SNP Landscapes Test Page - Data Table
| County | Company Name | Plan Name | Plan Type | SNP Type | Total Monthly Premium | Annual Part D Deductible Amount | Drug Benefit Category | Contract ID | Plan ID |
|---|---|---|---|---|---|---|---|---|---|
| Alamance | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Alamance | Aetna Medicare | Aetna Medicare Full Dual Care (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $28.20 | $615.00 | Enhanced | H3146 | 022 |
| Alamance | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Alamance | Cigna HealthCare | HealthSpring TotalCare (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $19.70 | $615.00 | Enhanced | H9725 | 003 |
| Alamance | Cigna HealthCare | HealthSpring TotalCare Plus (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $28.20 | $615.00 | Enhanced | H9725 | 013 |
| Alamance | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $35.00 | $615.00 | Enhanced | H5299 | 006 |
| Alamance | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 009 |
| Alamance | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 013 |
| Alamance | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 015 |
| Alamance | Devoted Health | DEVOTED C-SNP PREMIUM 017 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 017 |
| Alamance | HealthTeam Advantage | HealthTeam Advantage Diabetes & Heart Care (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $300.00 | Enhanced | H2624 | 001 |
| Alamance | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Alamance | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Alamance | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Alamance | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Alamance | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Alamance | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Alamance | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H6351 | 001 |
| Alamance | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $0.00 | Enhanced | H6351 | 004 |
| Alamance | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.70 | $615.00 | Basic | H6351 | 005 |
| Alamance | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H5374 | 001 |
| Alamance | NHC Advantage | NHC Advantage (HMO I-SNP) | HMO I-SNP | Institutional | $31.00 | $615.00 | Basic | H4172 | 001 |
| Alamance | NHC Advantage | Senior Care (HMO I-SNP) | HMO I-SNP | Institutional | $0.00 | $250.00 | Enhanced | H4172 | 003 |
| Alamance | UnitedHealthcare | UHC Nursing Home Plan NC-F001 (PPO I-SNP) | PPO I-SNP | Institutional | $36.20 | $615.00 | Basic | H0710 | 034 |
| Alamance | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Alamance | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Alamance | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Alamance | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Alamance | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Alamance | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $355.00 | Enhanced | H5253 | 189 |
| Alamance | Wellcare | Wellcare Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $25.80 | $395.00 | Basic | H1914 | 008 |
| Alamance | Wellcare | Wellcare Dual Access (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $32.20 | $385.00 | Basic | H4073 | 002 |
| Alamance | Wellcare | Wellcare Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $27.50 | $615.00 | Basic | H4073 | 003 |
| Alamance | Wellcare | Wellcare Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $425.00 | Basic | H4073 | 004 |
| Alexander | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Alexander | Aetna Medicare | Aetna Medicare Full Dual Care (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $28.20 | $615.00 | Enhanced | H3146 | 022 |
| Alexander | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Alexander | Cigna HealthCare | HealthSpring TotalCare (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $19.70 | $615.00 | Enhanced | H9725 | 003 |
| Alexander | Cigna HealthCare | HealthSpring TotalCare Plus (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $28.20 | $615.00 | Enhanced | H9725 | 013 |
| Alexander | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $35.00 | $615.00 | Enhanced | H5299 | 006 |
| Alexander | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 009 |
| Alexander | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 013 |
| Alexander | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 015 |
| Alexander | Devoted Health | DEVOTED C-SNP PREMIUM 016 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 016 |
| Alexander | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Alexander | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Alexander | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Alexander | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Alexander | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Alexander | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Alexander | Troy Medicare | Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $31.30 | $615.00 | Enhanced | H4676 | 002 |
| Alexander | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Alexander | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Alexander | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Alexander | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Alexander | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Alexander | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $355.00 | Enhanced | H5253 | 189 |
| Alexander | Wellcare | Wellcare Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $25.80 | $395.00 | Basic | H1914 | 008 |
| Alexander | Wellcare | Wellcare Dual Access (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $32.20 | $385.00 | Basic | H4073 | 002 |
| Alexander | Wellcare | Wellcare Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $27.50 | $615.00 | Basic | H4073 | 003 |
| Alexander | Wellcare | Wellcare Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $425.00 | Basic | H4073 | 004 |
| Alleghany | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Alleghany | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Alleghany | Cigna HealthCare | HealthSpring TotalCare (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $19.70 | $615.00 | Enhanced | H9725 | 003 |
| Alleghany | Cigna HealthCare | HealthSpring TotalCare Plus (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $28.20 | $615.00 | Enhanced | H9725 | 013 |
| Alleghany | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $35.00 | $615.00 | Enhanced | H5299 | 006 |
| Alleghany | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 009 |
| Alleghany | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 013 |
| Alleghany | Devoted Health | DEVOTED C-SNP PREMIUM 014 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 014 |
| Alleghany | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 015 |
| Alleghany | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Alleghany | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Alleghany | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Alleghany | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Alleghany | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Alleghany | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Alleghany | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Alleghany | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Alleghany | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Alleghany | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Alleghany | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Alleghany | UnitedHealthcare | UHC Complete Care NC-25 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $520.00 | Enhanced | H5253 | 186 |
| Alleghany | Wellcare | Wellcare Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $25.80 | $395.00 | Basic | H1914 | 008 |
| Alleghany | Wellcare | Wellcare Dual Access (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $32.20 | $385.00 | Basic | H4073 | 002 |
| Alleghany | Wellcare | Wellcare Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $27.50 | $615.00 | Basic | H4073 | 003 |
| Alleghany | Wellcare | Wellcare Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $425.00 | Basic | H4073 | 004 |
| Anson | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Anson | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Anson | Cigna HealthCare | HealthSpring TotalCare (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $19.70 | $615.00 | Enhanced | H9725 | 003 |
| Anson | Cigna HealthCare | HealthSpring TotalCare Plus (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $28.20 | $615.00 | Enhanced | H9725 | 013 |
| Anson | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $35.00 | $615.00 | Enhanced | H5299 | 006 |
| Anson | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 009 |
| Anson | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 013 |
| Anson | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 015 |
| Anson | Devoted Health | DEVOTED C-SNP PREMIUM 016 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 016 |
| Anson | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Anson | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Anson | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Anson | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Anson | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Anson | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Anson | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H5374 | 001 |
| Anson | Troy Medicare | Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $31.30 | $615.00 | Enhanced | H4676 | 002 |
| Anson | UnitedHealthcare | UHC Nursing Home Plan NC-F001 (PPO I-SNP) | PPO I-SNP | Institutional | $36.20 | $615.00 | Basic | H0710 | 034 |
| Anson | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Anson | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Anson | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Anson | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Anson | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Anson | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $355.00 | Enhanced | H5253 | 189 |
| Anson | Wellcare | Wellcare Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $25.80 | $395.00 | Basic | H1914 | 008 |
| Anson | Wellcare | Wellcare Dual Access (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $32.20 | $385.00 | Basic | H4073 | 002 |
| Anson | Wellcare | Wellcare Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $27.50 | $615.00 | Basic | H4073 | 003 |
| Anson | Wellcare | Wellcare Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $425.00 | Basic | H4073 | 004 |
| Ashe | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Ashe | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Ashe | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $35.00 | $615.00 | Enhanced | H5299 | 006 |
| Ashe | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 009 |
| Ashe | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 013 |
| Ashe | Devoted Health | DEVOTED C-SNP PREMIUM 014 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 014 |
| Ashe | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 015 |
| Ashe | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Ashe | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Ashe | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Ashe | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Ashe | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Ashe | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Ashe | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Ashe | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Ashe | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Ashe | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Ashe | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Ashe | UnitedHealthcare | UHC Complete Care NC-25 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $520.00 | Enhanced | H5253 | 186 |
| Ashe | Wellcare | Wellcare Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $25.80 | $395.00 | Basic | H1914 | 008 |
| Ashe | Wellcare | Wellcare Dual Access (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $32.20 | $385.00 | Basic | H4073 | 002 |
| Ashe | Wellcare | Wellcare Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $27.50 | $615.00 | Basic | H4073 | 003 |
| Ashe | Wellcare | Wellcare Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $425.00 | Basic | H4073 | 004 |
| Avery | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Avery | Alignment Health Plan | Alignment Health NC Duals (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5296 | 004 |
| Avery | Alignment Health Plan | Alignment Health Heart & Diabetes NCPlus (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $36.20 | $615.00 | Enhanced | H5296 | 009 |
| Avery | Alignment Health Plan | Alignment Health Heart & Diabetes Care (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $250.00 | Enhanced | H5296 | 011 |
| Avery | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Avery | Cigna HealthCare | HealthSpring TotalCare (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $19.70 | $615.00 | Enhanced | H9725 | 003 |
| Avery | Cigna HealthCare | HealthSpring TotalCare Plus (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $28.20 | $615.00 | Enhanced | H9725 | 013 |
| Avery | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $35.00 | $615.00 | Enhanced | H5299 | 006 |
| Avery | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 009 |
| Avery | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 013 |
| Avery | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 015 |
| Avery | Devoted Health | DEVOTED C-SNP PREMIUM 018 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 018 |
| Avery | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Avery | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Avery | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Avery | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Avery | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Avery | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Avery | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Avery | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Avery | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Avery | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Avery | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Avery | UnitedHealthcare | UHC Complete Care NC-25 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $520.00 | Enhanced | H5253 | 186 |
| Avery | Wellcare | Wellcare Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $25.80 | $395.00 | Basic | H1914 | 008 |
| Avery | Wellcare | Wellcare Dual Access (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $32.20 | $385.00 | Basic | H4073 | 002 |
| Avery | Wellcare | Wellcare Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $27.50 | $615.00 | Basic | H4073 | 003 |
| Avery | Wellcare | Wellcare Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $425.00 | Basic | H4073 | 004 |
| Beaufort | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Beaufort | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Beaufort | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Beaufort | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Beaufort | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Beaufort | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Beaufort | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Beaufort | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Beaufort | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Beaufort | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Beaufort | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Beaufort | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Beaufort | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Beaufort | UnitedHealthcare | UHC Complete Care NC-27 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $440.00 | Enhanced | H5253 | 188 |
| Bertie | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Bertie | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Bertie | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Bertie | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Bertie | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Bertie | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Bertie | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Bertie | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Bertie | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H6351 | 001 |
| Bertie | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $0.00 | Enhanced | H6351 | 004 |
| Bertie | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.70 | $615.00 | Basic | H6351 | 005 |
| Bertie | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Bertie | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Bertie | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Bertie | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Bertie | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Bertie | UnitedHealthcare | UHC Complete Care NC-27 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $440.00 | Enhanced | H5253 | 188 |
| Bladen | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Bladen | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Bladen | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $35.00 | $615.00 | Enhanced | H5299 | 006 |
| Bladen | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 009 |
| Bladen | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 013 |
| Bladen | Devoted Health | DEVOTED C-SNP PREMIUM 014 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 014 |
| Bladen | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 015 |
| Bladen | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Bladen | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Bladen | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Bladen | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Bladen | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Bladen | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Bladen | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H6351 | 001 |
| Bladen | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $0.00 | Enhanced | H6351 | 004 |
| Bladen | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.70 | $615.00 | Basic | H6351 | 005 |
| Bladen | Troy Medicare | Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $31.30 | $615.00 | Enhanced | H4676 | 002 |
| Bladen | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Bladen | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Bladen | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Bladen | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Bladen | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Bladen | UnitedHealthcare | UHC Complete Care NC-27 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $440.00 | Enhanced | H5253 | 188 |
| Bladen | Wellcare | Wellcare Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $25.80 | $395.00 | Basic | H1914 | 008 |
| Bladen | Wellcare | Wellcare Dual Access (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $32.20 | $385.00 | Basic | H4073 | 002 |
| Bladen | Wellcare | Wellcare Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $27.50 | $615.00 | Basic | H4073 | 003 |
| Bladen | Wellcare | Wellcare Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $425.00 | Basic | H4073 | 004 |
| Brunswick | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Brunswick | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Brunswick | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $35.00 | $615.00 | Enhanced | H5299 | 006 |
| Brunswick | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 009 |
| Brunswick | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 013 |
| Brunswick | Devoted Health | DEVOTED C-SNP PREMIUM 014 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 014 |
| Brunswick | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 015 |
| Brunswick | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Brunswick | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Brunswick | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Brunswick | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Brunswick | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Brunswick | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Brunswick | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H6351 | 001 |
| Brunswick | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $0.00 | Enhanced | H6351 | 004 |
| Brunswick | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.70 | $615.00 | Basic | H6351 | 005 |
| Brunswick | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H5374 | 001 |
| Brunswick | UnitedHealthcare | UHC Nursing Home Plan NC-F001 (PPO I-SNP) | PPO I-SNP | Institutional | $36.20 | $615.00 | Basic | H0710 | 034 |
| Brunswick | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Brunswick | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Brunswick | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Brunswick | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Brunswick | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Brunswick | UnitedHealthcare | UHC Complete Care NC-27 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $440.00 | Enhanced | H5253 | 188 |
| Buncombe | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Buncombe | Aetna Medicare | Aetna Medicare Full Dual Care (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $28.20 | $615.00 | Enhanced | H3146 | 022 |
| Buncombe | Alignment Health Plan | Alignment Health NC Duals (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5296 | 004 |
| Buncombe | Alignment Health Plan | Alignment Health Heart & Diabetes NCPlus (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $36.20 | $615.00 | Enhanced | H5296 | 009 |
