2021 UnitedHealthcare Medicare Advantage Plan Availability

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Proprietary information of UnitedHealth Group. For Agent use only. Not intended for use as marketing material for the general public. Do not distribute or reproduce any portion without the express permissions of UnitedHealth Group.

2021 UnitedHealthcare Medicare Advantage Plan Availability: National Network, Passport or Neither?

Plan ID State(s) Plan Type Plan Name SNP Type National Network, Passport or

Neither? H0169-001-000 IA HMO UnitedHealthcare Dual Complete Dual Neither H0169-002-000 MO HMO UnitedHealthcare Dual Complete Dual Neither H0169-003-000 NE HMO UnitedHealthcare Dual Complete Dual Neither H0169-004-000 KS HMOPOS UnitedHealthcare Dual Complete LP1 Dual Neither H0251-002-000 TN HMO UnitedHealthcare Dual Complete Dual Neither H0251-004-000 TN HMO UnitedHealthcare Dual Complete ONE Dual Neither H0251-005-000 TN HMO UnitedHealthcare Dual Complete ONE Plus Dual Neither H0271-002-000 ID Local PPO UnitedHealthcare Medicare Advantage

Assure Not SNP Neither

H0271-003-000 UT Local PPO UnitedHealthcare Medicare Advantage Assure

Not SNP Neither

H0271-004-000 IL Local PPO UnitedHealthcare Medicare Advantage Assure

Not SNP Neither

H0271-005-000 IN Local PPO UnitedHealthcare Dual Complete Dual Neither H0271-006-000 ME Local PPO UnitedHealthcare Dual Complete Dual Neither H0271-007-000 NH Local PPO UnitedHealthcare Medicare Advantage


H0271-008-000 AZ Local PPO UnitedHealthcare Medicare Advantage Assure

Not SNP Neither

H0271-010-000 NM Local PPO UnitedHealthcare Medicare Advantage Assure

Not SNP Neither

H0271-011-000 NM Local PPO UnitedHealthcare Medicare Advantage Assure

Not SNP Neither

H0271-012-000 VT Local PPO UnitedHealthcare Medicare Advantage Assure

Not SNP Neither

H0271-013-000 WV Local PPO UnitedHealthcare Dual Complete Dual Neither H0271-014-000 CT Local PPO UnitedHealthcare Dual Complete Dual Neither H0271-016-000 SC Local PPO UnitedHealthcare Dual Complete Dual Neither H0271-017-000 ND Local PPO UnitedHealthcare Medicare Advantage


H0271-018-000 SD Local PPO UnitedHealthcare Medicare Advantage Assure

Not SNP Neither

H0271-019-000 IL Local PPO UnitedHealthcare Medicare Advantage Assure

Not SNP Neither

H0271-020-000 ME Local PPO UnitedHealthcare Dual Complete Dual Neither H0271-022-000 OR Local PPO UnitedHealthcare Medicare Advantage


H0294-002-000 WI Local PPO UnitedHealthcare Medicare Advantage Assist

Chronic National Network

H0294-004-000 WI Local PPO AARP Medicare Advantage Open Plan 1 Not SNP National Network

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Neither? H0294-010-000 WI Local PPO UnitedHealthcare Medicare Advantage

Assist Chronic National Network

H0294-011-000 WI Local PPO AARP Medicare Advantage Open Not SNP National Network H0294-012-000 WI Local PPO AARP Medicare Advantage Open Premier Not SNP National Network H0294-014-000 WI Local PPO AARP Medicare Advantage Patriot Plan 1 Not SNP National Network H0294-015-000 WI Local PPO AARP Medicare Advantage Walgreens Not SNP National Network H0294-016-000 WI Local PPO AARP Medicare Advantage Open Plan 2 Not SNP National Network H0294-017-000 MI Local PPO AARP Medicare Advantage Open Not SNP National Network H0321-002-000 AZ HMO UnitedHealthcare Dual Complete LP Dual Neither H0321-004-000 AZ HMO UnitedHealthcare Dual Complete ONE Dual Neither H0432-001-000 AL HMO AARP Medicare Advantage Plan 1 Not SNP National Network H0432-002-000 AL HMO AARP Medicare Advantage Plan 2 Not SNP National Network H0432-003-000 AL HMO AARP Medicare Advantage Plan 1 Not SNP National Network H0432-004-000 AL HMO AARP Medicare Advantage Plan 2 Not SNP National Network H0432-009-000 AL HMO UnitedHealthcare Dual Complete Plan 1 Dual Neither H0432-010-000 AL HMO AARP Medicare Advantage Walgreens Not SNP National Network H0432-012-000 AL HMO AARP Medicare Advantage Patriot Not SNP National Network H0543-001-000 CA HMO AARP Medicare Advantage SecureHorizons

Plan 1 Not SNP Neither

H0543-013-000 CA HMO AARP Medicare Advantage SecureHorizons Value

Not SNP Neither

H0543-019-000 CA HMO AARP Medicare Advantage SecureHorizons Not SNP Neither H0543-022-000 CA HMO AARP Medicare Advantage SecureHorizons Not SNP Neither H0543-028-000 CA HMO AARP Medicare Advantage SecureHorizons


H0543-029-000 CA HMO AARP Medicare Advantage SecureHorizons Not SNP Neither H0543-032-000 CA HMO AARP Medicare Advantage SecureHorizons




H0543-060-000 CA HMO AARP Medicare Advantage SecureHorizons Premier

Not SNP Neither

H0543-070-000 CA HMO AARP Medicare Advantage SecureHorizons Plan 1

Not SNP Neither

H0543-086-000 CA HMO AARP Medicare Advantage SecureHorizons Not SNP Neither H0543-089-000 CA HMO AARP Medicare Advantage SecureHorizons Not SNP Neither H0543-121-000 CA HMO AARP Medicare Advantage Patriot Not SNP Neither H0543-138-000 CA HMO AARP Medicare Advantage SecureHorizons


H0543-140-000 CA HMO AARP Medicare Advantage SecureHorizons Not SNP Neither

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Neither? H0543-144-000 CA HMO AARP Medicare Advantage SecureHorizons


H0543-145-000 CA HMO Sharp SecureHorizons Plan by UnitedHealthcare

Not SNP Neither

H0543-146-000 CA HMO AARP Medicare Advantage SecureHorizons Focus

Not SNP Neither


Not SNP Neither




Not SNP Neither

H0543-153-000 CA HMO UnitedHealthcare Medicare Advantage Assure

Not SNP Neither


Not SNP Neither


Not SNP Neither


Not SNP Neither


Not SNP Neither


Not SNP Neither


Not SNP Neither


Not SNP Neither


Not SNP Neither


Not SNP Neither


Not SNP Neither


Not SNP Neither

H0543-175-000 CA HMO AARP Medicare Advantage SecureHorizons Not SNP Neither H0543-176-000 CA HMO AARP Medicare Advantage SecureHorizons Not SNP Neither H0543-177-000 CA HMO AARP Medicare Advantage SecureHorizons Not SNP Neither H0543-178-000 CA HMO AARP Medicare Advantage SecureHorizons Not SNP Neither

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Neither? H0543-179-000 CA HMO AARP Medicare Advantage SecureHorizons Not SNP Neither H0543-183-000 CA HMO UnitedHealthcare Medicare Advantage



Not SNP Neither

H0543-188-000 CA HMO UnitedHealthcare Canopy Health Medicare Advantage

Not SNP Neither


Not SNP Neither


Not SNP Neither


Not SNP Neither

H0543-194-000 CA HMO AARP Medicare Advantage SecureHorizons Not SNP Neither H0543-195-000 CA HMO AARP Medicare Advantage SecureHorizons Not SNP Neither H0543-196-000 CA HMO AARP Medicare Advantage SecureHorizons

