Idaho Illinois of Idaho of Idaho of Idaho of Idaho of Idaho Blue Shield of Illinois Blue Shield of Illinois Blue Shield of Illinois Blue Shield of Illinois Blue Shield of Illinois Blue Shield of Illinois Regence MedAdvantage Basic Regence MedAdvantage +R Classic Regence MedAdvantage +R Enhanced Regence Blue MedAdvantage Regence Blue MedAdvantage Plus Basic Basic Plus Premier Plus Blue Medicare Advantage Choice Plus Choice Premier Anthem MediBlue Access ( ) Indiana Anthem MediBlue Access () Anthem MediBlue Plus 4/14

5 2016 Medicare Advantage Plans Offered by Blue Cross Companies (continued) Blue Cross Anthem MediBlue Access ( ) Kentucky Anthem MediBlue Access () Anthem MediBlue Plus Louisiana Louisiana, Inc. Blue Advantage Anthem MediBlue Access () Maine Anthem MediBlue Plus of Massachusetts Medicare Blue PlusRx ( ) of Massachusetts Medicare Blue SaverRx Massachusetts of Massachusetts of Massachusetts Medicare Blue ValueRx Medicare Blue PlusRx of Massachusetts Medicare Blue ValueRx of Massachusetts Medicare Blue FlexRx ( ) of Michigan Medicare Plus Blue Assure of Michigan Medicare Plus Blue Essential of Michigan Medicare Plus Blue Signature of Michigan Medicare Plus Blue Vitality Blue Care Network ( of Michigan) BCN Advantage MyChoice Wellness Michigan Blue Care Network ( of Michigan) Blue Care Network ( of Michigan) Blue Care Network ( of Michigan) Blue Care Network ( of Michigan) Blue Care Network ( of Michigan) Blue Cross of Minnesota BCN Advantage Basic BCN Advantage Classic BCN Advantage Elements BCN Advantage Prestige BCN Advantage ConnectedCare Platinum Blue with Rx (Cost) Minnesota Blue Cross of Minnesota Platinum Blue (Cost) Blue Cross of Minnesota SecureBlue (SNP) 5/14

6 2016 Medicare Advantage Plans Offered by Blue Cross Companies (continued) Blue Cross Anthem MediBlue Access () Missouri Anthem MediBlue Plus Blue Cross of Kansas City Blue Medicare Advantage Complete Blue Cross of Kansas City Blue Medicare Advantage Plus Blue Cross of Montana Choice Plus Montana Blue Cross of Montana Choice Premier Blue Cross of Montana Basic New Hampshire Anthem Medicare Preferred Premier Anthem MediBlue Select Horizon of New Jersey Horizon Medicare Blue Value Horizon of New Jersey Horizon Medicare Blue Value w/ Rx New Jersey Horizon of New Jersey Horizon Medicare Blue Choice w/rx Horizon of New Jersey Horizon Medicare Blue Patient- Centered w/rx Horizon of New Jersey Blue Cross of Blue Cross of Horizon Medicare Blue Choice Plus Lovelace Medicare Plan Enhanced Blue Cross of Blue Cross of Lovelace Medicare Plan Basic Blue Cross of Premier Blue Cross of Dual Care (SNP) BlueCross BlueShield of Western Forever Blue Medicare New York and BlueShield of Northeastern New York BlueCross BlueShield of Western Forever Blue Medicare Value New York and BlueShield of Northeastern New York BlueCross BlueShield of Western New York and BlueShield of Senior Blue Northeastern New York BlueCross BlueShield of Western New York Senior Blue Select BlueShield of Northeastern New York Senior Blue 650 New York and Blue Shield Anthem MediBlue Access ( ) and Blue Shield Anthem MediBlue Plus 6/14