| Buncombe | Alignment Health Plan | Alignment Health Heart & Diabetes Care (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $250.00 | Enhanced | H5296 | 011 |
| Buncombe | AmeriHealth Caritas VIP Care | AmeriHealth Caritas VIP Care (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H8212 | 001 |
| Buncombe | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Buncombe | Cigna HealthCare | HealthSpring TotalCare (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $19.70 | $615.00 | Enhanced | H9725 | 003 |
| Buncombe | Cigna HealthCare | HealthSpring TotalCare Plus (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $28.20 | $615.00 | Enhanced | H9725 | 013 |
| Buncombe | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $35.00 | $615.00 | Enhanced | H5299 | 006 |
| Buncombe | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 009 |
| Buncombe | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 013 |
| Buncombe | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 015 |
| Buncombe | Devoted Health | DEVOTED C-SNP PREMIUM 018 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 018 |
| Buncombe | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Buncombe | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Buncombe | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Buncombe | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Buncombe | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Buncombe | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Buncombe | Humana | Humana Dual Select H6622-027 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $29.00 | $615.00 | Enhanced | H6622 | 027 |
| Buncombe | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H6351 | 001 |
| Buncombe | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $0.00 | Enhanced | H6351 | 004 |
| Buncombe | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.70 | $615.00 | Basic | H6351 | 005 |
| Buncombe | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H5374 | 001 |
| Buncombe | Troy Medicare | Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $31.30 | $615.00 | Enhanced | H4676 | 002 |
| Buncombe | UnitedHealthcare | UHC Nursing Home Plan NC-F001 (PPO I-SNP) | PPO I-SNP | Institutional | $36.20 | $615.00 | Basic | H0710 | 034 |
| Buncombe | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Buncombe | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Buncombe | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Buncombe | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Buncombe | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Buncombe | UnitedHealthcare | UHC Complete Care NC-25 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $520.00 | Enhanced | H5253 | 186 |
| Buncombe | Wellcare | Wellcare Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $25.80 | $395.00 | Basic | H1914 | 008 |
| Buncombe | Wellcare | Wellcare Dual Access (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $32.20 | $385.00 | Basic | H4073 | 002 |
| Buncombe | Wellcare | Wellcare Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $27.50 | $615.00 | Basic | H4073 | 003 |
| Buncombe | Wellcare | Wellcare Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $425.00 | Basic | H4073 | 004 |
| Burke | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Burke | Aetna Medicare | Aetna Medicare Full Dual Care (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $28.20 | $615.00 | Enhanced | H3146 | 022 |
| Burke | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Burke | Cigna HealthCare | HealthSpring TotalCare (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $19.70 | $615.00 | Enhanced | H9725 | 003 |
| Burke | Cigna HealthCare | HealthSpring TotalCare Plus (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $28.20 | $615.00 | Enhanced | H9725 | 013 |
| Burke | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $35.00 | $615.00 | Enhanced | H5299 | 006 |
| Burke | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 009 |
| Burke | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 013 |
| Burke | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 015 |
| Burke | Devoted Health | DEVOTED C-SNP PREMIUM 018 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 018 |
| Burke | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Burke | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Burke | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Burke | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Burke | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Burke | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Burke | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H6351 | 001 |
| Burke | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $0.00 | Enhanced | H6351 | 004 |
| Burke | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.70 | $615.00 | Basic | H6351 | 005 |
| Burke | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H5374 | 001 |
| Burke | Troy Medicare | Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $31.30 | $615.00 | Enhanced | H4676 | 002 |
| Burke | UnitedHealthcare | UHC Nursing Home Plan NC-F001 (PPO I-SNP) | PPO I-SNP | Institutional | $36.20 | $615.00 | Basic | H0710 | 034 |
| Burke | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Burke | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Burke | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Burke | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Burke | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Burke | UnitedHealthcare | UHC Complete Care NC-25 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $520.00 | Enhanced | H5253 | 186 |
| Burke | Wellcare | Wellcare Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $25.80 | $395.00 | Basic | H1914 | 008 |
| Burke | Wellcare | Wellcare Dual Access (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $32.20 | $385.00 | Basic | H4073 | 002 |
| Burke | Wellcare | Wellcare Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $27.50 | $615.00 | Basic | H4073 | 003 |
| Burke | Wellcare | Wellcare Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $425.00 | Basic | H4073 | 004 |
| Cabarrus | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Cabarrus | Aetna Medicare | Aetna Medicare Full Dual Care (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $28.20 | $615.00 | Enhanced | H3146 | 022 |
| Cabarrus | Aetna Medicare | Aetna Medicare Chronic Condition ConditionCare (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $615.00 | Enhanced | H3146 | 037 |
| Cabarrus | Aetna Medicare | Aetna Medicare Chronic Condition ConditionCare Value (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Enhanced | H3146 | 044 |
| Cabarrus | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Cabarrus | Cigna HealthCare | HealthSpring TotalCare (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $19.70 | $615.00 | Enhanced | H9725 | 003 |
| Cabarrus | Cigna HealthCare | HealthSpring TotalCare Plus (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $28.20 | $615.00 | Enhanced | H9725 | 013 |
| Cabarrus | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $35.00 | $615.00 | Enhanced | H5299 | 006 |
| Cabarrus | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 009 |
| Cabarrus | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 013 |
| Cabarrus | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 015 |
| Cabarrus | Devoted Health | DEVOTED C-SNP PREMIUM 016 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 016 |
| Cabarrus | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Cabarrus | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Cabarrus | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Cabarrus | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Cabarrus | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Cabarrus | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Cabarrus | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H6351 | 001 |
| Cabarrus | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $0.00 | Enhanced | H6351 | 004 |
| Cabarrus | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.70 | $615.00 | Basic | H6351 | 005 |
| Cabarrus | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H5374 | 001 |
| Cabarrus | Provider Partners Health Plans | Provider Partners North Carolina Advantage Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H4439 | 001 |
| Cabarrus | Provider Partners Health Plans | Provider Partners North Carolina Community Plan (HMO I-SNP) | HMO I-SNP | Institutional | $0.00 | $615.00 | Basic | H4439 | 002 |
| Cabarrus | Provider Partners Health Plans | Provider Partners North Carolina Essential Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H4439 | 003 |
| Cabarrus | PruittHealth Premier | PruittHealth Premier (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H6345 | 001 |
| Cabarrus | UnitedHealthcare | UHC Nursing Home Plan NC-F001 (PPO I-SNP) | PPO I-SNP | Institutional | $36.20 | $615.00 | Basic | H0710 | 034 |
| Cabarrus | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Cabarrus | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Cabarrus | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Cabarrus | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Cabarrus | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Cabarrus | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $355.00 | Enhanced | H5253 | 189 |
| Cabarrus | Wellcare | Wellcare Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $25.80 | $395.00 | Basic | H1914 | 008 |
| Cabarrus | Wellcare | Wellcare Dual Access (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $32.20 | $385.00 | Basic | H4073 | 002 |
| Cabarrus | Wellcare | Wellcare Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $27.50 | $615.00 | Basic | H4073 | 003 |
| Cabarrus | Wellcare | Wellcare Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $425.00 | Basic | H4073 | 004 |
| Caldwell | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Caldwell | Aetna Medicare | Aetna Medicare Full Dual Care (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $28.20 | $615.00 | Enhanced | H3146 | 022 |
| Caldwell | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Caldwell | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $35.00 | $615.00 | Enhanced | H5299 | 006 |
| Caldwell | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 009 |
| Caldwell | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 013 |
| Caldwell | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 015 |
| Caldwell | Devoted Health | DEVOTED C-SNP PREMIUM 016 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 016 |
| Caldwell | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Caldwell | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Caldwell | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Caldwell | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Caldwell | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Caldwell | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Caldwell | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H6351 | 001 |
| Caldwell | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $0.00 | Enhanced | H6351 | 004 |
| Caldwell | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.70 | $615.00 | Basic | H6351 | 005 |
| Caldwell | Troy Medicare | Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $31.30 | $615.00 | Enhanced | H4676 | 002 |
| Caldwell | UnitedHealthcare | UHC Nursing Home Plan NC-F001 (PPO I-SNP) | PPO I-SNP | Institutional | $36.20 | $615.00 | Basic | H0710 | 034 |
| Caldwell | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Caldwell | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Caldwell | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Caldwell | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Caldwell | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Caldwell | UnitedHealthcare | UHC Complete Care NC-25 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $520.00 | Enhanced | H5253 | 186 |
| Caldwell | Wellcare | Wellcare Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $25.80 | $395.00 | Basic | H1914 | 008 |
| Caldwell | Wellcare | Wellcare Dual Access (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $32.20 | $385.00 | Basic | H4073 | 002 |
| Caldwell | Wellcare | Wellcare Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $27.50 | $615.00 | Basic | H4073 | 003 |
| Caldwell | Wellcare | Wellcare Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $425.00 | Basic | H4073 | 004 |
| Camden | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Camden | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Camden | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Camden | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Camden | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Camden | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Camden | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Camden | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Camden | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Camden | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Camden | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Camden | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Camden | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Camden | UnitedHealthcare | UHC Complete Care NC-27 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $440.00 | Enhanced | H5253 | 188 |
| Carteret | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Carteret | PruittHealth Premier | PruittHealth Premier (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H6345 | 001 |
| Carteret | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Carteret | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Carteret | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Carteret | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Carteret | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Carteret | UnitedHealthcare | UHC Complete Care NC-27 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $440.00 | Enhanced | H5253 | 188 |
| Caswell | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Caswell | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Caswell | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $35.00 | $615.00 | Enhanced | H5299 | 006 |
| Caswell | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 009 |
| Caswell | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 013 |
| Caswell | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 015 |
| Caswell | Devoted Health | DEVOTED C-SNP PREMIUM 017 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 017 |
| Caswell | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Caswell | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Caswell | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Caswell | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Caswell | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Caswell | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Caswell | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H5374 | 001 |
| Caswell | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Caswell | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Caswell | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Caswell | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Caswell | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Caswell | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $355.00 | Enhanced | H5253 | 189 |
| Caswell | Wellcare | Wellcare Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $25.80 | $395.00 | Basic | H1914 | 008 |
| Caswell | Wellcare | Wellcare Dual Access (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $32.20 | $385.00 | Basic | H4073 | 002 |
| Caswell | Wellcare | Wellcare Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $27.50 | $615.00 | Basic | H4073 | 003 |
| Caswell | Wellcare | Wellcare Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $425.00 | Basic | H4073 | 004 |
| Catawba | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Catawba | Aetna Medicare | Aetna Medicare Full Dual Care (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $28.20 | $615.00 | Enhanced | H3146 | 022 |
| Catawba | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Catawba | Cigna HealthCare | HealthSpring TotalCare (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $19.70 | $615.00 | Enhanced | H9725 | 003 |
| Catawba | Cigna HealthCare | HealthSpring TotalCare Plus (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $28.20 | $615.00 | Enhanced | H9725 | 013 |
| Catawba | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $35.00 | $615.00 | Enhanced | H5299 | 006 |
| Catawba | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 009 |
| Catawba | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 013 |
| Catawba | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 015 |
| Catawba | Devoted Health | DEVOTED C-SNP PREMIUM 016 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 016 |
| Catawba | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Catawba | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Catawba | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Catawba | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Catawba | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Catawba | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Catawba | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H6351 | 001 |
| Catawba | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $0.00 | Enhanced | H6351 | 004 |
| Catawba | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.70 | $615.00 | Basic | H6351 | 005 |
| Catawba | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H5374 | 001 |
| Catawba | Provider Partners Health Plans | Provider Partners North Carolina Advantage Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H4439 | 001 |
| Catawba | Provider Partners Health Plans | Provider Partners North Carolina Community Plan (HMO I-SNP) | HMO I-SNP | Institutional | $0.00 | $615.00 | Basic | H4439 | 002 |
| Catawba | Provider Partners Health Plans | Provider Partners North Carolina Essential Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H4439 | 003 |
| Catawba | Troy Medicare | Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $31.30 | $615.00 | Enhanced | H4676 | 002 |
| Catawba | UnitedHealthcare | UHC Nursing Home Plan NC-F001 (PPO I-SNP) | PPO I-SNP | Institutional | $36.20 | $615.00 | Basic | H0710 | 034 |
| Catawba | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Catawba | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Catawba | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Catawba | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Catawba | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Catawba | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $355.00 | Enhanced | H5253 | 189 |
| Catawba | Wellcare | Wellcare Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $25.80 | $395.00 | Basic | H1914 | 008 |
| Catawba | Wellcare | Wellcare Dual Access (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $32.20 | $385.00 | Basic | H4073 | 002 |
| Catawba | Wellcare | Wellcare Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $27.50 | $615.00 | Basic | H4073 | 003 |
| Catawba | Wellcare | Wellcare Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $425.00 | Basic | H4073 | 004 |
| Chatham | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Chatham | Aetna Medicare | Aetna Medicare Full Dual Care (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $28.20 | $615.00 | Enhanced | H3146 | 022 |
| Chatham | Alignment Health Plan | Alignment Health NC Duals (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5296 | 004 |
| Chatham | Alignment Health Plan | Alignment Health Heart & Diabetes NCPlus (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $36.20 | $615.00 | Enhanced | H5296 | 009 |
| Chatham | Alignment Health Plan | Alignment Health Heart & Diabetes Care (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $250.00 | Enhanced | H5296 | 011 |
| Chatham | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Chatham | Cigna HealthCare | HealthSpring TotalCare (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $19.70 | $615.00 | Enhanced | H9725 | 003 |
| Chatham | Cigna HealthCare | HealthSpring TotalCare Plus (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $28.20 | $615.00 | Enhanced | H9725 | 013 |
| Chatham | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Chatham | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Chatham | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Chatham | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Chatham | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Chatham | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Chatham | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H6351 | 001 |
| Chatham | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $0.00 | Enhanced | H6351 | 004 |
| Chatham | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.70 | $615.00 | Basic | H6351 | 005 |
| Chatham | Troy Medicare | Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $31.30 | $615.00 | Enhanced | H4676 | 002 |
| Chatham | UnitedHealthcare | UHC Nursing Home Plan NC-F001 (PPO I-SNP) | PPO I-SNP | Institutional | $36.20 | $615.00 | Basic | H0710 | 034 |
| Chatham | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Chatham | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Chatham | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Chatham | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Chatham | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Chatham | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $355.00 | Enhanced | H5253 | 189 |
| Chatham | Wellcare | Wellcare Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $25.80 | $395.00 | Basic | H1914 | 008 |
| Chatham | Wellcare | Wellcare Dual Access (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $32.20 | $385.00 | Basic | H4073 | 002 |