Focus Not SNP Neither


Not SNP Neither

H0543-204-000 CA HMO AARP Medicare Advantage Walgreens Not SNP Neither H0543-205-000 CA HMO UnitedHealthcare Canopy Health Medicare

Advantage Not SNP Neither


Not SNP Neither

H0543-210-000 CA HMOPOS AARP Medicare Advantage Freedom Plus Not SNP Neither H0543-214-000 CA HMO UnitedHealthcare Chronic Complete Focus Chronic Neither H0543-215-000 CA HMOPOS AARP Medicare Advantage Freedom Plus Not SNP Neither H0543-216-000 CA HMOPOS AARP Medicare Advantage Freedom Plus Not SNP Neither H0609-007-000 CO HMO AARP Medicare Advantage SecureHorizons


H0609-012-000 CO HMO AARP Medicare Advantage SecureHorizons Plan 2

Not SNP Neither

H0609-018-000 CO HMO AARP Medicare Advantage Patriot Not SNP Neither H0609-025-000 AZ HMO AARP Medicare Advantage Not SNP Passport H0609-026-000 AZ HMO AARP Medicare Advantage Plan 1 Not SNP Passport H0609-027-000 AZ HMO AARP Medicare Advantage Plan 2 Not SNP Passport H0609-028-000 NV HMO AARP Medicare Advantage Not SNP Neither H0609-031-000 NV HMO AARP Medicare Advantage Premier Not SNP Neither H0609-032-000 NV HMO UnitedHealthcare Medicare Advantage

Focus Not SNP Neither

H0609-033-000 NV HMO AARP Medicare Advantage Plan 1 Not SNP Neither

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Neither? H0609-034-001 CO HMO AARP Medicare Advantage SecureHorizons



Not SNP Neither


Not SNP Neither


Not SNP Neither

H0609-037-000 NV HMO UnitedHealthcare Medicare Advantage Assist

Chronic Neither

H0609-038-000 NV HMO AARP Medicare Advantage Walgreens Plan 1

Not SNP Neither

H0609-040-000 NV HMO AARP Medicare Advantage Plan 2 Not SNP Neither H0609-041-000 CO HMO AARP Medicare Advantage Patriot Not SNP Neither H0624-001-000 CO HMO UnitedHealthcare Dual Complete Dual Neither H0710-004-000 AL, FL, MS,

TN Local PPO UnitedHealthcare Nursing Home Plan Institutional Neither

H0710-005-000 AZ Local PPO UnitedHealthcare Nursing Home Plan Institutional Neither H0710-007-000 CO Local PPO UnitedHealthcare Nursing Home Plan Institutional Neither H0710-008-000 CO Local PPO UnitedHealthcare Assisted Living Plan Institutional Neither H0710-009-000 CT Local PPO UnitedHealthcare Assisted Living Plan Institutional Neither H0710-010-000 FL Local PPO UnitedHealthcare Nursing Home Plan Institutional Neither H0710-012-000 FL Local PPO UnitedHealthcare Assisted Living Plan Institutional Neither H0710-013-000 IN Local PPO UnitedHealthcare Nursing Home Plan Institutional Neither H0710-015-000 ME, NH Local PPO UnitedHealthcare Nursing Home Plan Institutional Neither H0710-016-000 MO Local PPO UnitedHealthcare Nursing Home Plan Institutional Neither H0710-017-000 DE, PA Local PPO UnitedHealthcare Nursing Home Plan 2 Institutional Neither H0710-020-000 TX Local PPO UnitedHealthcare Nursing Home Plan Institutional Neither H0710-026-000 CT, NJ Local PPO UnitedHealthcare Nursing Home Plan Institutional Neither H0710-027-000 OH Local PPO UnitedHealthcare Nursing Home Plan 2 Institutional Neither H0710-030-000 WA Local PPO UnitedHealthcare Assisted Living Plan Institutional Neither H0710-031-000 ID, WA Local PPO UnitedHealthcare Nursing Home Plan Institutional Neither H0710-032-000 MD, VA Local PPO UnitedHealthcare Nursing Home Plan 2 Institutional Neither H0710-033-000 GA Local PPO UnitedHealthcare Nursing Home Plan 2 Institutional Neither H0710-034-000 NC Local PPO UnitedHealthcare Nursing Home Plan Institutional Neither H0710-035-000 RI Local PPO UnitedHealthcare Nursing Home Plan 2 Institutional Neither H0710-036-000 OR Local PPO UnitedHealthcare Nursing Home Plan 2 Institutional Neither H0710-037-000 OR Local PPO UnitedHealthcare Assisted Living Plan 2 Institutional Neither H0710-038-000 FL Local PPO UnitedHealthcare Nursing Home Plan Institutional Neither H0710-039-000 IL Local PPO UnitedHealthcare Nursing Home Plan 2 Institutional Neither H0710-041-000 MN Local PPO UnitedHealthcare Nursing Home Plan Institutional Neither

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Neither? H0710-042-000 WI Local PPO UnitedHealthcare Assisted Living Plan Institutional Neither H0710-043-000 WI Local PPO UnitedHealthcare Nursing Home Plan 2 Institutional Neither H0710-046-000 IA Local PPO UnitedHealthcare Nursing Home Plan Institutional Neither H0710-047-000 MN Local PPO UnitedHealthcare Assisted Living Plan Institutional Neither H0710-049-000 NH Local PPO UnitedHealthcare Assisted Living Plan Institutional Neither H0710-050-000 RI Local PPO UnitedHealthcare Assisted Living Plan 2 Institutional Neither H0710-051-000 UT Local PPO UnitedHealthcare Nursing Home Plan Institutional Neither H0710-052-000 OK Local PPO UnitedHealthcare Nursing Home Plan Institutional Neither H0710-053-000 SC Local PPO UnitedHealthcare Nursing Home Plan Institutional Neither H0755-030-000 CT HMO UnitedHealthcare Medicare Advantage

Plan 1 Not SNP National Network

H0755-031-000 CT HMO UnitedHealthcare Medicare Advantage Plan 2

Not SNP National Network

H0755-032-000 CT HMO UnitedHealthcare Medicare Advantage Patriot


H0755-033-000 CT HMO UnitedHealthcare Medicare Advantage Plan 3


H0755-037-000 NJ HMO AARP Medicare Advantage Patriot Not SNP National Network H0755-038-000 NJ HMO AARP Medicare Advantage Plan 2 Not SNP National Network H0755-040-001 NJ HMO AARP Medicare Advantage Plan 1 Not SNP National Network H0755-040-002 NJ HMO AARP Medicare Advantage Plan 1 Not SNP National Network H0755-041-001 NJ HMO AARP Medicare Advantage Plan 3 Not SNP National Network H0755-041-002 NJ HMO AARP Medicare Advantage Plan 3 Not SNP National Network H0755-042-001 NJ HMO AARP Medicare Advantage Plan 4 Not SNP National Network H0755-042-002 NJ HMO AARP Medicare Advantage Plan 4 Not SNP National Network H1045-001-000 FL HMO Preferred Choice Dade Not SNP Neither H1045-005-000 FL HMO Preferred Choice Broward Not SNP Neither H1045-012-000 FL HMO Preferred Medicare Assist Plan 1 Dual Neither H1045-018-000 FL HMO Preferred Special Care Miami-Dade Chronic Neither H1045-025-000 FL HMO UnitedHealthcare The Villages Medicare