7 2016 Medicare Advantage Plans Offered by Blue Cross Companies (continued) Blue Cross and Blue Shield Anthem MediBlue Core and Blue Shield Excellus BlueCross BlueShield Medicare Bassett Excellus BlueCross BlueShield Medicare Blue Excellus BlueCross BlueShield Medicare Blue Choice Blue Cross of North Carolina Blue Medicare Enhanced Blue Cross of North Carolina Blue Medicare Essential North Carolina Blue Cross of North Carolina Blue Cross of North Carolina Blue Medicare Standard Blue Medicare Enhanced Blue Cross of North Carolina Blue Medicare Medical Only Anthem MediBlue Access ( ) Anthem MediBlue Access Core ( ) Anthem MediBlue Access Enhanced () Ohio Anthem MediBlue Access () Anthem MediBlue Plus Anthem MediBlue Essential Blue Cross of Oklahoma Choice Plus Oklahoma Blue Cross of Oklahoma Blue Cross of Oklahoma Blue Cross of Oklahoma Blue Cross Medicare Advantage Basic Blue Cross Medicare Advantage Premier Plus ( ) Basic Blue Cross of Oklahoma Premier Plus Regence BlueCross BlueShield of Oregon Regence MedAdvantage Basic Oregon Regence BlueCross BlueShield of Oregon Regence BlueCross BlueShield of Oregon Regence MedAdvantage +R Enhanced Regence MedAdvantage + R Classic Regence BlueCross BlueShield of Oregon Regence BlueAdvantage 7/14

8 2016 Medicare Advantage Plans Offered by Blue Cross Companies (continued) Blue Cross Capital BlueCross SeniorBlue Capital BlueCross SeniorBlue Highmark Inc. Freedom Blue Highmark Inc. Security Blue Pennsylvania Highmark Inc. Community Blue Medicare Independence Blue Cross PersonalChoice65 Independence Blue Cross Keystone65 Preferred Independence Blue Cross Keystone65 Select Independence Blue Cross Keystone65 Focus Independence Blue Cross Keystone VIP Choice (SNP) Triple-S Advantage Óptimo Triple-S Advantage Óptimo Plus Triple-S Advantage Óptimo Advance Triple-S Advantage Basic Puerto Rico Triple-S Advantage Royal Triple-S Advantage Royal Plus Triple-S Advantage Classic Triple-S Advantage Vital Plus Triple-S Advantage Platino Plus Blue Cross & Blue Shield of Rhode Island BlueCHiP for Medicare Core Blue Cross & Blue Shield of Rhode Island BlueCHiP for Medicare Advance Blue Cross & Blue Shield of Rhode Island BlueCHiP for Medicare Plus Rhode Island Blue Cross & Blue Shield of Rhode Island BlueCHiP for Medicare Standard with Drugs Blue Cross & Blue Shield of Rhode Island BlueCHiP for Medicare Extra Blue Cross & Blue Shield of Rhode Island BlueCHiP for Medicare Preferred Blue Cross & Blue Shield of Rhode Island BlueCHiP for Medicare Value 8/14

9 2016 Medicare Advantage Plans Offered by Blue Cross Companies (continued) Blue Cross Tennessee Texas Utah Virginia Washington BlueCross BlueShield of Tennessee, Inc. Volunteer Health Plan (BlueCross BlueShield of Tennessee, Inc.) SecurityCare of Tennessee, Inc. (BlueCross BlueShield of Tennessee, Inc.) SecurityCare of Tennessee, Inc. (BlueCross BlueShield of Tennessee, Inc.) Blue Shield of Texas Blue Shield of Texas Blue Shield of Texas Blue Shield of Texas Blue Shield of Texas Regence BlueCross BlueShield of Utah Regence BlueCross BlueShield of Utah Regence BlueCross BlueShield of Utah Regence BlueCross BlueShield of Utah Premera Blue Cross Premera Blue Cross Premera Blue Cross West Virginia Highmark Inc. Wisconsin BlueAdvantage BlueCare Plus Tennessee ( SNP) BlueChoice BlueChoice Plus Choice Plus Choice Premier Blue Cross Advantage Basic Premier Dual Care Regence MedAdvantage Basic Regence MedAdvantage +R Classic Regence MedAdvantage +R Enhanced Regence BlueAdvantage Anthem MediBlue Access () Premera Blue Cross Medicare Advantage Premera Blue Cross Medicare Advantage Plus Premera Blue Cross Medicare Advantage Regence MedAdvantage Basic Regence MedAdvantage +R Classic Regence BlueAdvantage Freedom Blue Anthem MediBlue Access () Anthem MediBlue Plus Anthem MediBlue Plus 9/14