| Chatham | Wellcare | Wellcare Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $27.50 | $615.00 | Basic | H4073 | 003 |
| Chatham | Wellcare | Wellcare Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $425.00 | Basic | H4073 | 004 |
| Cherokee | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Cherokee | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Cherokee | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $35.00 | $615.00 | Enhanced | H5299 | 006 |
| Cherokee | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 009 |
| Cherokee | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 013 |
| Cherokee | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 015 |
| Cherokee | Devoted Health | DEVOTED C-SNP PREMIUM 018 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 018 |
| Cherokee | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Cherokee | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Cherokee | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Cherokee | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Cherokee | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Cherokee | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Cherokee | Humana | Humana Dual Select H6622-027 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $29.00 | $615.00 | Enhanced | H6622 | 027 |
| Cherokee | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Cherokee | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Cherokee | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Cherokee | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Cherokee | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Cherokee | UnitedHealthcare | UHC Complete Care NC-25 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $520.00 | Enhanced | H5253 | 186 |
| Chowan | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Chowan | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Chowan | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Chowan | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Chowan | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Chowan | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Chowan | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Chowan | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Chowan | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Chowan | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Chowan | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Chowan | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Chowan | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Chowan | UnitedHealthcare | UHC Complete Care NC-27 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $440.00 | Enhanced | H5253 | 188 |
| Clay | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Clay | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Clay | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $35.00 | $615.00 | Enhanced | H5299 | 006 |
| Clay | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 009 |
| Clay | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 013 |
| Clay | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 015 |
| Clay | Devoted Health | DEVOTED C-SNP PREMIUM 018 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 018 |
| Clay | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Clay | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Clay | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Clay | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Clay | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Clay | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Clay | Humana | Humana Dual Select H6622-027 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $29.00 | $615.00 | Enhanced | H6622 | 027 |
| Clay | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Clay | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Clay | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Clay | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Clay | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Clay | UnitedHealthcare | UHC Complete Care NC-25 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $520.00 | Enhanced | H5253 | 186 |
| Clay | Wellcare | Wellcare Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $25.80 | $395.00 | Basic | H1914 | 008 |
| Clay | Wellcare | Wellcare Dual Access (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $32.20 | $385.00 | Basic | H4073 | 002 |
| Clay | Wellcare | Wellcare Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $27.50 | $615.00 | Basic | H4073 | 003 |
| Clay | Wellcare | Wellcare Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $425.00 | Basic | H4073 | 004 |
| Cleveland | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Cleveland | Aetna Medicare | Aetna Medicare Full Dual Care (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $28.20 | $615.00 | Enhanced | H3146 | 022 |
| Cleveland | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Cleveland | Cigna HealthCare | HealthSpring TotalCare (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $19.70 | $615.00 | Enhanced | H9725 | 003 |
| Cleveland | Cigna HealthCare | HealthSpring TotalCare Plus (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $28.20 | $615.00 | Enhanced | H9725 | 013 |
| Cleveland | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $35.00 | $615.00 | Enhanced | H5299 | 006 |
| Cleveland | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 009 |
| Cleveland | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 013 |
| Cleveland | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 015 |
| Cleveland | Devoted Health | DEVOTED C-SNP PREMIUM 016 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 016 |
| Cleveland | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Cleveland | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Cleveland | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Cleveland | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Cleveland | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Cleveland | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Cleveland | UnitedHealthcare | UHC Nursing Home Plan NC-F001 (PPO I-SNP) | PPO I-SNP | Institutional | $36.20 | $615.00 | Basic | H0710 | 034 |
| Cleveland | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Cleveland | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Cleveland | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Cleveland | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Cleveland | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Cleveland | UnitedHealthcare | UHC Complete Care NC-25 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $520.00 | Enhanced | H5253 | 186 |
| Cleveland | Wellcare | Wellcare Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $25.80 | $395.00 | Basic | H1914 | 008 |
| Cleveland | Wellcare | Wellcare Dual Access (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $32.20 | $385.00 | Basic | H4073 | 002 |
| Cleveland | Wellcare | Wellcare Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $27.50 | $615.00 | Basic | H4073 | 003 |
| Cleveland | Wellcare | Wellcare Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $425.00 | Basic | H4073 | 004 |
| Columbus | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Columbus | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Columbus | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $35.00 | $615.00 | Enhanced | H5299 | 006 |
| Columbus | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 009 |
| Columbus | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 013 |
| Columbus | Devoted Health | DEVOTED C-SNP PREMIUM 014 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 014 |
| Columbus | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 015 |
| Columbus | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Columbus | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Columbus | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Columbus | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Columbus | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Columbus | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Columbus | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H6351 | 001 |
| Columbus | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $0.00 | Enhanced | H6351 | 004 |
| Columbus | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.70 | $615.00 | Basic | H6351 | 005 |
| Columbus | Troy Medicare | Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $31.30 | $615.00 | Enhanced | H4676 | 002 |
| Columbus | UnitedHealthcare | UHC Nursing Home Plan NC-F001 (PPO I-SNP) | PPO I-SNP | Institutional | $36.20 | $615.00 | Basic | H0710 | 034 |
| Columbus | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Columbus | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Columbus | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Columbus | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Columbus | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Columbus | UnitedHealthcare | UHC Complete Care NC-27 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $440.00 | Enhanced | H5253 | 188 |
| Columbus | Wellcare | Wellcare Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $25.80 | $395.00 | Basic | H1914 | 008 |
| Columbus | Wellcare | Wellcare Dual Access (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $32.20 | $385.00 | Basic | H4073 | 002 |
| Columbus | Wellcare | Wellcare Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $27.50 | $615.00 | Basic | H4073 | 003 |
| Columbus | Wellcare | Wellcare Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $425.00 | Basic | H4073 | 004 |
| Craven | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Craven | PruittHealth Premier | PruittHealth Premier (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H6345 | 001 |
| Craven | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Craven | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Craven | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Craven | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Craven | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Craven | UnitedHealthcare | UHC Complete Care NC-27 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $440.00 | Enhanced | H5253 | 188 |
| Cumberland | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Cumberland | Aetna Medicare | Aetna Medicare Full Dual Care (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $28.20 | $615.00 | Enhanced | H3146 | 022 |
| Cumberland | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Cumberland | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Cumberland | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Cumberland | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Cumberland | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Cumberland | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Cumberland | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Cumberland | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H6351 | 001 |
| Cumberland | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $0.00 | Enhanced | H6351 | 004 |
| Cumberland | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.70 | $615.00 | Basic | H6351 | 005 |
| Cumberland | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H5374 | 001 |
| Cumberland | Troy Medicare | Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $31.30 | $615.00 | Enhanced | H4676 | 002 |
| Cumberland | UnitedHealthcare | UHC Nursing Home Plan NC-F001 (PPO I-SNP) | PPO I-SNP | Institutional | $36.20 | $615.00 | Basic | H0710 | 034 |
| Cumberland | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Cumberland | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Cumberland | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Cumberland | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Cumberland | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Cumberland | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $355.00 | Enhanced | H5253 | 189 |
| Cumberland | Wellcare | Wellcare Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $25.80 | $395.00 | Basic | H1914 | 008 |
| Cumberland | Wellcare | Wellcare Dual Access (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $32.20 | $385.00 | Basic | H4073 | 002 |
| Cumberland | Wellcare | Wellcare Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $27.50 | $615.00 | Basic | H4073 | 003 |
| Cumberland | Wellcare | Wellcare Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $425.00 | Basic | H4073 | 004 |
| Currituck | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Currituck | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Currituck | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Currituck | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Currituck | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Currituck | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Currituck | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Currituck | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Currituck | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Currituck | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Currituck | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Currituck | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Currituck | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Currituck | UnitedHealthcare | UHC Complete Care NC-27 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $440.00 | Enhanced | H5253 | 188 |
| Dare | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Dare | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Dare | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Dare | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Dare | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Dare | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Dare | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Dare | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Dare | UnitedHealthcare | UHC Complete Care NC-27 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $440.00 | Enhanced | H5253 | 188 |
| Davidson | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Davidson | Aetna Medicare | Aetna Medicare Full Dual Care (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $28.20 | $615.00 | Enhanced | H3146 | 022 |
| Davidson | Alignment Health Plan | Alignment Health NC Duals (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5296 | 004 |
| Davidson | Alignment Health Plan | Alignment Health Heart & Diabetes NCPlus (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $36.20 | $615.00 | Enhanced | H5296 | 009 |
| Davidson | Alignment Health Plan | Alignment Health Heart & Diabetes Care (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $250.00 | Enhanced | H5296 | 011 |
| Davidson | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Davidson | Cigna HealthCare | HealthSpring TotalCare (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $19.70 | $615.00 | Enhanced | H9725 | 003 |
| Davidson | Cigna HealthCare | HealthSpring TotalCare Plus (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $28.20 | $615.00 | Enhanced | H9725 | 013 |
| Davidson | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $35.00 | $615.00 | Enhanced | H5299 | 006 |
| Davidson | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 009 |
| Davidson | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 013 |
| Davidson | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 015 |
| Davidson | Devoted Health | DEVOTED C-SNP PREMIUM 017 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 017 |
| Davidson | HealthTeam Advantage | HealthTeam Advantage Diabetes & Heart Care (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $300.00 | Enhanced | H2624 | 001 |
| Davidson | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Davidson | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Davidson | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Davidson | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Davidson | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Davidson | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Davidson | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H6351 | 001 |
| Davidson | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $0.00 | Enhanced | H6351 | 004 |
| Davidson | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.70 | $615.00 | Basic | H6351 | 005 |
| Davidson | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H5374 | 001 |
| Davidson | Provider Partners Health Plans | Provider Partners North Carolina Advantage Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H4439 | 001 |
| Davidson | Provider Partners Health Plans | Provider Partners North Carolina Community Plan (HMO I-SNP) | HMO I-SNP | Institutional | $0.00 | $615.00 | Basic | H4439 | 002 |
| Davidson | Provider Partners Health Plans | Provider Partners North Carolina Essential Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H4439 | 003 |
| Davidson | UnitedHealthcare | UHC Nursing Home Plan NC-F001 (PPO I-SNP) | PPO I-SNP | Institutional | $36.20 | $615.00 | Basic | H0710 | 034 |
| Davidson | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Davidson | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Davidson | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Davidson | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Davidson | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Davidson | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $355.00 | Enhanced | H5253 | 189 |
| Davidson | Wellcare | Wellcare Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $25.80 | $395.00 | Basic | H1914 | 008 |
| Davidson | Wellcare | Wellcare Dual Access (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $32.20 | $385.00 | Basic | H4073 | 002 |
| Davidson | Wellcare | Wellcare Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $27.50 | $615.00 | Basic | H4073 | 003 |
| Davidson | Wellcare | Wellcare Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $425.00 | Basic | H4073 | 004 |
| Davie | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Davie | Alignment Health Plan | Alignment Health NC Duals (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5296 | 004 |
| Davie | Alignment Health Plan | Alignment Health Heart & Diabetes NCPlus (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $36.20 | $615.00 | Enhanced | H5296 | 009 |
| Davie | Alignment Health Plan | Alignment Health Heart & Diabetes Care (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $250.00 | Enhanced | H5296 | 011 |
| Davie | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Davie | Cigna HealthCare | HealthSpring TotalCare (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $19.70 | $615.00 | Enhanced | H9725 | 003 |
| Davie | Cigna HealthCare | HealthSpring TotalCare Plus (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $28.20 | $615.00 | Enhanced | H9725 | 013 |
| Davie | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $35.00 | $615.00 | Enhanced | H5299 | 006 |
| Davie | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 009 |
| Davie | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 013 |
| Davie | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 015 |
| Davie | Devoted Health | DEVOTED C-SNP PREMIUM 017 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 017 |
| Davie | HealthTeam Advantage | HealthTeam Advantage Diabetes & Heart Care (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $300.00 | Enhanced | H2624 | 001 |
| Davie | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Davie | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Davie | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Davie | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Davie | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Davie | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Davie | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H6351 | 001 |
| Davie | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $0.00 | Enhanced | H6351 | 004 |
| Davie | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.70 | $615.00 | Basic | H6351 | 005 |
| Davie | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H5374 | 001 |
| Davie | Provider Partners Health Plans | Provider Partners North Carolina Advantage Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H4439 | 001 |
| Davie | Provider Partners Health Plans | Provider Partners North Carolina Community Plan (HMO I-SNP) | HMO I-SNP | Institutional | $0.00 | $615.00 | Basic | H4439 | 002 |
| Davie | Provider Partners Health Plans | Provider Partners North Carolina Essential Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H4439 | 003 |
| Davie | UnitedHealthcare | UHC Nursing Home Plan NC-F001 (PPO I-SNP) | PPO I-SNP | Institutional | $36.20 | $615.00 | Basic | H0710 | 034 |
| Davie | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Davie | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Davie | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Davie | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Davie | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Davie | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $355.00 | Enhanced | H5253 | 189 |
| Davie | Wellcare | Wellcare Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $25.80 | $395.00 | Basic | H1914 | 008 |
| Davie | Wellcare | Wellcare Dual Access (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $32.20 | $385.00 | Basic | H4073 | 002 |
| Davie | Wellcare | Wellcare Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $27.50 | $615.00 | Basic | H4073 | 003 |
| Davie | Wellcare | Wellcare Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $425.00 | Basic | H4073 | 004 |