Advantage Not SNP Passport

H1045-026-000 FL HMOPOS AARP Medicare Advantage Not SNP Passport H1045-028-000 FL HMOPOS AARP Medicare Advantage Not SNP Passport H1045-030-000 FL HMOPOS AARP Medicare Advantage Not SNP Passport H1045-031-000 FL HMOPOS AARP Medicare Advantage Not SNP Passport H1045-032-000 FL HMOPOS AARP Medicare Advantage Not SNP Passport H1045-033-000 FL HMO AARP Medicare Advantage Not SNP Passport H1045-034-000 FL HMO AARP Medicare Advantage Plan 2 Not SNP Passport H1045-036-000 FL HMOPOS AARP Medicare Advantage Focus Not SNP Passport H1045-037-000 FL HMO Preferred Choice Palm Beach Not SNP Neither H1045-038-000 FL HMO Preferred Medicare Assist Palm Beach Dual Neither

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Neither? H1045-039-000 FL HMO UnitedHealthcare Dual Complete LP Dual Neither H1045-041-000 FL HMOPOS AARP Medicare Advantage Not SNP Passport H1045-042-000 FL HMOPOS AARP Medicare Advantage Not SNP Passport H1045-043-000 FL HMOPOS AARP Medicare Advantage Not SNP Passport H1045-045-000 FL HMOPOS AARP Medicare Advantage Focus Not SNP Passport H1045-046-000 FL HMO Preferred Complete Care Not SNP Neither H1045-048-001 FL HMO UnitedHealthcare Medicare Advantage

Walgreens Chronic Neither

H1045-048-002 FL HMO UnitedHealthcare Medicare Advantage Walgreens

Chronic Neither


Chronic Neither


Chronic Neither

H1045-053-000 FL HMO Preferred Medicare Assist Plan 2 Dual Neither H1111-009-001 GA HMO AARP Medicare Advantage Walgreens Not SNP National Network H1111-009-002 GA HMO AARP Medicare Advantage Walgreens Not SNP National Network H1278-001-000 IA, NE Local PPO AARP Medicare Advantage Choice Not SNP National Network H1278-003-000 TX Local PPO AARP Medicare Advantage Choice Not SNP National Network H1278-004-000 TX Local PPO AARP Medicare Advantage Walgreens Not SNP National Network H1278-005-000 TX Local PPO AARP Medicare Advantage Choice Not SNP National Network H1278-007-000 IA, NE, SD Local PPO AARP Medicare Advantage Choice Not SNP National Network H1278-009-000 SD Local PPO AARP Medicare Advantage Choice Not SNP National Network H1278-010-000 TX Local PPO AARP Medicare Advantage Choice Not SNP National Network H1278-013-000 TX Local PPO AARP Medicare Advantage Choice Not SNP National Network H1278-014-000 TX Local PPO AARP Medicare Advantage Choice Not SNP National Network H1278-015-000 TX Local PPO AARP Medicare Advantage Choice Not SNP National Network H1278-016-000 TX Local PPO AARP Medicare Advantage Choice Not SNP National Network H1278-018-000 IA, NE Local PPO AARP Medicare Advantage Patriot Not SNP National Network H1278-019-000 IA, NE, SD Local PPO AARP Medicare Advantage Patriot Not SNP National Network H1360-001-000 NV HMO UnitedHealthcare Dual Complete Dual Neither H1375-001-000 CA HMO UnitedHealthcare Dual Complete Dual Neither H1375-002-000 CA HMO UnitedHealthcare Dual Complete Dual Neither H1537-005-000 NY Local PPO UnitedHealthcare Medicare Advantage

Choice Not SNP National Network

H1659-002-000 VA Local PPO UnitedHealthcare Medicare Advantage Choice Plan 1


H1659-003-000 VA Local PPO UnitedHealthcare Medicare Advantage Choice Plan 2


H1821-001-000 WA Local PPO AARP Medicare Advantage Choice Not SNP National Network H1821-002-000 WA Local PPO AARP Medicare Advantage Choice Not SNP National Network

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Neither? H1821-003-000 WA Local PPO AARP Medicare Advantage Choice Not SNP National Network H1889-002-001 FL Local PPO UnitedHealthcare Dual Complete Choice Dual Neither H1889-002-002 FL Local PPO UnitedHealthcare Dual Complete Choice Dual Neither H1944-001-000 MA HMO AARP Medicare Advantage Plan 1 Not SNP National Network H1944-004-000 MA HMO AARP Medicare Advantage Plan 2 Not SNP National Network H1944-005-000 MA HMO AARP Medicare Advantage Plan 1 Not SNP National Network H1944-006-000 MA HMO AARP Medicare Advantage Plan 2 Not SNP National Network H1944-009-000 PA HMO AARP Medicare Advantage Not SNP National Network H1944-010-000 PA HMO AARP Medicare Advantage Plan 1 Not SNP National Network H1944-011-000 PA HMO AARP Medicare Advantage Plan 2 Not SNP National Network H1944-014-000 RI HMOPOS AARP Medicare Advantage Plan 2 Not SNP National Network H1944-015-000 RI HMOPOS AARP Medicare Advantage Patriot Not SNP National Network H1944-016-000 RI HMOPOS AARP Medicare Advantage Plan 1 Not SNP National Network H1944-017-000 NH HMO AARP Medicare Advantage Plan 2 Not SNP National Network H1944-018-000 VT HMO AARP Medicare Advantage Plan 1 Not SNP National Network H1944-024-000 PA HMO AARP Medicare Advantage Not SNP National Network H1944-028-000 VT HMO AARP Medicare Advantage Plan 2 Not SNP National Network H1944-030-000 PA HMO AARP Medicare Advantage Patriot Not SNP National Network H1944-031-000 NH HMO AARP Medicare Advantage Plan 4 Not SNP National Network H1944-032-000 VT HMO AARP Medicare Advantage Plan 3 Not SNP National Network H1961-003-000 LA HMO Peoples Health Secure Health Dual Neither H1961-011-000 LA HMO Peoples Health Secure Choice Dual Neither H1961-014-001 LA HMO Peoples Health Choices 65 Not SNP Neither H1961-014-002 LA HMO Peoples Health Choices 65 Not SNP Neither H1961-014-003 LA HMO Peoples Health Choices 65 Not SNP Neither H1961-014-004 LA HMO Peoples Health Choices 65 Not SNP Neither H1961-017-000 LA HMO Peoples Health Choices Gold Not SNP Neither H1961-018-000 LA HMO Peoples Health Choices Value Not SNP Neither H1961-019-000 LA HMO Peoples Health Secure Complete Dual Neither H2001-001-000 ME Local PPO AARP Medicare Advantage Choice Plan 1 Not SNP National Network H2001-010-000 ME Local PPO AARP Medicare Advantage Choice Plan 2 Not SNP National Network H2001-017-000 UT Local PPO UnitedHealthcare Medicare Advantage


H2001-018-000 ME Local PPO AARP Medicare Advantage Choice Plan 1 Not SNP National Network H2001-019-000 ME Local PPO AARP Medicare Advantage Choice Plan 3 Not SNP National Network H2196-001-000 MS HMO AARP Medicare Advantage Not SNP National Network H2196-002-000 MS HMO AARP Medicare Advantage Not SNP National Network H2226-001-000 MA HMO UnitedHealthcare Senior Care Options Dual Neither H2226-003-000 MA HMO UnitedHealthcare Senior Care Options

NHC Dual Neither

H2228-002-000 RI Local PPO UnitedHealthcare Nursing Home Plan 1 Institutional Neither