10 2015 Standalone Prescription Drug Plans by Offered by Blue Cross Companies Standalone Prescription Drug Plan (PDP) Blue Cross Alabama Blue Cross of Alabama BlueRx Option I BlueRx Option II Arizona of Arizona Blue MedicareRx Enhanced Blue MedicareRx Value Arkansas Arkansas Blue Cross MediPak Rx Basic Arkansas Blue Cross MediPak Rx Premier MedicareRx Gold MedicareRx Plus California MedicareRx Standard Blue Shield of California Blue Shield Medicare Basic Plan Blue Shield Medicare Enhanced Plan Colorado Connecticut Blue MedicareRx Value Plus Blue MedicareRx Premier Florida BlueMedicare Rx Option 1 BlueMedicare Rx Option 2 BCBSGa Blue MedicareRx Plus Georgia Blue Cross of Georgia BCBSGa Blue MedicareRx Premier BCBSGa Blue MedicareRx Standard 10/14

11 2016 Standalone Prescription Drug Plans by Offered by Blue Cross Companies (continued) Standalone Prescription Drug Plan (PDP) Blue Cross Hawaii Blue Cross of Hawaii Medicare Rx (EGWP only) Regence Medicare Script Basic Idaho of Idaho Regence Medicare Script Enhanced Blue Cross MedicareRx Basic Illinois Blue Cross of Illinois Blue Cross MedicareRx Plus Blue Cross MedicareRx Value Indiana Iowa Wellmark Blue Cross of Iowa Medicare Blue Rx Standard Medicare Blue Rx Premier Blue MedicareRx Plus Kansas Blue Cross of Kansas Blue MedicareRx Premier Blue MedicareRx Value Kentucky Maine Blue MedicareRx Premier Massachusetts of Massachusetts Blue MedicareRx Value Plus 11/14

12 2016 Standalone Prescription Drug Plans by Offered by Blue Cross Companies (continued) Standalone Prescription Drug Plan (PDP) Blue Cross Prescription Blue Option A Michigan of Michigan Prescription Blue Option B MedicareBlue Rx Standard Minnesota Blue Cross of Minnesota Medicare Blue Rx Premier Blue MedicareRx Plus Missouri Blue MedicareRx Premier Blue MedicareRx Value MedicareBlue Rx Standard Montana Blue Cross of Montana MedicareBlue Rx Premier MedicareBlue Rx Standard Nebraska Blue Cross of Nebraska MedicareBlue Rx Premier Nevada New Hampshire New Jersey Horizon of New Jersey Horizon Medicare Blue Rx Standard Horizon Medicare Blue Rx Enhanced Blue Cross MedicareRx Basic Blue Cross of Blue Cross MedicareRx Plus Blue Cross MedicareRx Value 12/14

13 2016 Standalone Prescription Drug Plans by Offered by Blue Cross Companies (continued) Standalone Prescription Drug Plan (PDP) Blue Cross North Carolina Blue Cross of North Carolina Blue Medicare Rx Standard Blue Medicare R Enhanced MedicareBlue Rx Standard North Dakota of North Dakota MedicareBlue Rx Premier Ohio Blue Cross MedicareRx Basic Oklahoma Blue Cross of Oklahoma Blue Cross MedicareRx Plus Blue Cross MedicareRx Value Pennsylvania Highmark Inc. Blue Rx Rhode Island Blue Cross & Blue Shield of Rhode Island Blue MedicareRx Value Plus Blue MedicareRx Premier South Carolina BlueCross BlueShield of South Carolina Blue Cross Rx Value BlueCross Rx Plus South Dakota Wellmark of South Dakota MedicareBlue Rx Standard MedicareBlue Rx Premier Blue Cross MedicareRx Basic Texas Blue Cross of Texas Blue Cross MedicareRx Plus Blue Cross MedicareRx Value Utah Regence BlueCross BlueShield of Utah Regence Medicare Script Basic Regence Medicare Script Enhanced Vermont Blue Cross of Vermont Blue MedicareRx Value Plus Blue MedicareRx Premier 13/14

14 2016 Standalone Prescription Drug Plans by Offered by Blue Cross Companies (continued) Standalone Prescription Drug Plan (PDP) Blue Cross Virginia West Virginia Highmark Inc. Blue Rx Wisconsin Wyoming of Wyoming MedicareBlue Rx Standard MedicareBlue Rx Premier 14/14

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