| Duplin | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Duplin | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Duplin | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Duplin | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Duplin | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Duplin | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Duplin | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Duplin | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Duplin | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H5374 | 001 |
| Duplin | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Duplin | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Duplin | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Duplin | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Duplin | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Duplin | UnitedHealthcare | UHC Complete Care NC-27 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $440.00 | Enhanced | H5253 | 188 |
| Duplin | Wellcare | Wellcare Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $25.80 | $395.00 | Basic | H1914 | 008 |
| Duplin | Wellcare | Wellcare Dual Access (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $32.20 | $385.00 | Basic | H4073 | 002 |
| Duplin | Wellcare | Wellcare Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $27.50 | $615.00 | Basic | H4073 | 003 |
| Duplin | Wellcare | Wellcare Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $425.00 | Basic | H4073 | 004 |
| Durham | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Durham | Aetna Medicare | Aetna Medicare Full Dual Care (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $28.20 | $615.00 | Enhanced | H3146 | 022 |
| Durham | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Durham | Cigna HealthCare | HealthSpring TotalCare (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $19.70 | $615.00 | Enhanced | H9725 | 003 |
| Durham | Cigna HealthCare | HealthSpring TotalCare Plus (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $28.20 | $615.00 | Enhanced | H9725 | 013 |
| Durham | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Durham | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Durham | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Durham | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Durham | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Durham | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Durham | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H6351 | 001 |
| Durham | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $0.00 | Enhanced | H6351 | 004 |
| Durham | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.70 | $615.00 | Basic | H6351 | 005 |
| Durham | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H5374 | 001 |
| Durham | PruittHealth Premier | PruittHealth Premier (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H6345 | 001 |
| Durham | Troy Medicare | Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $31.30 | $615.00 | Enhanced | H4676 | 002 |
| Durham | UnitedHealthcare | UHC Nursing Home Plan NC-F001 (PPO I-SNP) | PPO I-SNP | Institutional | $36.20 | $615.00 | Basic | H0710 | 034 |
| Durham | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Durham | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Durham | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Durham | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Durham | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Durham | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $355.00 | Enhanced | H5253 | 189 |
| Durham | Wellcare | Wellcare Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $25.80 | $395.00 | Basic | H1914 | 008 |
| Durham | Wellcare | Wellcare Dual Access (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $32.20 | $385.00 | Basic | H4073 | 002 |
| Durham | Wellcare | Wellcare Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $27.50 | $615.00 | Basic | H4073 | 003 |
| Durham | Wellcare | Wellcare Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $425.00 | Basic | H4073 | 004 |
| Edgecombe | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Edgecombe | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Edgecombe | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Edgecombe | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Edgecombe | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Edgecombe | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Edgecombe | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Edgecombe | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Edgecombe | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H5374 | 001 |
| Edgecombe | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Edgecombe | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Edgecombe | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Edgecombe | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Edgecombe | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Edgecombe | UnitedHealthcare | UHC Complete Care NC-27 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $440.00 | Enhanced | H5253 | 188 |
| Forsyth | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Forsyth | Aetna Medicare | Aetna Medicare Full Dual Care (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $28.20 | $615.00 | Enhanced | H3146 | 022 |
| Forsyth | Alignment Health Plan | Alignment Health NC Duals (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5296 | 004 |
| Forsyth | Alignment Health Plan | Alignment Health Heart & Diabetes NCPlus (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $36.20 | $615.00 | Enhanced | H5296 | 009 |
| Forsyth | Alignment Health Plan | Alignment Health Heart & Diabetes Care (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $250.00 | Enhanced | H5296 | 011 |
| Forsyth | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Forsyth | Cigna HealthCare | HealthSpring TotalCare (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $19.70 | $615.00 | Enhanced | H9725 | 003 |
| Forsyth | Cigna HealthCare | HealthSpring TotalCare Plus (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $28.20 | $615.00 | Enhanced | H9725 | 013 |
| Forsyth | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $35.00 | $615.00 | Enhanced | H5299 | 006 |
| Forsyth | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 009 |
| Forsyth | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 013 |
| Forsyth | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 015 |
| Forsyth | Devoted Health | DEVOTED C-SNP PREMIUM 017 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 017 |
| Forsyth | HealthTeam Advantage | HealthTeam Advantage Diabetes & Heart Care (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $300.00 | Enhanced | H2624 | 001 |
| Forsyth | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Forsyth | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Forsyth | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Forsyth | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Forsyth | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Forsyth | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Forsyth | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H6351 | 001 |
| Forsyth | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $0.00 | Enhanced | H6351 | 004 |
| Forsyth | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.70 | $615.00 | Basic | H6351 | 005 |
| Forsyth | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H5374 | 001 |
| Forsyth | Provider Partners Health Plans | Provider Partners North Carolina Advantage Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H4439 | 001 |
| Forsyth | Provider Partners Health Plans | Provider Partners North Carolina Community Plan (HMO I-SNP) | HMO I-SNP | Institutional | $0.00 | $615.00 | Basic | H4439 | 002 |
| Forsyth | Provider Partners Health Plans | Provider Partners North Carolina Essential Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H4439 | 003 |
| Forsyth | PruittHealth Premier | PruittHealth Premier (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H6345 | 001 |
| Forsyth | UnitedHealthcare | UHC Nursing Home Plan NC-F001 (PPO I-SNP) | PPO I-SNP | Institutional | $36.20 | $615.00 | Basic | H0710 | 034 |
| Forsyth | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Forsyth | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Forsyth | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Forsyth | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Forsyth | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Forsyth | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $355.00 | Enhanced | H5253 | 189 |
| Forsyth | Wellcare | Wellcare Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $25.80 | $395.00 | Basic | H1914 | 008 |
| Forsyth | Wellcare | Wellcare Dual Access (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $32.20 | $385.00 | Basic | H4073 | 002 |
| Forsyth | Wellcare | Wellcare Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $27.50 | $615.00 | Basic | H4073 | 003 |
| Forsyth | Wellcare | Wellcare Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $425.00 | Basic | H4073 | 004 |
| Franklin | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Franklin | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Franklin | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Franklin | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Franklin | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Franklin | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Franklin | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Franklin | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Franklin | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H6351 | 001 |
| Franklin | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $0.00 | Enhanced | H6351 | 004 |
| Franklin | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.70 | $615.00 | Basic | H6351 | 005 |
| Franklin | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H5374 | 001 |
| Franklin | Troy Medicare | Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $31.30 | $615.00 | Enhanced | H4676 | 002 |
| Franklin | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Franklin | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Franklin | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Franklin | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Franklin | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Franklin | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $355.00 | Enhanced | H5253 | 189 |
| Franklin | Wellcare | Wellcare Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $25.80 | $395.00 | Basic | H1914 | 008 |
| Franklin | Wellcare | Wellcare Dual Access (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $32.20 | $385.00 | Basic | H4073 | 002 |
| Franklin | Wellcare | Wellcare Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $27.50 | $615.00 | Basic | H4073 | 003 |
| Franklin | Wellcare | Wellcare Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $425.00 | Basic | H4073 | 004 |
| Gaston | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Gaston | Aetna Medicare | Aetna Medicare Full Dual Care (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $28.20 | $615.00 | Enhanced | H3146 | 022 |
| Gaston | Aetna Medicare | Aetna Medicare Chronic Condition ConditionCare (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $615.00 | Enhanced | H3146 | 037 |
| Gaston | Aetna Medicare | Aetna Medicare Chronic Condition ConditionCare Value (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Enhanced | H3146 | 044 |
| Gaston | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Gaston | Cigna HealthCare | HealthSpring TotalCare (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $19.70 | $615.00 | Enhanced | H9725 | 003 |
| Gaston | Cigna HealthCare | HealthSpring TotalCare Plus (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $28.20 | $615.00 | Enhanced | H9725 | 013 |
| Gaston | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $35.00 | $615.00 | Enhanced | H5299 | 006 |
| Gaston | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 009 |
| Gaston | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 013 |
| Gaston | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 015 |
| Gaston | Devoted Health | DEVOTED C-SNP PREMIUM 016 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 016 |
| Gaston | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Gaston | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Gaston | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Gaston | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Gaston | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Gaston | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Gaston | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H5374 | 001 |
| Gaston | Provider Partners Health Plans | Provider Partners North Carolina Advantage Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H4439 | 001 |
| Gaston | Provider Partners Health Plans | Provider Partners North Carolina Community Plan (HMO I-SNP) | HMO I-SNP | Institutional | $0.00 | $615.00 | Basic | H4439 | 002 |
| Gaston | Provider Partners Health Plans | Provider Partners North Carolina Essential Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H4439 | 003 |
| Gaston | UnitedHealthcare | UHC Nursing Home Plan NC-F001 (PPO I-SNP) | PPO I-SNP | Institutional | $36.20 | $615.00 | Basic | H0710 | 034 |
| Gaston | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Gaston | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Gaston | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Gaston | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Gaston | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Gaston | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $355.00 | Enhanced | H5253 | 189 |
| Gaston | Wellcare | Wellcare Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $25.80 | $395.00 | Basic | H1914 | 008 |
| Gaston | Wellcare | Wellcare Dual Access (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $32.20 | $385.00 | Basic | H4073 | 002 |
| Gaston | Wellcare | Wellcare Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $27.50 | $615.00 | Basic | H4073 | 003 |
| Gaston | Wellcare | Wellcare Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $425.00 | Basic | H4073 | 004 |
| Gates | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Gates | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Gates | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Gates | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Gates | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Gates | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Gates | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Gates | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Gates | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Gates | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Gates | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Gates | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Gates | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Gates | UnitedHealthcare | UHC Complete Care NC-27 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $440.00 | Enhanced | H5253 | 188 |
| Graham | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Graham | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Graham | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $35.00 | $615.00 | Enhanced | H5299 | 006 |
| Graham | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 009 |
| Graham | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 013 |
| Graham | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 015 |
| Graham | Devoted Health | DEVOTED C-SNP PREMIUM 018 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 018 |
| Graham | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Graham | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Graham | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Graham | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Graham | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Graham | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Graham | Humana | Humana Dual Select H6622-027 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $29.00 | $615.00 | Enhanced | H6622 | 027 |
| Graham | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Graham | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Graham | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Graham | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Graham | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Graham | UnitedHealthcare | UHC Complete Care NC-25 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $520.00 | Enhanced | H5253 | 186 |
| Graham | Wellcare | Wellcare Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $25.80 | $395.00 | Basic | H1914 | 008 |
| Graham | Wellcare | Wellcare Dual Access (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $32.20 | $385.00 | Basic | H4073 | 002 |
| Graham | Wellcare | Wellcare Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $27.50 | $615.00 | Basic | H4073 | 003 |
| Graham | Wellcare | Wellcare Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $425.00 | Basic | H4073 | 004 |
| Granville | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Granville | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Granville | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Granville | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Granville | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Granville | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Granville | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Granville | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Granville | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H6351 | 001 |
| Granville | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $0.00 | Enhanced | H6351 | 004 |
| Granville | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.70 | $615.00 | Basic | H6351 | 005 |
| Granville | Troy Medicare | Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $31.30 | $615.00 | Enhanced | H4676 | 002 |
| Granville | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Granville | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Granville | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Granville | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Granville | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Granville | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $355.00 | Enhanced | H5253 | 189 |
| Granville | Wellcare | Wellcare Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $25.80 | $395.00 | Basic | H1914 | 008 |
| Granville | Wellcare | Wellcare Dual Access (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $32.20 | $385.00 | Basic | H4073 | 002 |
| Granville | Wellcare | Wellcare Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $27.50 | $615.00 | Basic | H4073 | 003 |
| Granville | Wellcare | Wellcare Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $425.00 | Basic | H4073 | 004 |
| Greene | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Greene | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Greene | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Greene | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Greene | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Greene | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Greene | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Greene | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H6351 | 001 |
| Greene | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $0.00 | Enhanced | H6351 | 004 |
| Greene | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.70 | $615.00 | Basic | H6351 | 005 |
| Greene | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Greene | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Greene | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Greene | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Greene | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Greene | UnitedHealthcare | UHC Complete Care NC-27 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $440.00 | Enhanced | H5253 | 188 |
| Greene | Wellcare | Wellcare Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $25.80 | $395.00 | Basic | H1914 | 008 |
| Greene | Wellcare | Wellcare Dual Access (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $32.20 | $385.00 | Basic | H4073 | 002 |
| Greene | Wellcare | Wellcare Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $27.50 | $615.00 | Basic | H4073 | 003 |
| Greene | Wellcare | Wellcare Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $425.00 | Basic | H4073 | 004 |
| Guilford | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Guilford | Aetna Medicare | Aetna Medicare Full Dual Care (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $28.20 | $615.00 | Enhanced | H3146 | 022 |
| Guilford | Alignment Health Plan | Alignment Health NC Duals (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5296 | 004 |
| Guilford | Alignment Health Plan | Alignment Health Heart & Diabetes NCPlus (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $36.20 | $615.00 | Enhanced | H5296 | 009 |
| Guilford | Alignment Health Plan | Alignment Health Heart & Diabetes Care (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $250.00 | Enhanced | H5296 | 011 |
| Guilford | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Guilford | Cigna HealthCare | HealthSpring TotalCare (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $19.70 | $615.00 | Enhanced | H9725 | 003 |
| Guilford | Cigna HealthCare | HealthSpring TotalCare Plus (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $28.20 | $615.00 | Enhanced | H9725 | 013 |
| Guilford | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $35.00 | $615.00 | Enhanced | H5299 | 006 |
| Guilford | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 009 |
| Guilford | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 013 |
| Guilford | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 015 |