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Neither? H2228-010-000 DE, MD, VA Local PPO UnitedHealthcare Nursing Home Plan 1 Institutional Neither H2228-011-000 MD Local PPO UnitedHealthcare Assisted Living Plan Institutional Neither H2228-013-000 GA Local PPO UnitedHealthcare Nursing Home Plan 1 Institutional Neither H2228-016-000 OR Local PPO UnitedHealthcare Nursing Home Plan 1 Institutional Neither H2228-017-000 OR Local PPO UnitedHealthcare Assisted Living Plan 1 Institutional Neither H2228-018-000 NC Local PPO AARP Medicare Advantage Choice Not SNP National Network H2228-019-000 IN Local PPO AARP Medicare Advantage Choice Plan 1 Not SNP National Network H2228-020-000 IN Local PPO AARP Medicare Advantage Focus Not SNP National Network H2228-021-000 IN Local PPO AARP Medicare Advantage Choice Plan 1 Not SNP National Network H2228-022-000 IN Local PPO AARP Medicare Advantage Choice Not SNP National Network H2228-023-000 NM, TX Local PPO AARP Medicare Advantage Choice Not SNP National Network H2228-024-000 HI Local PPO AARP Medicare Advantage Choice Plan 1 Not SNP Passport H2228-025-000 HI Local PPO AARP Medicare Advantage Patriot Not SNP Passport H2228-029-000 OR Local PPO AARP Medicare Advantage Choice Not SNP National Network H2228-030-000 IL, MO Local PPO AARP Medicare Advantage Choice Plan 1 Not SNP National Network H2228-031-000 ID Local PPO AARP Medicare Advantage Choice Plan 1 Not SNP National Network H2228-032-000 ID Local PPO AARP Medicare Advantage Choice Plan 2 Not SNP National Network H2228-035-000 PA Local PPO AARP Medicare Advantage Choice Plan 1 Not SNP National Network H2228-036-000 PA Local PPO AARP Medicare Advantage Choice Plan 2 Not SNP National Network H2228-037-000 PA Local PPO AARP Medicare Advantage Choice Plan 1 Not SNP National Network H2228-039-000 RI Local PPO UnitedHealthcare Assisted Living Plan 1 Institutional Neither H2228-041-000 TX Local PPO UnitedHealthcare Dual Complete Choice

Premier Dual Neither

H2228-043-000 HI Local PPO UnitedHealthcare Dual Complete Dual Neither H2228-044-000 GA Local PPO UnitedHealthcare Dual Complete Dual Neither H2228-045-000 DC Local PPO UnitedHealthcare Dual Complete Dual Neither H2228-047-000 NM Local PPO AARP Medicare Advantage Choice Not SNP National Network H2228-049-000 NM Local PPO AARP Medicare Advantage Choice Not SNP National Network H2228-064-000 IN Local PPO AARP Medicare Advantage Choice Not SNP National Network H2228-065-000 IN Local PPO AARP Medicare Advantage Choice Not SNP National Network H2228-066-000 IN Local PPO AARP Medicare Advantage Choice Not SNP National Network H2228-067-000 HI Local PPO AARP Medicare Advantage Choice Plan 2 Not SNP Passport H2228-068-000 HI Local PPO AARP Medicare Advantage Choice Not SNP Passport H2228-071-000 KS, MO Local PPO AARP Medicare Advantage Choice Plan 1 Not SNP National Network H2228-074-000 AZ Local PPO AARP Medicare Advantage Walgreens Plan

1 Not SNP National Network

H2228-075-000 AZ Local PPO AARP Medicare Advantage Walgreens Plan 1


H2228-076-000 AZ Local PPO AARP Medicare Advantage Choice Plan 1 Not SNP National Network H2228-077-000 AZ Local PPO AARP Medicare Advantage Walgreens Plan


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Neither? H2228-079-000 ID Local PPO AARP Medicare Advantage Walgreens Not SNP National Network H2228-080-000 IN Local PPO AARP Medicare Advantage Choice Plan 2 Not SNP National Network H2228-081-000 IN Local PPO AARP Medicare Advantage Choice Plan 2 Not SNP National Network H2228-082-000 MO Local PPO AARP Medicare Advantage Choice Not SNP National Network H2228-083-000 IL, MO Local PPO AARP Medicare Advantage Walgreens Not SNP National Network H2228-084-000 OR Local PPO AARP Medicare Advantage Walgreens Not SNP National Network H2228-085-000 PA Local PPO AARP Medicare Advantage Choice Plan 2 Not SNP National Network H2228-086-000 PA Local PPO AARP Medicare Advantage Choice Plan 3 Not SNP National Network H2228-088-000 OR Local PPO AARP Medicare Advantage Patriot Not SNP National Network H2228-091-000 IN Local PPO AARP Medicare Advantage Patriot Not SNP National Network H2228-092-000 IN Local PPO AARP Medicare Advantage Choice Premier Not SNP National Network H2228-093-000 DE Local PPO AARP Medicare Advantage Choice Not SNP National Network H2228-094-000 AZ Local PPO AARP Medicare Advantage Choice Plan 2 Not SNP National Network H2228-095-000 AZ Local PPO AARP Medicare Advantage Patriot Not SNP National Network H2228-096-000 AZ Local PPO AARP Medicare Advantage Walgreens Plan


H2228-097-000 AZ Local PPO AARP Medicare Advantage Walgreens Plan 3


H2228-098-000 NM Local PPO AARP Medicare Advantage Patriot Not SNP National Network H2247-001-000 MI HMO UnitedHealthcare Dual Complete Dual Neither H2247-002-000 MI HMO UnitedHealthcare Dual Complete Dual Neither H2292-001-000 NY Local PPO UnitedHealthcare Nursing Home Plan 1 Institutional Neither H2292-002-000 NY Local PPO UnitedHealthcare Nursing Home Plan 1 Institutional Neither H2292-003-000 NY Local PPO UnitedHealthcare Assisted Living Plan Institutional Neither H2406-001-000 OH Local PPO UnitedHealthcare Nursing Home Plan 1 Institutional Neither H2406-008-000 FL Local PPO AARP Medicare Advantage Choice Not SNP National Network H2406-009-000 FL Local PPO AARP Medicare Advantage Choice Not SNP National Network H2406-010-000 FL Local PPO AARP Medicare Advantage Choice Not SNP National Network H2406-011-000 FL Local PPO AARP Medicare Advantage Choice Not SNP National Network H2406-012-000 FL Local PPO AARP Medicare Advantage Choice Not SNP National Network H2406-013-000 FL Local PPO AARP Medicare Advantage Choice Not SNP National Network H2406-014-000 FL Local PPO AARP Medicare Advantage Choice Not SNP National Network H2406-015-000 FL Local PPO AARP Medicare Advantage Choice Not SNP National Network H2406-016-000 FL Local PPO AARP Medicare Advantage Choice Not SNP National Network H2406-017-000 FL Local PPO AARP Medicare Advantage Choice Not SNP National Network H2406-018-000 FL Local PPO AARP Medicare Advantage Choice Not SNP National Network H2406-019-000 FL Local PPO AARP Medicare Advantage Choice Not SNP National Network H2531-001-000 OH MMP

HMO UnitedHealthcare Connected for MyCareOhio

N/A Neither

H2577-001-001 CO Local PPO AARP Medicare Advantage Choice Plan 1 Not SNP National Network H2577-001-002 CO Local PPO AARP Medicare Advantage Choice Plan 1 Not SNP National Network