| Guilford | Devoted Health | DEVOTED C-SNP PREMIUM 017 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 017 |
| Guilford | HealthTeam Advantage | HealthTeam Advantage Diabetes & Heart Care (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $300.00 | Enhanced | H2624 | 001 |
| Guilford | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Guilford | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Guilford | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Guilford | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Guilford | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Guilford | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Guilford | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H6351 | 001 |
| Guilford | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $0.00 | Enhanced | H6351 | 004 |
| Guilford | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.70 | $615.00 | Basic | H6351 | 005 |
| Guilford | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H5374 | 001 |
| Guilford | Provider Partners Health Plans | Provider Partners North Carolina Advantage Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H4439 | 001 |
| Guilford | Provider Partners Health Plans | Provider Partners North Carolina Community Plan (HMO I-SNP) | HMO I-SNP | Institutional | $0.00 | $615.00 | Basic | H4439 | 002 |
| Guilford | Provider Partners Health Plans | Provider Partners North Carolina Essential Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H4439 | 003 |
| Guilford | UnitedHealthcare | UHC Nursing Home Plan NC-F001 (PPO I-SNP) | PPO I-SNP | Institutional | $36.20 | $615.00 | Basic | H0710 | 034 |
| Guilford | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Guilford | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Guilford | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Guilford | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Guilford | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Guilford | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $355.00 | Enhanced | H5253 | 189 |
| Guilford | Wellcare | Wellcare Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $25.80 | $395.00 | Basic | H1914 | 008 |
| Guilford | Wellcare | Wellcare Dual Access (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $32.20 | $385.00 | Basic | H4073 | 002 |
| Guilford | Wellcare | Wellcare Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $27.50 | $615.00 | Basic | H4073 | 003 |
| Guilford | Wellcare | Wellcare Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $425.00 | Basic | H4073 | 004 |
| Halifax | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Halifax | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Halifax | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Halifax | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Halifax | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Halifax | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Halifax | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Halifax | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Halifax | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H6351 | 001 |
| Halifax | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $0.00 | Enhanced | H6351 | 004 |
| Halifax | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.70 | $615.00 | Basic | H6351 | 005 |
| Halifax | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Halifax | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Halifax | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Halifax | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Halifax | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Halifax | UnitedHealthcare | UHC Complete Care NC-27 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $440.00 | Enhanced | H5253 | 188 |
| Harnett | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Harnett | Aetna Medicare | Aetna Medicare Full Dual Care (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $28.20 | $615.00 | Enhanced | H3146 | 022 |
| Harnett | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Harnett | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Harnett | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Harnett | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Harnett | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Harnett | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Harnett | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Harnett | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H6351 | 001 |
| Harnett | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $0.00 | Enhanced | H6351 | 004 |
| Harnett | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.70 | $615.00 | Basic | H6351 | 005 |
| Harnett | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H5374 | 001 |
| Harnett | Troy Medicare | Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $31.30 | $615.00 | Enhanced | H4676 | 002 |
| Harnett | UnitedHealthcare | UHC Nursing Home Plan NC-F001 (PPO I-SNP) | PPO I-SNP | Institutional | $36.20 | $615.00 | Basic | H0710 | 034 |
| Harnett | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Harnett | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Harnett | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Harnett | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Harnett | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Harnett | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $355.00 | Enhanced | H5253 | 189 |
| Harnett | Wellcare | Wellcare Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $25.80 | $395.00 | Basic | H1914 | 008 |
| Harnett | Wellcare | Wellcare Dual Access (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $32.20 | $385.00 | Basic | H4073 | 002 |
| Harnett | Wellcare | Wellcare Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $27.50 | $615.00 | Basic | H4073 | 003 |
| Harnett | Wellcare | Wellcare Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $425.00 | Basic | H4073 | 004 |
| Haywood | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Haywood | Aetna Medicare | Aetna Medicare Full Dual Care (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $28.20 | $615.00 | Enhanced | H3146 | 022 |
| Haywood | AmeriHealth Caritas VIP Care | AmeriHealth Caritas VIP Care (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H8212 | 001 |
| Haywood | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Haywood | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $35.00 | $615.00 | Enhanced | H5299 | 006 |
| Haywood | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 009 |
| Haywood | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 013 |
| Haywood | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 015 |
| Haywood | Devoted Health | DEVOTED C-SNP PREMIUM 018 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 018 |
| Haywood | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Haywood | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Haywood | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Haywood | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Haywood | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Haywood | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Haywood | Humana | Humana Dual Select H6622-027 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $29.00 | $615.00 | Enhanced | H6622 | 027 |
| Haywood | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H6351 | 001 |
| Haywood | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $0.00 | Enhanced | H6351 | 004 |
| Haywood | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.70 | $615.00 | Basic | H6351 | 005 |
| Haywood | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H5374 | 001 |
| Haywood | Troy Medicare | Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $31.30 | $615.00 | Enhanced | H4676 | 002 |
| Haywood | UnitedHealthcare | UHC Nursing Home Plan NC-F001 (PPO I-SNP) | PPO I-SNP | Institutional | $36.20 | $615.00 | Basic | H0710 | 034 |
| Haywood | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Haywood | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Haywood | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Haywood | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Haywood | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Haywood | UnitedHealthcare | UHC Complete Care NC-25 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $520.00 | Enhanced | H5253 | 186 |
| Haywood | Wellcare | Wellcare Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $25.80 | $395.00 | Basic | H1914 | 008 |
| Haywood | Wellcare | Wellcare Dual Access (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $32.20 | $385.00 | Basic | H4073 | 002 |
| Haywood | Wellcare | Wellcare Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $27.50 | $615.00 | Basic | H4073 | 003 |
| Haywood | Wellcare | Wellcare Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $425.00 | Basic | H4073 | 004 |
| Henderson | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Henderson | Alignment Health Plan | Alignment Health NC Duals (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5296 | 004 |
| Henderson | Alignment Health Plan | Alignment Health Heart & Diabetes NCPlus (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $36.20 | $615.00 | Enhanced | H5296 | 009 |
| Henderson | Alignment Health Plan | Alignment Health Heart & Diabetes Care (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $250.00 | Enhanced | H5296 | 011 |
| Henderson | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Henderson | Cigna HealthCare | HealthSpring TotalCare (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $19.70 | $615.00 | Enhanced | H9725 | 003 |
| Henderson | Cigna HealthCare | HealthSpring TotalCare Plus (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $28.20 | $615.00 | Enhanced | H9725 | 013 |
| Henderson | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $35.00 | $615.00 | Enhanced | H5299 | 006 |
| Henderson | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 009 |
| Henderson | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 013 |
| Henderson | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 015 |
| Henderson | Devoted Health | DEVOTED C-SNP PREMIUM 018 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 018 |
| Henderson | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Henderson | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Henderson | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Henderson | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Henderson | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Henderson | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Henderson | Humana | Humana Dual Select H6622-027 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $29.00 | $615.00 | Enhanced | H6622 | 027 |
| Henderson | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H6351 | 001 |
| Henderson | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $0.00 | Enhanced | H6351 | 004 |
| Henderson | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.70 | $615.00 | Basic | H6351 | 005 |
| Henderson | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H5374 | 001 |
| Henderson | Troy Medicare | Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $31.30 | $615.00 | Enhanced | H4676 | 002 |
| Henderson | UnitedHealthcare | UHC Nursing Home Plan NC-F001 (PPO I-SNP) | PPO I-SNP | Institutional | $36.20 | $615.00 | Basic | H0710 | 034 |
| Henderson | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Henderson | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Henderson | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Henderson | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Henderson | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Henderson | UnitedHealthcare | UHC Complete Care NC-25 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $520.00 | Enhanced | H5253 | 186 |
| Henderson | Wellcare | Wellcare Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $25.80 | $395.00 | Basic | H1914 | 008 |
| Henderson | Wellcare | Wellcare Dual Access (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $32.20 | $385.00 | Basic | H4073 | 002 |
| Henderson | Wellcare | Wellcare Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $27.50 | $615.00 | Basic | H4073 | 003 |
| Henderson | Wellcare | Wellcare Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $425.00 | Basic | H4073 | 004 |
| Hertford | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Hertford | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Hertford | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Hertford | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Hertford | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Hertford | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Hertford | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Hertford | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Hertford | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Hertford | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Hertford | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Hertford | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Hertford | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Hertford | UnitedHealthcare | UHC Complete Care NC-27 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $440.00 | Enhanced | H5253 | 188 |
| Hoke | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Hoke | Aetna Medicare | Aetna Medicare Full Dual Care (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $28.20 | $615.00 | Enhanced | H3146 | 022 |
| Hoke | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Hoke | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Hoke | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Hoke | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Hoke | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Hoke | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Hoke | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Hoke | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H5374 | 001 |
| Hoke | Troy Medicare | Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $31.30 | $615.00 | Enhanced | H4676 | 002 |
| Hoke | UnitedHealthcare | UHC Nursing Home Plan NC-F001 (PPO I-SNP) | PPO I-SNP | Institutional | $36.20 | $615.00 | Basic | H0710 | 034 |
| Hoke | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Hoke | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Hoke | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Hoke | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Hoke | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Hoke | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $355.00 | Enhanced | H5253 | 189 |
| Hoke | Wellcare | Wellcare Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $25.80 | $395.00 | Basic | H1914 | 008 |
| Hoke | Wellcare | Wellcare Dual Access (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $32.20 | $385.00 | Basic | H4073 | 002 |
| Hoke | Wellcare | Wellcare Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $27.50 | $615.00 | Basic | H4073 | 003 |
| Hoke | Wellcare | Wellcare Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $425.00 | Basic | H4073 | 004 |
| Hyde | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Hyde | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Hyde | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Hyde | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Hyde | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Hyde | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Hyde | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Hyde | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Hyde | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H6351 | 001 |
| Hyde | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $0.00 | Enhanced | H6351 | 004 |
| Hyde | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.70 | $615.00 | Basic | H6351 | 005 |
| Hyde | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Hyde | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Hyde | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Hyde | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Hyde | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Hyde | UnitedHealthcare | UHC Complete Care NC-27 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $440.00 | Enhanced | H5253 | 188 |
| Iredell | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Iredell | Aetna Medicare | Aetna Medicare Full Dual Care (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $28.20 | $615.00 | Enhanced | H3146 | 022 |
| Iredell | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Iredell | Cigna HealthCare | HealthSpring TotalCare (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $19.70 | $615.00 | Enhanced | H9725 | 003 |
| Iredell | Cigna HealthCare | HealthSpring TotalCare Plus (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $28.20 | $615.00 | Enhanced | H9725 | 013 |
| Iredell | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $35.00 | $615.00 | Enhanced | H5299 | 006 |
| Iredell | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 009 |
| Iredell | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 013 |
| Iredell | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 015 |
| Iredell | Devoted Health | DEVOTED C-SNP PREMIUM 016 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 016 |
| Iredell | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Iredell | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Iredell | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Iredell | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Iredell | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Iredell | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Iredell | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H5374 | 001 |
| Iredell | Troy Medicare | Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $31.30 | $615.00 | Enhanced | H4676 | 002 |
| Iredell | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Iredell | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Iredell | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Iredell | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Iredell | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Iredell | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $355.00 | Enhanced | H5253 | 189 |
| Iredell | Wellcare | Wellcare Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $25.80 | $395.00 | Basic | H1914 | 008 |
| Iredell | Wellcare | Wellcare Dual Access (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $32.20 | $385.00 | Basic | H4073 | 002 |
| Iredell | Wellcare | Wellcare Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $27.50 | $615.00 | Basic | H4073 | 003 |
| Iredell | Wellcare | Wellcare Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $425.00 | Basic | H4073 | 004 |
| Jackson | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Jackson | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Jackson | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $35.00 | $615.00 | Enhanced | H5299 | 006 |
| Jackson | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 009 |
| Jackson | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 013 |
| Jackson | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 015 |
| Jackson | Devoted Health | DEVOTED C-SNP PREMIUM 018 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 018 |
| Jackson | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Jackson | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Jackson | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Jackson | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Jackson | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Jackson | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Jackson | Humana | Humana Dual Select H6622-027 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $29.00 | $615.00 | Enhanced | H6622 | 027 |
| Jackson | Troy Medicare | Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $31.30 | $615.00 | Enhanced | H4676 | 002 |
| Jackson | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Jackson | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Jackson | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Jackson | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Jackson | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Jackson | UnitedHealthcare | UHC Complete Care NC-25 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $520.00 | Enhanced | H5253 | 186 |
| Jackson | Wellcare | Wellcare Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $25.80 | $395.00 | Basic | H1914 | 008 |
| Jackson | Wellcare | Wellcare Dual Access (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $32.20 | $385.00 | Basic | H4073 | 002 |
| Jackson | Wellcare | Wellcare Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $27.50 | $615.00 | Basic | H4073 | 003 |
| Jackson | Wellcare | Wellcare Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $425.00 | Basic | H4073 | 004 |
| Johnston | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Johnston | Aetna Medicare | Aetna Medicare Full Dual Care (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $28.20 | $615.00 | Enhanced | H3146 | 022 |
| Johnston | Alignment Health Plan | Alignment Health NC Duals (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5296 | 004 |
| Johnston | Alignment Health Plan | Alignment Health Heart & Diabetes NCPlus (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $36.20 | $615.00 | Enhanced | H5296 | 009 |
| Johnston | Alignment Health Plan | Alignment Health Heart & Diabetes Care (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $250.00 | Enhanced | H5296 | 011 |
| Johnston | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Johnston | Cigna HealthCare | HealthSpring TotalCare (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $19.70 | $615.00 | Enhanced | H9725 | 003 |
| Johnston | Cigna HealthCare | HealthSpring TotalCare Plus (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $28.20 | $615.00 | Enhanced | H9725 | 013 |