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Neither? H2577-002-000 CO Local PPO AARP Medicare Advantage Walgreens Not SNP National Network H2577-003-001 CO Local PPO AARP Medicare Advantage Choice Plan 2 Not SNP National Network H2577-003-002 CO Local PPO AARP Medicare Advantage Choice Plan 2 Not SNP National Network H2577-004-000 NC Local PPO AARP Medicare Advantage Choice Not SNP National Network H2577-005-000 SC Local PPO AARP Medicare Advantage Walgreens Not SNP National Network H2577-006-000 SC Local PPO AARP Medicare Advantage Choice Not SNP National Network H2577-007-000 TN Local PPO AARP Medicare Advantage Walgreens Not SNP National Network H2577-008-000 TN Local PPO AARP Medicare Advantage Walgreens Not SNP National Network H2577-009-000 VA Local PPO AARP Medicare Advantage Walgreens Not SNP National Network H2577-011-000 VA Local PPO AARP Medicare Advantage Choice Not SNP National Network H2577-013-000 VA Local PPO AARP Medicare Advantage Walgreens Not SNP National Network H2577-014-000 VA Local PPO AARP Medicare Advantage Choice Not SNP National Network H2577-015-000 VA Local PPO AARP Medicare Advantage Patriot Not SNP National Network H2577-016-000 NC Local PPO AARP Medicare Advantage Choice Not SNP National Network H2577-017-000 NC Local PPO AARP Medicare Advantage Choice Not SNP National Network H2577-018-000 NC Local PPO AARP Medicare Advantage Choice Plan 2 Not SNP National Network H2577-019-000 NC Local PPO AARP Medicare Advantage Patriot Not SNP National Network H2577-020-000 TN Local PPO UnitedHealthcare Medicare Advantage


H2577-021-000 PA Local PPO AARP Medicare Advantage Choice Not SNP National Network H2582-002-000 CO HMO Rocky Mountain Health Plans DualCare

Plus Dual Neither

H2582-004-000 CO HMO Rocky Mountain Health Plans CareAdvantage Value

Not SNP Neither

H2582-005-000 CO HMO Rocky Mountain Health Plans CareAdvantage Enhanced

Not SNP Neither

H2802-001-000 IA, NE HMOPOS AARP Medicare Advantage Not SNP National Network H2802-007-000 IN HMOPOS AARP Medicare Advantage Profile Not SNP Passport H2802-008-000 IN HMOPOS AARP Medicare Advantage Plan 1 Not SNP National Network H2802-010-000 IN HMOPOS AARP Medicare Advantage Plan 1 Not SNP National Network H2802-012-000 IN HMOPOS AARP Medicare Advantage Plan 1 Not SNP National Network H2802-015-000 IN HMOPOS AARP Medicare Advantage Plan 2 Not SNP National Network H2802-016-000 IN HMOPOS AARP Medicare Advantage Plan 1 Not SNP National Network H2802-018-000 IN HMOPOS AARP Medicare Advantage Plan 1 Not SNP National Network H2802-020-000 IN HMOPOS AARP Medicare Advantage Plan 1 Not SNP National Network H2802-024-000 IL HMO AARP Medicare Advantage Access Not SNP Passport H2802-025-000 IL HMO AARP Medicare Advantage Plan 1 Not SNP National Network H2802-026-000 IL HMO AARP Medicare Advantage Plan 2 Not SNP National Network H2802-027-000 IL HMOPOS UnitedHealthcare Nursing Home Plan 1 Institutional Neither H2802-028-000 IL, MO HMOPOS AARP Medicare Advantage Not SNP National Network H2802-029-000 MO HMOPOS AARP Medicare Advantage Plan 1 Not SNP National Network

12




Neither? H2802-030-000 MO HMOPOS AARP Medicare Advantage Plan 2 Not SNP National Network H2802-031-000 MO HMOPOS AARP Medicare Advantage Plan 1 Not SNP National Network H2802-032-000 KS, MO HMOPOS AARP Medicare Advantage Plan 2 Not SNP National Network H2802-033-000 KS, MO HMOPOS AARP Medicare Advantage Plan 1 Not SNP National Network H2802-034-000 KS HMOPOS AARP Medicare Advantage Plan 1 Not SNP National Network H2802-035-000 KS HMOPOS AARP Medicare Advantage Plan 2 Not SNP National Network H2802-041-000 AL HMO AARP Medicare Advantage Plan 3 Not SNP National Network H2802-044-000 AL HMO UnitedHealthcare Dual Complete Plan 2 Dual Neither H2802-048-000 MO HMO AARP Medicare Advantage Plan 2 Not SNP National Network H2802-049-000 MO HMOPOS AARP Medicare Advantage Not SNP National Network H2802-050-000 IL, MO HMOPOS AARP Medicare Advantage Patriot Not SNP National Network H3113-001-000 NJ HMO UnitedHealthcare Nursing Home Plan Institutional Neither H3113-005-000 NJ HMO UnitedHealthcare Dual Complete ONE Dual Neither H3113-008-000 OR HMOPOS UnitedHealthcare Assisted Living Plan Institutional Neither H3113-009-000 PA HMO UnitedHealthcare Dual Complete Dual Neither H3113-010-000 RI HMO UnitedHealthcare Dual Complete Dual Neither H3113-011-000 DE HMO UnitedHealthcare Dual Complete Dual Neither H3256-001-000 GA Local PPO UnitedHealthcare Dual Complete Choice

LP Dual Neither

H3307-002-000 NY HMO AARP Medicare Advantage Plan 1 Not SNP National Network H3307-012-000 NY HMO AARP Medicare Advantage Plan 1 Not SNP National Network H3307-015-000 NY HMO AARP Medicare Advantage Prime Not SNP National Network H3307-018-000 NY HMO AARP Medicare Advantage Patriot Not SNP National Network H3307-023-000 NY HMO AARP Medicare Advantage Plan 2 Not SNP National Network H3307-025-000 NY HMO AARP Medicare Advantage Not SNP National Network H3379-001-000 NY HMO AARP Medicare Advantage Plan 2 Not SNP National Network H3379-002-000 NY HMO UnitedHealthcare Nursing Home Plan 2 Institutional Neither H3379-022-000 NY HMOPOS UnitedHealthcare Nursing Home Plan Institutional Neither H3379-039-000 NY HMO AARP Medicare Advantage Not SNP National Network H3379-040-000 NY HMO AARP Medicare Advantage Not SNP National Network H3379-041-000 NY HMO AARP Medicare Advantage Not SNP National Network H3379-042-000 NY HMO UnitedHealthcare Nursing Home Plan 2 Institutional Neither H3387-010-000 NY HMO UnitedHealthcare Dual Complete Dual Neither H3387-013-000 NY HMO UnitedHealthcare Dual Complete One Dual Neither H3418-001-000 NY Local PPO AARP Medicare Advantage Mosaic Choice Not SNP Passport H3442-001-000 CT Local PPO AARP Medicare Advantage Walgreens Not SNP National Network H3442-003-000 MA Local PPO AARP Medicare Advantage Walgreens Not SNP National Network H3442-004-000 MA Local PPO AARP Medicare Advantage Walgreens Not SNP National Network H3442-005-000 MA Local PPO AARP Medicare Advantage Patriot Not SNP National Network H3442-006-000 RI Local PPO AARP Medicare Advantage Choice Plan 1 Not SNP National Network H3442-007-000 NH Local PPO AARP Medicare Advantage Walgreens Not SNP National Network