| Johnston | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Johnston | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Johnston | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Johnston | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Johnston | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Johnston | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Johnston | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H6351 | 001 |
| Johnston | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $0.00 | Enhanced | H6351 | 004 |
| Johnston | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.70 | $615.00 | Basic | H6351 | 005 |
| Johnston | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H5374 | 001 |
| Johnston | UnitedHealthcare | UHC Nursing Home Plan NC-F001 (PPO I-SNP) | PPO I-SNP | Institutional | $36.20 | $615.00 | Basic | H0710 | 034 |
| Johnston | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Johnston | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Johnston | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Johnston | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Johnston | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Johnston | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $355.00 | Enhanced | H5253 | 189 |
| Johnston | Wellcare | Wellcare Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $25.80 | $395.00 | Basic | H1914 | 008 |
| Johnston | Wellcare | Wellcare Dual Access (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $32.20 | $385.00 | Basic | H4073 | 002 |
| Johnston | Wellcare | Wellcare Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $27.50 | $615.00 | Basic | H4073 | 003 |
| Johnston | Wellcare | Wellcare Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $425.00 | Basic | H4073 | 004 |
| Jones | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Jones | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Jones | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Jones | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Jones | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Jones | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Jones | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Jones | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Jones | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Jones | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Jones | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Jones | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Jones | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Jones | UnitedHealthcare | UHC Complete Care NC-27 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $440.00 | Enhanced | H5253 | 188 |
| Jones | Wellcare | Wellcare Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $25.80 | $395.00 | Basic | H1914 | 008 |
| Lee | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Lee | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Lee | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Lee | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Lee | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Lee | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Lee | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Lee | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Lee | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H6351 | 001 |
| Lee | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $0.00 | Enhanced | H6351 | 004 |
| Lee | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.70 | $615.00 | Basic | H6351 | 005 |
| Lee | Troy Medicare | Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $31.30 | $615.00 | Enhanced | H4676 | 002 |
| Lee | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Lee | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Lee | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Lee | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Lee | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Lee | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $355.00 | Enhanced | H5253 | 189 |
| Lee | Wellcare | Wellcare Dual Access (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $32.20 | $385.00 | Basic | H4073 | 002 |
| Lee | Wellcare | Wellcare Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $27.50 | $615.00 | Basic | H4073 | 003 |
| Lee | Wellcare | Wellcare Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $425.00 | Basic | H4073 | 004 |
| Lenoir | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Lenoir | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Lenoir | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Lenoir | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Lenoir | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Lenoir | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Lenoir | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Lenoir | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Lenoir | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H6351 | 001 |
| Lenoir | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $0.00 | Enhanced | H6351 | 004 |
| Lenoir | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.70 | $615.00 | Basic | H6351 | 005 |
| Lenoir | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Lenoir | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Lenoir | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Lenoir | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Lenoir | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Lenoir | UnitedHealthcare | UHC Complete Care NC-27 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $440.00 | Enhanced | H5253 | 188 |
| Lincoln | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Lincoln | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Lincoln | Cigna HealthCare | HealthSpring TotalCare (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $19.70 | $615.00 | Enhanced | H9725 | 003 |
| Lincoln | Cigna HealthCare | HealthSpring TotalCare Plus (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $28.20 | $615.00 | Enhanced | H9725 | 013 |
| Lincoln | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $35.00 | $615.00 | Enhanced | H5299 | 006 |
| Lincoln | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 009 |
| Lincoln | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 013 |
| Lincoln | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 015 |
| Lincoln | Devoted Health | DEVOTED C-SNP PREMIUM 016 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 016 |
| Lincoln | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Lincoln | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Lincoln | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Lincoln | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Lincoln | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Lincoln | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Lincoln | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H5374 | 001 |
| Lincoln | Provider Partners Health Plans | Provider Partners North Carolina Advantage Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H4439 | 001 |
| Lincoln | Provider Partners Health Plans | Provider Partners North Carolina Community Plan (HMO I-SNP) | HMO I-SNP | Institutional | $0.00 | $615.00 | Basic | H4439 | 002 |
| Lincoln | Provider Partners Health Plans | Provider Partners North Carolina Essential Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H4439 | 003 |
| Lincoln | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Lincoln | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Lincoln | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Lincoln | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Lincoln | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Lincoln | UnitedHealthcare | UHC Complete Care NC-25 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $520.00 | Enhanced | H5253 | 186 |
| Lincoln | Wellcare | Wellcare Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $25.80 | $395.00 | Basic | H1914 | 008 |
| Lincoln | Wellcare | Wellcare Dual Access (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $32.20 | $385.00 | Basic | H4073 | 002 |
| Lincoln | Wellcare | Wellcare Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $27.50 | $615.00 | Basic | H4073 | 003 |
| Lincoln | Wellcare | Wellcare Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $425.00 | Basic | H4073 | 004 |
| Macon | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Macon | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Macon | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Macon | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Macon | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Macon | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Macon | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Macon | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Macon | Humana | Humana Dual Select H6622-027 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $29.00 | $615.00 | Enhanced | H6622 | 027 |
| Macon | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Macon | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Macon | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Macon | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Macon | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Macon | UnitedHealthcare | UHC Complete Care NC-25 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $520.00 | Enhanced | H5253 | 186 |
| Macon | Wellcare | Wellcare Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $25.80 | $395.00 | Basic | H1914 | 008 |
| Macon | Wellcare | Wellcare Dual Access (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $32.20 | $385.00 | Basic | H4073 | 002 |
| Macon | Wellcare | Wellcare Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $27.50 | $615.00 | Basic | H4073 | 003 |
| Macon | Wellcare | Wellcare Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $425.00 | Basic | H4073 | 004 |
| Madison | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Madison | Alignment Health Plan | Alignment Health NC Duals (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5296 | 004 |
| Madison | Alignment Health Plan | Alignment Health Heart & Diabetes NCPlus (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $36.20 | $615.00 | Enhanced | H5296 | 009 |
| Madison | Alignment Health Plan | Alignment Health Heart & Diabetes Care (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $250.00 | Enhanced | H5296 | 011 |
| Madison | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Madison | Cigna HealthCare | HealthSpring TotalCare (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $19.70 | $615.00 | Enhanced | H9725 | 003 |
| Madison | Cigna HealthCare | HealthSpring TotalCare Plus (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $28.20 | $615.00 | Enhanced | H9725 | 013 |
| Madison | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $35.00 | $615.00 | Enhanced | H5299 | 006 |
| Madison | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 009 |
| Madison | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 013 |
| Madison | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 015 |
| Madison | Devoted Health | DEVOTED C-SNP PREMIUM 018 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 018 |
| Madison | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Madison | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Madison | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Madison | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Madison | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Madison | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Madison | Humana | Humana Dual Select H6622-027 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $29.00 | $615.00 | Enhanced | H6622 | 027 |
| Madison | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Madison | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Madison | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Madison | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Madison | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Madison | UnitedHealthcare | UHC Complete Care NC-25 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $520.00 | Enhanced | H5253 | 186 |
| Madison | Wellcare | Wellcare Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $25.80 | $395.00 | Basic | H1914 | 008 |
| Madison | Wellcare | Wellcare Dual Access (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $32.20 | $385.00 | Basic | H4073 | 002 |
| Madison | Wellcare | Wellcare Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $27.50 | $615.00 | Basic | H4073 | 003 |
| Madison | Wellcare | Wellcare Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $425.00 | Basic | H4073 | 004 |
| Martin | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Martin | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Martin | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Martin | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Martin | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Martin | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Martin | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Martin | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Martin | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H6351 | 001 |
| Martin | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $0.00 | Enhanced | H6351 | 004 |
| Martin | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.70 | $615.00 | Basic | H6351 | 005 |
| Martin | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Martin | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Martin | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Martin | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Martin | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Martin | UnitedHealthcare | UHC Complete Care NC-27 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $440.00 | Enhanced | H5253 | 188 |
| Martin | Wellcare | Wellcare Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $25.80 | $395.00 | Basic | H1914 | 008 |
| McDowell | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| McDowell | Alignment Health Plan | Alignment Health NC Duals (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5296 | 004 |
| McDowell | Alignment Health Plan | Alignment Health Heart & Diabetes NCPlus (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $36.20 | $615.00 | Enhanced | H5296 | 009 |
| McDowell | Alignment Health Plan | Alignment Health Heart & Diabetes Care (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $250.00 | Enhanced | H5296 | 011 |
| McDowell | AmeriHealth Caritas VIP Care | AmeriHealth Caritas VIP Care (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H8212 | 001 |
| McDowell | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| McDowell | Cigna HealthCare | HealthSpring TotalCare (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $19.70 | $615.00 | Enhanced | H9725 | 003 |
| McDowell | Cigna HealthCare | HealthSpring TotalCare Plus (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $28.20 | $615.00 | Enhanced | H9725 | 013 |
| McDowell | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $35.00 | $615.00 | Enhanced | H5299 | 006 |
| McDowell | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 009 |
| McDowell | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 013 |
| McDowell | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 015 |
| McDowell | Devoted Health | DEVOTED C-SNP PREMIUM 018 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 018 |
| McDowell | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| McDowell | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| McDowell | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| McDowell | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| McDowell | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| McDowell | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| McDowell | Humana | Humana Dual Select H6622-027 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $29.00 | $615.00 | Enhanced | H6622 | 027 |
| McDowell | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H5374 | 001 |
| McDowell | Troy Medicare | Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $31.30 | $615.00 | Enhanced | H4676 | 002 |
| McDowell | UnitedHealthcare | UHC Nursing Home Plan NC-F001 (PPO I-SNP) | PPO I-SNP | Institutional | $36.20 | $615.00 | Basic | H0710 | 034 |
| McDowell | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| McDowell | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| McDowell | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| McDowell | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| McDowell | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| McDowell | UnitedHealthcare | UHC Complete Care NC-25 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $520.00 | Enhanced | H5253 | 186 |
| McDowell | Wellcare | Wellcare Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $25.80 | $395.00 | Basic | H1914 | 008 |
| McDowell | Wellcare | Wellcare Dual Access (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $32.20 | $385.00 | Basic | H4073 | 002 |
| McDowell | Wellcare | Wellcare Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $27.50 | $615.00 | Basic | H4073 | 003 |
| McDowell | Wellcare | Wellcare Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $425.00 | Basic | H4073 | 004 |
| Mecklenburg | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Mecklenburg | Aetna Medicare | Aetna Medicare Full Dual Care (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $28.20 | $615.00 | Enhanced | H3146 | 022 |
| Mecklenburg | Aetna Medicare | Aetna Medicare Chronic Condition ConditionCare (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $615.00 | Enhanced | H3146 | 037 |
| Mecklenburg | Aetna Medicare | Aetna Medicare Chronic Condition ConditionCare Value (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Enhanced | H3146 | 044 |
| Mecklenburg | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Mecklenburg | Cigna HealthCare | HealthSpring TotalCare (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $19.70 | $615.00 | Enhanced | H9725 | 003 |
| Mecklenburg | Cigna HealthCare | HealthSpring TotalCare Plus (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $28.20 | $615.00 | Enhanced | H9725 | 013 |
| Mecklenburg | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $35.00 | $615.00 | Enhanced | H5299 | 006 |
| Mecklenburg | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 009 |
| Mecklenburg | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 013 |
| Mecklenburg | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 015 |
| Mecklenburg | Devoted Health | DEVOTED C-SNP PREMIUM 016 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 016 |
| Mecklenburg | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Mecklenburg | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Mecklenburg | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Mecklenburg | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Mecklenburg | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Mecklenburg | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Mecklenburg | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H6351 | 001 |
| Mecklenburg | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $0.00 | Enhanced | H6351 | 004 |
| Mecklenburg | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.70 | $615.00 | Basic | H6351 | 005 |
| Mecklenburg | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H5374 | 001 |
| Mecklenburg | Provider Partners Health Plans | Provider Partners North Carolina Advantage Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H4439 | 001 |
| Mecklenburg | Provider Partners Health Plans | Provider Partners North Carolina Community Plan (HMO I-SNP) | HMO I-SNP | Institutional | $0.00 | $615.00 | Basic | H4439 | 002 |
| Mecklenburg | Provider Partners Health Plans | Provider Partners North Carolina Essential Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H4439 | 003 |
| Mecklenburg | UnitedHealthcare | UHC Nursing Home Plan NC-F001 (PPO I-SNP) | PPO I-SNP | Institutional | $36.20 | $615.00 | Basic | H0710 | 034 |
| Mecklenburg | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Mecklenburg | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Mecklenburg | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Mecklenburg | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Mecklenburg | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Mecklenburg | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $355.00 | Enhanced | H5253 | 189 |
| Mecklenburg | UnitedHealthcare | Erickson Advantage Guardian (HMO-POS I-SNP) | HMO-POS I-SNP | Institutional | $0.00 | $0.00 | Enhanced | H5652 | 003 |
| Mecklenburg | UnitedHealthcare | Erickson Advantage Champion (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $182.00 | $270.00 | Enhanced | H5652 | 004 |
| Mecklenburg | Wellcare | Wellcare Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $25.80 | $395.00 | Basic | H1914 | 008 |
| Mecklenburg | Wellcare | Wellcare Dual Access (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $32.20 | $385.00 | Basic | H4073 | 002 |
| Mecklenburg | Wellcare | Wellcare Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $27.50 | $615.00 | Basic | H4073 | 003 |
| Mecklenburg | Wellcare | Wellcare Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $425.00 | Basic | H4073 | 004 |
| Mitchell | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Mitchell | Alignment Health Plan | Alignment Health NC Duals (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5296 | 004 |
| Mitchell | Alignment Health Plan | Alignment Health Heart & Diabetes NCPlus (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $36.20 | $615.00 | Enhanced | H5296 | 009 |
| Mitchell | Alignment Health Plan | Alignment Health Heart & Diabetes Care (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $250.00 | Enhanced | H5296 | 011 |
| Mitchell | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Mitchell | Cigna HealthCare | HealthSpring TotalCare (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $19.70 | $615.00 | Enhanced | H9725 | 003 |
| Mitchell | Cigna HealthCare | HealthSpring TotalCare Plus (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $28.20 | $615.00 | Enhanced | H9725 | 013 |
| Mitchell | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $35.00 | $615.00 | Enhanced | H5299 | 006 |
| Mitchell | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 009 |
| Mitchell | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 013 |
| Mitchell | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 015 |
| Mitchell | Devoted Health | DEVOTED C-SNP PREMIUM 018 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 018 |
| Mitchell | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Mitchell | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Mitchell | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Mitchell | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Mitchell | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Mitchell | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Mitchell | Humana | Humana Dual Select H6622-027 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $29.00 | $615.00 | Enhanced | H6622 | 027 |
| Mitchell | Provider Partners Health Plans | Provider Partners North Carolina Advantage Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H4439 | 001 |
| Mitchell | Provider Partners Health Plans | Provider Partners North Carolina Community Plan (HMO I-SNP) | HMO I-SNP | Institutional | $0.00 | $615.00 | Basic | H4439 | 002 |
| Mitchell | Provider Partners Health Plans | Provider Partners North Carolina Essential Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H4439 | 003 |
| Mitchell | Troy Medicare | Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $31.30 | $615.00 | Enhanced | H4676 | 002 |
| Mitchell | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Mitchell | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Mitchell | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Mitchell | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Mitchell | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Mitchell | UnitedHealthcare | UHC Complete Care NC-25 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $520.00 | Enhanced | H5253 | 186 |
| Mitchell | Wellcare | Wellcare Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $25.80 | $395.00 | Basic | H1914 | 008 |
| Mitchell | Wellcare | Wellcare Dual Access (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $32.20 | $385.00 | Basic | H4073 | 002 |
| Mitchell | Wellcare | Wellcare Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $27.50 | $615.00 | Basic | H4073 | 003 |
| Mitchell | Wellcare | Wellcare Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $425.00 | Basic | H4073 | 004 |
| Montgomery | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Montgomery | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Montgomery | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Montgomery | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Montgomery | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Montgomery | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Montgomery | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Montgomery | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Montgomery | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H5374 | 001 |
| Montgomery | Troy Medicare | Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $31.30 | $615.00 | Enhanced | H4676 | 002 |
| Montgomery | UnitedHealthcare | UHC Nursing Home Plan NC-F001 (PPO I-SNP) | PPO I-SNP | Institutional | $36.20 | $615.00 | Basic | H0710 | 034 |
| Montgomery | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Montgomery | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Montgomery | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Montgomery | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Montgomery | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Montgomery | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $355.00 | Enhanced | H5253 | 189 |
| Montgomery | Wellcare | Wellcare Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $25.80 | $395.00 | Basic | H1914 | 008 |
| Montgomery | Wellcare | Wellcare Dual Access (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $32.20 | $385.00 | Basic | H4073 | 002 |
| Montgomery | Wellcare | Wellcare Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $27.50 | $615.00 | Basic | H4073 | 003 |
| Montgomery | Wellcare | Wellcare Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $425.00 | Basic | H4073 | 004 |
| Moore | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Moore | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Moore | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Moore | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Moore | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Moore | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Moore | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Moore | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Moore | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H6351 | 001 |
| Moore | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $0.00 | Enhanced | H6351 | 004 |
| Moore | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.70 | $615.00 | Basic | H6351 | 005 |
| Moore | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H5374 | 001 |
| Moore | Troy Medicare | Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $31.30 | $615.00 | Enhanced | H4676 | 002 |
| Moore | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Moore | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Moore | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Moore | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Moore | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Moore | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $355.00 | Enhanced | H5253 | 189 |
| Moore | Wellcare | Wellcare Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $25.80 | $395.00 | Basic | H1914 | 008 |
| Moore | Wellcare | Wellcare Dual Access (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $32.20 | $385.00 | Basic | H4073 | 002 |
| Moore | Wellcare | Wellcare Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $27.50 | $615.00 | Basic | H4073 | 003 |
| Moore | Wellcare | Wellcare Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $425.00 | Basic | H4073 | 004 |
| Nash | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Nash | Aetna Medicare | Aetna Medicare Full Dual Care (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $28.20 | $615.00 | Enhanced | H3146 | 022 |
| Nash | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Nash | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Nash | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Nash | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Nash | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Nash | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Nash | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Nash | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H5374 | 001 |
| Nash | UnitedHealthcare | UHC Nursing Home Plan NC-F001 (PPO I-SNP) | PPO I-SNP | Institutional | $36.20 | $615.00 | Basic | H0710 | 034 |
| Nash | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Nash | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Nash | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Nash | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Nash | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Nash | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $355.00 | Enhanced | H5253 | 189 |
| Nash | Wellcare | Wellcare Dual Access (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $32.20 | $385.00 | Basic | H4073 | 002 |
| Nash | Wellcare | Wellcare Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $27.50 | $615.00 | Basic | H4073 | 003 |
| Nash | Wellcare | Wellcare Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $425.00 | Basic | H4073 | 004 |
| New Hanover | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| New Hanover | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| New Hanover | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $35.00 | $615.00 | Enhanced | H5299 | 006 |
| New Hanover | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 009 |
| New Hanover | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 013 |
| New Hanover | Devoted Health | DEVOTED C-SNP PREMIUM 014 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 014 |
| New Hanover | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 015 |
| New Hanover | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| New Hanover | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| New Hanover | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| New Hanover | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| New Hanover | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| New Hanover | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| New Hanover | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H6351 | 001 |
| New Hanover | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $0.00 | Enhanced | H6351 | 004 |
| New Hanover | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.70 | $615.00 | Basic | H6351 | 005 |
| New Hanover | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H5374 | 001 |
| New Hanover | Provider Partners Health Plans | Provider Partners North Carolina Advantage Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H4439 | 001 |
| New Hanover | Provider Partners Health Plans | Provider Partners North Carolina Community Plan (HMO I-SNP) | HMO I-SNP | Institutional | $0.00 | $615.00 | Basic | H4439 | 002 |
| New Hanover | Provider Partners Health Plans | Provider Partners North Carolina Essential Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H4439 | 003 |
| New Hanover | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| New Hanover | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| New Hanover | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| New Hanover | UnitedHealthcare | UHC Complete Care NC-27 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $440.00 | Enhanced | H5253 | 188 |
| Northampton | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Northampton | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Northampton | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Northampton | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Northampton | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Northampton | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Northampton | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Northampton | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Northampton | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Northampton | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Northampton | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Northampton | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Northampton | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Northampton | UnitedHealthcare | UHC Complete Care NC-27 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $440.00 | Enhanced | H5253 | 188 |
| Onslow | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Onslow | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Onslow | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Onslow | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Onslow | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Onslow | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Onslow | UnitedHealthcare | UHC Complete Care NC-27 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $440.00 | Enhanced | H5253 | 188 |
| Orange | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Orange | Aetna Medicare | Aetna Medicare Full Dual Care (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $28.20 | $615.00 | Enhanced | H3146 | 022 |
| Orange | Alignment Health Plan | Alignment Health NC Duals (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5296 | 004 |
| Orange | Alignment Health Plan | Alignment Health Heart & Diabetes NCPlus (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $36.20 | $615.00 | Enhanced | H5296 | 009 |
| Orange | Alignment Health Plan | Alignment Health Heart & Diabetes Care (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $250.00 | Enhanced | H5296 | 011 |
| Orange | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Orange | Cigna HealthCare | HealthSpring TotalCare (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $19.70 | $615.00 | Enhanced | H9725 | 003 |
| Orange | Cigna HealthCare | HealthSpring TotalCare Plus (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $28.20 | $615.00 | Enhanced | H9725 | 013 |
| Orange | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Orange | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Orange | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Orange | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Orange | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Orange | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H6351 | 001 |
| Orange | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $0.00 | Enhanced | H6351 | 004 |
| Orange | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.70 | $615.00 | Basic | H6351 | 005 |
| Orange | Troy Medicare | Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $31.30 | $615.00 | Enhanced | H4676 | 002 |
| Orange | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Orange | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Orange | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Orange | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Orange | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Orange | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $355.00 | Enhanced | H5253 | 189 |
| Orange | Wellcare | Wellcare Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $25.80 | $395.00 | Basic | H1914 | 008 |
| Orange | Wellcare | Wellcare Dual Access (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $32.20 | $385.00 | Basic | H4073 | 002 |
| Orange | Wellcare | Wellcare Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $27.50 | $615.00 | Basic | H4073 | 003 |
| Orange | Wellcare | Wellcare Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $425.00 | Basic | H4073 | 004 |
| Pamlico | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Pamlico | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Pamlico | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Pamlico | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Pamlico | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Pamlico | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Pamlico | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Pamlico | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Pamlico | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Pamlico | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Pamlico | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Pamlico | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Pamlico | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Pamlico | UnitedHealthcare | UHC Complete Care NC-27 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $440.00 | Enhanced | H5253 | 188 |
| Pasquotank | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Pasquotank | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Pasquotank | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Pasquotank | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Pasquotank | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Pasquotank | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Pasquotank | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Pasquotank | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Pasquotank | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Pasquotank | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Pasquotank | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Pasquotank | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Pasquotank | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Pasquotank | UnitedHealthcare | UHC Complete Care NC-27 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $440.00 | Enhanced | H5253 | 188 |
| Pender | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Pender | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Pender | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $35.00 | $615.00 | Enhanced | H5299 | 006 |
| Pender | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 009 |
| Pender | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 013 |
| Pender | Devoted Health | DEVOTED C-SNP PREMIUM 014 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 014 |
| Pender | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 015 |
| Pender | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Pender | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Pender | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Pender | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Pender | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Pender | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Pender | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H6351 | 001 |
| Pender | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $0.00 | Enhanced | H6351 | 004 |
| Pender | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.70 | $615.00 | Basic | H6351 | 005 |
| Pender | Provider Partners Health Plans | Provider Partners North Carolina Advantage Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H4439 | 001 |
| Pender | Provider Partners Health Plans | Provider Partners North Carolina Community Plan (HMO I-SNP) | HMO I-SNP | Institutional | $0.00 | $615.00 | Basic | H4439 | 002 |
| Pender | Provider Partners Health Plans | Provider Partners North Carolina Essential Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H4439 | 003 |
| Pender | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Pender | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Pender | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Pender | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Pender | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Pender | UnitedHealthcare | UHC Complete Care NC-27 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $440.00 | Enhanced | H5253 | 188 |
| Perquimans | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Perquimans | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Perquimans | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Perquimans | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Perquimans | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Perquimans | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Perquimans | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Perquimans | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Perquimans | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Perquimans | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Perquimans | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Perquimans | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Perquimans | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Perquimans | UnitedHealthcare | UHC Complete Care NC-27 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $440.00 | Enhanced | H5253 | 188 |
| Person | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Person | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Person | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $35.00 | $615.00 | Enhanced | H5299 | 006 |
| Person | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 009 |
| Person | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 013 |
| Person | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 015 |
| Person | Devoted Health | DEVOTED C-SNP PREMIUM 017 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 017 |
| Person | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Person | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Person | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Person | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Person | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Person | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Person | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H6351 | 001 |
| Person | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $0.00 | Enhanced | H6351 | 004 |
| Person | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.70 | $615.00 | Basic | H6351 | 005 |
| Person | Troy Medicare | Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $31.30 | $615.00 | Enhanced | H4676 | 002 |
| Person | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Person | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Person | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Person | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Person | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Person | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $355.00 | Enhanced | H5253 | 189 |
| Person | Wellcare | Wellcare Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $25.80 | $395.00 | Basic | H1914 | 008 |
| Person | Wellcare | Wellcare Dual Access (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $32.20 | $385.00 | Basic | H4073 | 002 |
| Person | Wellcare | Wellcare Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $27.50 | $615.00 | Basic | H4073 | 003 |
| Person | Wellcare | Wellcare Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $425.00 | Basic | H4073 | 004 |