13




Neither? H3442-008-000 NH Local PPO AARP Medicare Advantage Patriot Not SNP National Network H3464-001-000 AR HMO AARP Medicare Advantage Plan 1 Not SNP National Network H3464-002-000 AR HMO AARP Medicare Advantage Plan 2 Not SNP National Network H3464-003-000 AR HMO AARP Medicare Advantage Plan 1 Not SNP National Network H3464-004-000 AR HMO AARP Medicare Advantage Plan 2 Not SNP National Network H3464-007-000 AR HMO AARP Medicare Advantage Patriot Not SNP National Network H3749-001-000 OK HMOPOS AARP Medicare Advantage Plan 1 Not SNP Neither H3749-017-000 OK HMOPOS AARP Medicare Advantage Plan 1 Not SNP Neither H3749-018-000 OK HMOPOS AARP Medicare Advantage Plan 2 Not SNP Neither H3749-020-000 OK HMOPOS AARP Medicare Advantage Plan 2 Not SNP Neither H3794-002-000 WI HMO UnitedHealthcare Dual Complete LP1 Dual Neither H3805-001-000 OR HMO AARP Medicare Advantage Plan 1 Not SNP Neither H3805-007-000 OR HMO AARP Medicare Advantage Plan 1 Not SNP Neither H3805-015-000 WA HMO AARP Medicare Advantage Plan 3 Not SNP Neither H3805-016-000 WA HMO AARP Medicare Advantage Plan 2 Not SNP Neither H3805-017-000 WA HMO AARP Medicare Advantage Plan 2 Not SNP Neither H3805-019-000 WA HMO AARP Medicare Advantage Plan 2 Not SNP Neither H3805-020-000 WA HMO AARP Medicare Advantage Plan 2 Not SNP Neither H3805-021-000 WA HMO AARP Medicare Advantage Not SNP Neither H3805-023-001 OR HMO AARP Medicare Advantage Plan 2 Not SNP Neither H3805-023-002 OR HMO AARP Medicare Advantage Plan 2 Not SNP Neither H3805-025-001 WA HMO AARP Medicare Advantage Plan 2 Not SNP Neither H3805-025-002 WA HMO AARP Medicare Advantage Plan 2 Not SNP Neither H3805-029-000 WA HMO AARP Medicare Advantage Not SNP Neither H3805-030-000 WA HMO AARP Medicare Advantage Walgreens Not SNP Neither H3805-032-000 WA HMOPOS AARP Medicare Advantage Walgreens Not SNP Neither H3805-033-000 WA HMOPOS AARP Medicare Advantage Plan 1 Not SNP Passport H3805-034-000 WA HMOPOS AARP Medicare Advantage Plan 2 Not SNP Passport H3805-035-000 WA HMOPOS AARP Medicare Advantage Patriot Not SNP Passport H3805-036-000 OR HMO AARP Medicare Advantage Plan 2 Not SNP Neither H3805-037-000 WA HMO AARP Medicare Advantage Plan 1 Not SNP Neither H4094-001-000 MD HMO UnitedHealthcare Dual Complete Dual Neither H4514-007-000 TX HMO AARP Medicare Advantage Plan 2 Not SNP Passport H4514-013-001 TX HMO UnitedHealthcare Dual Complete Dual Neither H4514-013-002 TX HMO UnitedHealthcare Dual Complete Dual Neither H4514-013-003 TX HMO UnitedHealthcare Dual Complete Dual Neither H4527-001-000 TX HMO AARP Medicare Advantage Not SNP Neither H4527-002-000 TX HMO AARP Medicare Advantage Not SNP Neither H4527-003-000 TX HMO UnitedHealthcare Dual Complete Focus Dual Neither H4527-004-000 TX HMO UnitedHealthcare Dual Complete Plan 1 Dual Neither H4527-005-000 TX HMO AARP Medicare Advantage Not SNP Neither

14




Neither? H4527-006-000 TX HMO UnitedHealthcare Dual Complete Dual Neither H4527-013-000 TX HMO AARP Medicare Advantage Not SNP Neither H4527-015-000 TX HMO UnitedHealthcare Dual Complete Plan 1 Dual Neither H4527-024-000 TX HMOPOS AARP Medicare Advantage Patriot Not SNP Neither H4527-037-000 TX HMOPOS AARP Medicare Advantage Plan 1 Not SNP Passport H4527-039-000 TX HMO UnitedHealthcare Chronic Complete Chronic Neither H4527-040-000 TX HMO UnitedHealthcare Chronic Complete Chronic Neither H4527-041-000 TX HMO UnitedHealthcare Chronic Complete Chronic Neither H4527-042-000 TX HMO UnitedHealthcare Chronic Complete Chronic Neither H4544-001-000 LA Local PPO Peoples Health Choices Not SNP Neither H4544-002-000 LA Local PPO Peoples Health Patriot Not SNP Neither H4590-010-000 TX HMO AARP Medicare Advantage SecureHorizons Not SNP Neither H4590-012-000 TX HMOPOS AARP Medicare Advantage SecureHorizons


H4590-020-000 TX HMO UnitedHealthcare Dual Complete Dual Neither H4590-022-000 TX HMO UnitedHealthcare Dual Complete Dual Neither H4590-025-000 TX HMO AARP Medicare Advantage SecureHorizons Not SNP Neither H4590-027-000 TX HMOPOS AARP Medicare Advantage Patriot Not SNP Neither H4590-029-000 TX HMO AARP Medicare Advantage Patriot Not SNP Neither H4590-033-000 TX HMO UnitedHealthcare Dual Complete Plan 2 Dual Neither H4590-037-000 TX HMO UnitedHealthcare Chronic Complete Chronic Neither H4590-041-000 TX HMOPOS AARP Medicare Advantage SecureHorizons


H4590-042-000 TX HMOPOS AARP Medicare Advantage Not SNP Neither H4590-043-000 TX HMOPOS AARP Medicare Advantage Not SNP Neither H4590-044-000 TX HMOPOS UnitedHealthcare Medicare Advantage

Ally Chronic Neither

H4604-003-000 UT HMO AARP Medicare Advantage Plan 1 Not SNP Passport H4604-005-000 UT HMO AARP Medicare Advantage Patriot Not SNP Passport H4604-011-000 UT HMO AARP Medicare Advantage Plan 2 Not SNP Passport H4604-012-000 ID HMO AARP Medicare Advantage Not SNP National Network H4604-013-000 ID HMO AARP Medicare Advantage Plan 1 Not SNP National Network H4604-014-000 ID HMO AARP Medicare Advantage Plan 1 Not SNP National Network H4604-015-000 ID HMO AARP Medicare Advantage Focus Not SNP Passport H4604-016-000 UT HMO AARP Medicare Advantage Not SNP National Network H4604-017-000 UT HMO UnitedHealthcare Medicare Advantage

Assist Chronic Neither

H4604-018-000 UT HMO AARP Medicare Advantage Walgreens Not SNP Passport H4604-019-000 ID HMO AARP Medicare Advantage Patriot Not SNP National Network H4604-020-000 ID HMO AARP Medicare Advantage Plan 2 Not SNP National Network H4829-002-000 CA Local PPO AARP Medicare Advantage Choice Not SNP National Network

15




Neither? H4829-003-000 CA Local PPO AARP Medicare Advantage Choice Not SNP National Network H4829-004-000 CA Local PPO AARP Medicare Advantage Choice Not SNP National Network H5008-001-000 WA HMOPOS UnitedHealthcare Nursing Home Plan Institutional Neither H5008-002-000 WA HMO UnitedHealthcare Dual Complete Dual Neither H5008-010-000 LA HMO UnitedHealthcare Dual Complete Dual Neither H5008-011-000 MS HMO UnitedHealthcare Dual Complete Dual Neither H5253-004-000 WI HMOPOS AARP Medicare Advantage Not SNP National Network H5253-007-000 WI HMOPOS UnitedHealthcare Nursing Home Plan 1 Institutional Neither H5253-011-000 WI HMOPOS AARP Medicare Advantage Not SNP National Network H5253-021-000 WI HMOPOS AARP Medicare Advantage Patriot Plan 2 Not SNP National Network H5253-024-000 WI HMO UnitedHealthcare Dual Complete LP Dual Neither H5253-030-000 WI HMOPOS AARP Medicare Advantage Not SNP National Network H5253-033-000 WI HMOPOS AARP Medicare Advantage Value Not SNP National Network H5253-034-000 WI HMOPOS AARP Medicare Advantage Value Not SNP National Network H5253-035-000 AZ HMOPOS AARP Medicare Advantage Plus Not SNP Passport H5253-036-000 AZ HMO AARP Medicare Advantage Not SNP Passport H5253-037-000 NC HMOPOS AARP Medicare Advantage Plan 1 Not SNP National Network H5253-038-000 NC HMOPOS AARP Medicare Advantage Plan 2 Not SNP National Network H5253-039-000 NC HMOPOS AARP Medicare Advantage Plan 2 Not SNP National Network H5253-040-000 NC HMOPOS AARP Medicare Advantage Patriot Not SNP National Network H5253-041-000 NC HMOPOS UnitedHealthcare Dual Complete Dual Neither H5253-042-000 NC HMOPOS UnitedHealthcare Nursing Home Plan Institutional Neither H5253-043-000 NC HMOPOS UnitedHealthcare Assisted Living Plan Institutional Neither H5253-047-000 TN, VA HMO AARP Medicare Advantage Plan 1 Not SNP National Network H5253-048-000 TN, VA HMO AARP Medicare Advantage Plan 2 Not SNP National Network H5253-049-000 OH HMO AARP Medicare Advantage Plan 7 Not SNP National Network H5253-050-000 OH HMO AARP Medicare Advantage Plan 1 Not SNP National Network H5253-051-000 KY, OH HMO AARP Medicare Advantage Plan 3 Not SNP National Network H5253-052-000 KY, OH HMO AARP Medicare Advantage Plan 6 Not SNP National Network H5253-059-000 OH HMO UnitedHealthcare Dual Complete LP Dual Neither H5253-060-000 OH HMOPOS UnitedHealthcare Nursing Home Plan Institutional Neither H5253-061-000 OH HMOPOS UnitedHealthcare Assisted Living Plan Institutional Neither H5253-062-000 OH HMO AARP Medicare Advantage Plan 5 Not SNP National Network H5253-064-000 WI HMOPOS UnitedHealthcare Assisted Living Plan Institutional Neither H5253-067-000 KY HMO AARP Medicare Advantage Plan 1 Not SNP National Network H5253-072-000 WI HMOPOS AARP Medicare Advantage Value Not SNP National Network H5253-073-000 WI HMOPOS AARP Medicare Advantage Not SNP National Network H5253-079-000 NC HMOPOS AARP Medicare Advantage Plan 2 Not SNP National Network H5253-080-000 NC HMOPOS AARP Medicare Advantage Plan 1 Not SNP National Network H5253-081-000 TN HMO AARP Medicare Advantage Plan 1 Not SNP National Network H5253-082-000 TN HMO AARP Medicare Advantage Plan 2 Not SNP National Network

16




Neither? H5253-083-000 TN HMO AARP Medicare Advantage Plan 1 Not SNP National Network H5253-084-000 TN HMO AARP Medicare Advantage Plan 2 Not SNP National Network H5253-087-000 VA HMOPOS AARP Medicare Advantage Plan 1 Not SNP National Network H5253-088-000 VA HMOPOS AARP Medicare Advantage Plan 2 Not SNP National Network H5253-089-000 VA HMOPOS AARP Medicare Advantage Not SNP National Network H5253-091-000 KY HMO AARP Medicare Advantage Plan 3 Not SNP National Network H5253-097-000 WI HMO AARP Medicare Advantage Value Not SNP National Network H5253-099-000 KY HMO AARP Medicare Advantage Plan 1 Not SNP National Network H5253-100-000 KY HMO AARP Medicare Advantage Plan 2 Not SNP National Network H5253-102-000 NC HMOPOS AARP Medicare Advantage Plan 1 Not SNP National Network H5253-103-000 NC HMOPOS AARP Medicare Advantage Plan 2 Not SNP National Network H5253-104-000 NC HMOPOS AARP Medicare Advantage Plan 1 Not SNP National Network H5253-105-000 NC HMOPOS AARP Medicare Advantage Walgreens Not SNP National Network H5253-107-001 IA HMOPOS AARP Medicare Advantage Plan 2 Not SNP National Network H5253-107-002 IA, IL HMOPOS AARP Medicare Advantage Plan 2 Not SNP National Network H5253-108-001 IL HMOPOS AARP Medicare Advantage Not SNP National Network H5253-108-002 IA, IL HMOPOS AARP Medicare Advantage Not SNP National Network H5253-108-003 IA HMOPOS AARP Medicare Advantage Not SNP National Network H5253-109-001 OH HMO AARP Medicare Advantage Plan 2 Not SNP National Network H5253-109-002 KY, OH HMO AARP Medicare Advantage Plan 2 Not SNP National Network H5253-110-000 NC HMOPOS AARP Medicare Advantage Walgreens Not SNP National Network H5253-111-001 VA HMOPOS AARP Medicare Advantage Plan 1 Not SNP National Network H5253-111-002 VA HMOPOS AARP Medicare Advantage Plan 1 Not SNP National Network H5253-112-001 VA HMOPOS AARP Medicare Advantage Plan 2 Not SNP National Network H5253-112-002 VA HMOPOS AARP Medicare Advantage Plan 2 Not SNP National Network H5253-113-000 TN, VA HMO AARP Medicare Advantage Patriot Not SNP National Network H5322-001-000 OH, VA HMOPOS UnitedHealthcare Nursing Home Plan Institutional Neither H5322-003-000 FL, NJ HMO UnitedHealthcare Nursing Home Plan Institutional Neither H5322-004-000 GA HMOPOS UnitedHealthcare Nursing Home Plan Institutional Neither H5322-025-000 TX HMO UnitedHealthcare Dual Complete Dual Neither H5322-026-000 TX HMO UnitedHealthcare Dual Complete Plan 2 Dual Neither H5322-028-000 OH HMOPOS UnitedHealthcare Dual Complete Dual Neither H5322-029-000 KS HMOPOS UnitedHealthcare Dual Complete LP Dual Neither H5322-030-000 GA HMOPOS UnitedHealthcare Dual Complete Dual Neither H5322-031-000 OK HMO UnitedHealthcare Dual Complete LP Dual Neither H5420-001-000 FL HMO Medica HealthCare Plans MedicareMax Not SNP Neither H5420-003-000 FL HMO Medica HealthCare Plans MedicareMax Not SNP Neither H5420-006-000 FL HMO Medica HealthCare Plans MedicareMax

Plus Dual Neither

17




Neither? H5435-001-000 KS, KY, MO,

MT, NE, OK, WY

PFFS UnitedHealthcare MedicareDirect Patriot Not SNP Neither

H5435-024-000 KS, KY, MO, MT, NE, OK, WY

PFFS UnitedHealthcare MedicareDirect Rx Not SNP Neither

H5652-001-000 CO, FL, KS, MA, MD, MI, NC, NJ, PA, TX, VA

HMOPOS Erickson Advantage Signature with Drugs Not SNP Neither


HMOPOS Erickson Advantage Liberty without Drugs Not SNP Neither

H5652-003-000 CO, KS, MA, MD, MI, NC, NJ, PA, TX, VA

HMOPOS Erickson Advantage Guardian Institutional Neither


HMOPOS Erickson Advantage Champion Chronic Neither


HMOPOS Erickson Advantage Freedom Not SNP Neither


HMOPOS Erickson Advantage Liberty with Drugs Not SNP Neither

H6526-001-000 NM HMO AARP Medicare Advantage Not SNP Passport H6526-002-000 NM HMO AARP Medicare Advantage Not SNP Passport H6528-006-000 GA Local PPO UnitedHealthcare Medicare Advantage

Choice Plan 1 Not SNP National Network

H6528-031-000 AR Local PPO AARP Medicare Advantage Choice Not SNP National Network H6528-032-000 AR Local PPO AARP Medicare Advantage Choice Not SNP National Network H6528-033-000 AL Local PPO AARP Medicare Advantage Choice Not SNP National Network H6595-002-001 KY HMO UnitedHealthcare Dual Complete Dual Neither H6595-002-002 KY HMO UnitedHealthcare Dual Complete Dual Neither H6706-001-000 CO HMO AARP Medicare Advantage Not SNP Neither H7404-001-000 MN Local PPO AARP Medicare Advantage Headwaters Not SNP Passport

18




Neither? H7404-002-000 MN Local PPO AARP Medicare Advantage Lakeshore Not SNP Passport H7404-004-000 MN, ND Local PPO AARP Medicare Advantage Premier Not SNP National Network H7404-005-000 MN, ND Local PPO AARP Medicare Advantage Headwaters Not SNP National Network H7404-006-000 MN, ND Local PPO AARP Medicare Advantage Lakeshore Not SNP National Network H7404-011-000 MN Local PPO AARP Medicare Advantage Headwaters Not SNP National Network H7404-012-000 MN Local PPO AARP Medicare Advantage Lakeshore Not SNP National Network H7404-014-000 MN Local PPO AARP Medicare Advantage Riverbank Not SNP Passport H7404-015-000 MN, ND Local PPO AARP Medicare Advantage Patriot Not SNP National Network H7404-018-000 NV Local PPO AARP Medicare Advantage Choice Not SNP National Network H7404-019-000 NV Local PPO AARP Medicare Advantage Patriot Not SNP National Network H7404-020-000 NV Local PPO AARP Medicare Advantage Walgreens Plan


H7404-021-000 UT Local PPO AARP Medicare Advantage Choice Not SNP National Network H7445-004-000 IL HMO UnitedHealthcare Medicare Advantage Not SNP National Network H7445-005-000 DE HMO AARP Medicare Advantage Not SNP National Network H7445-006-000 DE HMO AARP Medicare Advantage Patriot Not SNP National Network H7464-001-000 VA HMO UnitedHealthcare Dual Complete Dual Neither H7464-005-000 VA HMO UnitedHealthcare Dual Complete ONE Dual Neither H7833-001-000 TX MMP

HMO UnitedHealthcare Connected N/A Neither

H8125-002-000 OH HMO UnitedHealthcare Dual Complete LP1 Dual Neither H8125-003-000 OK HMO UnitedHealthcare Dual Complete LP1 Dual Neither H8211-001-000 WV Local PPO AARP Medicare Advantage Choice Plan 1 Not SNP National Network H8211-002-000 WV Local PPO AARP Medicare Advantage Choice Plan 2 Not SNP National Network H8211-005-000 WV Local PPO AARP Medicare Advantage Patriot Not SNP National Network H8211-006-000 WV Local PPO AARP Medicare Advantage Choice Plan 3 Not SNP National Network H8211-007-000 MT Local PPO AARP Medicare Advantage Choice Not SNP National Network H8748-002-000 SC HMOPOS AARP Medicare Advantage Plan 1 Not SNP National Network H8748-008-000 GA HMOPOS AARP Medicare Advantage Plus Plan 1 Not SNP National Network H8748-009-000 GA HMOPOS AARP Medicare Advantage Plus Plan 2 Not SNP National Network H8748-019-000 SC HMOPOS AARP Medicare Advantage Patriot Not SNP National Network H8748-025-000 SC HMOPOS AARP Medicare Advantage Plan 2 Not SNP National Network H8768-003-000 IL Local PPO AARP Medicare Advantage Choice Not SNP National Network H8768-005-000 IL Local PPO AARP Medicare Advantage Choice Not SNP National Network H8768-006-000 OH Local PPO AARP Medicare Advantage Choice Not SNP National Network H8768-007-000 OH Local PPO AARP Medicare Advantage Choice Not SNP National Network H8768-008-000 OK Local PPO AARP Medicare Advantage Choice Plan 1 Not SNP National Network H8768-009-000 OK Local PPO AARP Medicare Advantage Choice Not SNP National Network H8768-010-000 IL Local PPO AARP Medicare Advantage Walgreens Not SNP National Network H8768-011-000 IL Local PPO AARP Medicare Advantage Walgreens Not SNP National Network H8768-012-000 KY Local PPO AARP Medicare Advantage Choice Not SNP National Network

19




Neither? H8768-013-000 KY Local PPO AARP Medicare Advantage Choice Not SNP National Network H8768-014-000 OH Local PPO AARP Medicare Advantage Walgreens Not SNP National Network H8768-015-000 KY, OH Local PPO AARP Medicare Advantage Walgreens Not SNP National Network H8768-016-000 OK Local PPO AARP Medicare Advantage Choice Plan 2 Not SNP National Network H8768-017-001 IA Local PPO AARP Medicare Advantage Choice Not SNP National Network H8768-017-002 IA, IL Local PPO AARP Medicare Advantage Choice Not SNP National Network H8768-018-000 IA, IL Local PPO AARP Medicare Advantage Patriot Not SNP National Network H8768-019-000 IL Local PPO AARP Medicare Advantage Patriot Not SNP National Network H8768-020-000 KY Local PPO AARP Medicare Advantage Patriot Not SNP National Network H8768-021-000 KY, OH Local PPO AARP Medicare Advantage Patriot Not SNP National Network H8768-022-000 NJ Local PPO AARP Medicare Advantage Choice Not SNP National Network H8768-023-000 KS, MO Local PPO AARP Medicare Advantage Choice Plan 2 Not SNP National Network H8768-024-000 KS Local PPO AARP Medicare Advantage Choice Plan 1 Not SNP National Network H8768-025-000 KS, MO Local PPO AARP Medicare Advantage Patriot Not SNP National Network H8768-026-000 MO Local PPO AARP Medicare Advantage Choice Not SNP National Network H8768-027-000 MO Local PPO AARP Medicare Advantage Choice Not SNP National Network H8768-028-000 OK Local PPO AARP Medicare Advantage Patriot Not SNP National Network H8768-029-000 MS Local PPO AARP Medicare Advantage Choice Not SNP National Network H8768-030-000 MS Local PPO AARP Medicare Advantage Choice Not SNP National Network H8768-031-000 MS Local PPO AARP Medicare Advantage Patriot Not SNP National Network R0759-001-000 FL Regional

PPO AARP Medicare Advantage Choice Plan 2 Not SNP National Network

R0759-002-000 FL Regional PPO

AARP Medicare Advantage Patriot Not SNP National Network

R0759-003-000 FL Regional PPO

UnitedHealthcare Dual Complete RP Dual Neither

R1548-001-000 NC, VA Regional PPO


R2604-001-000 GA, SC Regional PPO

UnitedHealthcare Medicare Advantage Choice



UnitedHealthcare Medicare Silver Chronic Neither


UnitedHealthcare Medicare Gold Chronic National Network


UnitedHealthcare Dual Complete Choice Dual Neither


UnitedHealthcare Medicare Advantage Patriot


R3175-003-000 HI Regional PPO


20




Neither? R3444-008-000 AR, MO Regional

PPO UnitedHealthcare Medicare Silver Chronic Neither

R3444-009-000 AR, MO Regional PPO





UnitedHealthcare Medicare Advantage Choice Plan 2





R5329-001-000 ME, NH Regional PPO

AARP Medicare Advantage Choice Not SNP National Network

R5342-001-000 NY Regional PPO




UnitedHealthcare Medicare Advantage Patriot








R6801-008-000 TX Regional PPO

UnitedHealthcare Medicare Silver Chronic Neither






UnitedHealthcare Medicare Advantage Choice


R7444-001-000 CT, MA, RI, VT

Regional PPO

AARP Medicare Advantage Choice Not SNP National Network

Documents

2021 UnitedHealthcare Medicare Advantage Plan Availability