| Pitt | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Pitt | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Pitt | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Pitt | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Pitt | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Pitt | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Pitt | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Pitt | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Pitt | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H6351 | 001 |
| Pitt | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $0.00 | Enhanced | H6351 | 004 |
| Pitt | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.70 | $615.00 | Basic | H6351 | 005 |
| Pitt | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H5374 | 001 |
| Pitt | PruittHealth Premier | PruittHealth Premier (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H6345 | 001 |
| Pitt | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Pitt | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Pitt | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Pitt | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Pitt | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Pitt | UnitedHealthcare | UHC Complete Care NC-27 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $440.00 | Enhanced | H5253 | 188 |
| Polk | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Polk | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Polk | Cigna HealthCare | HealthSpring TotalCare (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $19.70 | $615.00 | Enhanced | H9725 | 003 |
| Polk | Cigna HealthCare | HealthSpring TotalCare Plus (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $28.20 | $615.00 | Enhanced | H9725 | 013 |
| Polk | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $35.00 | $615.00 | Enhanced | H5299 | 006 |
| Polk | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 009 |
| Polk | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 013 |
| Polk | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 015 |
| Polk | Devoted Health | DEVOTED C-SNP PREMIUM 018 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 018 |
| Polk | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Polk | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Polk | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Polk | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Polk | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Polk | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Polk | Humana | Humana Dual Select H6622-027 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $29.00 | $615.00 | Enhanced | H6622 | 027 |
| Polk | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H6351 | 001 |
| Polk | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $0.00 | Enhanced | H6351 | 004 |
| Polk | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.70 | $615.00 | Basic | H6351 | 005 |
| Polk | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H5374 | 001 |
| Polk | NHC Advantage | NHC Advantage (HMO I-SNP) | HMO I-SNP | Institutional | $31.00 | $615.00 | Basic | H4172 | 001 |
| Polk | NHC Advantage | Senior Care (HMO I-SNP) | HMO I-SNP | Institutional | $0.00 | $250.00 | Enhanced | H4172 | 003 |
| Polk | Troy Medicare | Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $31.30 | $615.00 | Enhanced | H4676 | 002 |
| Polk | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Polk | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Polk | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Polk | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Polk | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Polk | UnitedHealthcare | UHC Complete Care NC-25 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $520.00 | Enhanced | H5253 | 186 |
| Polk | Wellcare | Wellcare Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $25.80 | $395.00 | Basic | H1914 | 008 |
| Polk | Wellcare | Wellcare Dual Access (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $32.20 | $385.00 | Basic | H4073 | 002 |
| Polk | Wellcare | Wellcare Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $27.50 | $615.00 | Basic | H4073 | 003 |
| Polk | Wellcare | Wellcare Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $425.00 | Basic | H4073 | 004 |
| Randolph | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Randolph | Aetna Medicare | Aetna Medicare Full Dual Care (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $28.20 | $615.00 | Enhanced | H3146 | 022 |
| Randolph | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Randolph | Cigna HealthCare | HealthSpring TotalCare (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $19.70 | $615.00 | Enhanced | H9725 | 003 |
| Randolph | Cigna HealthCare | HealthSpring TotalCare Plus (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $28.20 | $615.00 | Enhanced | H9725 | 013 |
| Randolph | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $35.00 | $615.00 | Enhanced | H5299 | 006 |
| Randolph | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 009 |
| Randolph | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 013 |
| Randolph | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 015 |
| Randolph | Devoted Health | DEVOTED C-SNP PREMIUM 017 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 017 |
| Randolph | HealthTeam Advantage | HealthTeam Advantage Diabetes & Heart Care (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $300.00 | Enhanced | H2624 | 001 |
| Randolph | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Randolph | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Randolph | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Randolph | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Randolph | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Randolph | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Randolph | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H6351 | 001 |
| Randolph | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $0.00 | Enhanced | H6351 | 004 |
| Randolph | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.70 | $615.00 | Basic | H6351 | 005 |
| Randolph | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H5374 | 001 |
| Randolph | UnitedHealthcare | UHC Nursing Home Plan NC-F001 (PPO I-SNP) | PPO I-SNP | Institutional | $36.20 | $615.00 | Basic | H0710 | 034 |
| Randolph | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Randolph | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Randolph | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Randolph | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Randolph | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Randolph | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $355.00 | Enhanced | H5253 | 189 |
| Randolph | Wellcare | Wellcare Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $25.80 | $395.00 | Basic | H1914 | 008 |
| Randolph | Wellcare | Wellcare Dual Access (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $32.20 | $385.00 | Basic | H4073 | 002 |
| Randolph | Wellcare | Wellcare Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $27.50 | $615.00 | Basic | H4073 | 003 |
| Randolph | Wellcare | Wellcare Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $425.00 | Basic | H4073 | 004 |
| Richmond | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Richmond | Aetna Medicare | Aetna Medicare Full Dual Care (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $28.20 | $615.00 | Enhanced | H3146 | 022 |
| Richmond | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Richmond | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Richmond | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Richmond | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Richmond | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Richmond | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Richmond | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Richmond | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H6351 | 001 |
| Richmond | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $0.00 | Enhanced | H6351 | 004 |
| Richmond | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.70 | $615.00 | Basic | H6351 | 005 |
| Richmond | PruittHealth Premier | PruittHealth Premier (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H6345 | 001 |
| Richmond | Troy Medicare | Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $31.30 | $615.00 | Enhanced | H4676 | 002 |
| Richmond | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Richmond | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Richmond | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Richmond | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Richmond | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Richmond | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $355.00 | Enhanced | H5253 | 189 |
| Richmond | Wellcare | Wellcare Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $25.80 | $395.00 | Basic | H1914 | 008 |
| Richmond | Wellcare | Wellcare Dual Access (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $32.20 | $385.00 | Basic | H4073 | 002 |
| Richmond | Wellcare | Wellcare Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $27.50 | $615.00 | Basic | H4073 | 003 |
| Richmond | Wellcare | Wellcare Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $425.00 | Basic | H4073 | 004 |
| Robeson | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Robeson | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Robeson | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Robeson | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Robeson | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Robeson | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Robeson | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Robeson | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Robeson | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H6351 | 001 |
| Robeson | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $0.00 | Enhanced | H6351 | 004 |
| Robeson | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.70 | $615.00 | Basic | H6351 | 005 |
| Robeson | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H5374 | 001 |
| Robeson | Troy Medicare | Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $31.30 | $615.00 | Enhanced | H4676 | 002 |
| Robeson | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Robeson | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Robeson | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Robeson | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Robeson | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Robeson | UnitedHealthcare | UHC Complete Care NC-27 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $440.00 | Enhanced | H5253 | 188 |
| Robeson | Wellcare | Wellcare Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $25.80 | $395.00 | Basic | H1914 | 008 |
| Robeson | Wellcare | Wellcare Dual Access (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $32.20 | $385.00 | Basic | H4073 | 002 |
| Robeson | Wellcare | Wellcare Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $27.50 | $615.00 | Basic | H4073 | 003 |
| Robeson | Wellcare | Wellcare Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $425.00 | Basic | H4073 | 004 |
| Rockingham | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Rockingham | Aetna Medicare | Aetna Medicare Full Dual Care (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $28.20 | $615.00 | Enhanced | H3146 | 022 |
| Rockingham | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Rockingham | Cigna HealthCare | HealthSpring TotalCare (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $19.70 | $615.00 | Enhanced | H9725 | 003 |
| Rockingham | Cigna HealthCare | HealthSpring TotalCare Plus (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $28.20 | $615.00 | Enhanced | H9725 | 013 |
| Rockingham | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $35.00 | $615.00 | Enhanced | H5299 | 006 |
| Rockingham | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 009 |
| Rockingham | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 013 |
| Rockingham | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 015 |
| Rockingham | Devoted Health | DEVOTED C-SNP PREMIUM 017 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 017 |
| Rockingham | HealthTeam Advantage | HealthTeam Advantage Diabetes & Heart Care (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $300.00 | Enhanced | H2624 | 001 |
| Rockingham | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Rockingham | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Rockingham | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Rockingham | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Rockingham | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Rockingham | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Rockingham | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H6351 | 001 |
| Rockingham | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $0.00 | Enhanced | H6351 | 004 |
| Rockingham | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.70 | $615.00 | Basic | H6351 | 005 |
| Rockingham | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H5374 | 001 |
| Rockingham | UnitedHealthcare | UHC Nursing Home Plan NC-F001 (PPO I-SNP) | PPO I-SNP | Institutional | $36.20 | $615.00 | Basic | H0710 | 034 |
| Rockingham | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Rockingham | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Rockingham | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Rockingham | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Rockingham | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Rockingham | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $355.00 | Enhanced | H5253 | 189 |
| Rockingham | Wellcare | Wellcare Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $25.80 | $395.00 | Basic | H1914 | 008 |
| Rockingham | Wellcare | Wellcare Dual Access (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $32.20 | $385.00 | Basic | H4073 | 002 |
| Rockingham | Wellcare | Wellcare Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $27.50 | $615.00 | Basic | H4073 | 003 |
| Rockingham | Wellcare | Wellcare Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $425.00 | Basic | H4073 | 004 |
| Rowan | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Rowan | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Rowan | Cigna HealthCare | HealthSpring TotalCare (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $19.70 | $615.00 | Enhanced | H9725 | 003 |
| Rowan | Cigna HealthCare | HealthSpring TotalCare Plus (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $28.20 | $615.00 | Enhanced | H9725 | 013 |
| Rowan | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $35.00 | $615.00 | Enhanced | H5299 | 006 |
| Rowan | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 009 |
| Rowan | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 013 |
| Rowan | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 015 |
| Rowan | Devoted Health | DEVOTED C-SNP PREMIUM 016 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 016 |
| Rowan | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Rowan | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Rowan | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Rowan | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Rowan | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Rowan | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Rowan | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H6351 | 001 |
| Rowan | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $0.00 | Enhanced | H6351 | 004 |
| Rowan | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.70 | $615.00 | Basic | H6351 | 005 |
| Rowan | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H5374 | 001 |
| Rowan | UnitedHealthcare | UHC Nursing Home Plan NC-F001 (PPO I-SNP) | PPO I-SNP | Institutional | $36.20 | $615.00 | Basic | H0710 | 034 |
| Rowan | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Rowan | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Rowan | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Rowan | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Rowan | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Rowan | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $355.00 | Enhanced | H5253 | 189 |
| Rowan | Wellcare | Wellcare Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $25.80 | $395.00 | Basic | H1914 | 008 |
| Rowan | Wellcare | Wellcare Dual Access (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $32.20 | $385.00 | Basic | H4073 | 002 |
| Rowan | Wellcare | Wellcare Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $27.50 | $615.00 | Basic | H4073 | 003 |
| Rowan | Wellcare | Wellcare Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $425.00 | Basic | H4073 | 004 |
| Rutherford | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Rutherford | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Rutherford | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $35.00 | $615.00 | Enhanced | H5299 | 006 |
| Rutherford | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 009 |
| Rutherford | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 013 |
| Rutherford | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 015 |
| Rutherford | Devoted Health | DEVOTED C-SNP PREMIUM 018 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 018 |
| Rutherford | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Rutherford | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Rutherford | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Rutherford | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Rutherford | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Rutherford | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Rutherford | Humana | Humana Dual Select H6622-027 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $29.00 | $615.00 | Enhanced | H6622 | 027 |
| Rutherford | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H5374 | 001 |
| Rutherford | UnitedHealthcare | UHC Nursing Home Plan NC-F001 (PPO I-SNP) | PPO I-SNP | Institutional | $36.20 | $615.00 | Basic | H0710 | 034 |
| Rutherford | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Rutherford | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Rutherford | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Rutherford | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Rutherford | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Rutherford | UnitedHealthcare | UHC Complete Care NC-25 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $520.00 | Enhanced | H5253 | 186 |
| Rutherford | Wellcare | Wellcare Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $25.80 | $395.00 | Basic | H1914 | 008 |
| Rutherford | Wellcare | Wellcare Dual Access (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $32.20 | $385.00 | Basic | H4073 | 002 |
| Rutherford | Wellcare | Wellcare Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $27.50 | $615.00 | Basic | H4073 | 003 |
| Rutherford | Wellcare | Wellcare Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $425.00 | Basic | H4073 | 004 |
| Sampson | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Sampson | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Sampson | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Sampson | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Sampson | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Sampson | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Sampson | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Sampson | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Sampson | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H6351 | 001 |
| Sampson | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $0.00 | Enhanced | H6351 | 004 |
| Sampson | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.70 | $615.00 | Basic | H6351 | 005 |
| Sampson | Troy Medicare | Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $31.30 | $615.00 | Enhanced | H4676 | 002 |
| Sampson | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Sampson | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Sampson | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Sampson | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Sampson | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Sampson | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $355.00 | Enhanced | H5253 | 189 |
| Sampson | Wellcare | Wellcare Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $25.80 | $395.00 | Basic | H1914 | 008 |
| Sampson | Wellcare | Wellcare Dual Access (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $32.20 | $385.00 | Basic | H4073 | 002 |
| Sampson | Wellcare | Wellcare Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $27.50 | $615.00 | Basic | H4073 | 003 |
| Sampson | Wellcare | Wellcare Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $425.00 | Basic | H4073 | 004 |
| Scotland | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Scotland | Aetna Medicare | Aetna Medicare Full Dual Care (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $28.20 | $615.00 | Enhanced | H3146 | 022 |
| Scotland | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Scotland | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Scotland | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Scotland | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Scotland | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Scotland | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Scotland | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Scotland | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H6351 | 001 |
| Scotland | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $0.00 | Enhanced | H6351 | 004 |
| Scotland | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.70 | $615.00 | Basic | H6351 | 005 |
| Scotland | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H5374 | 001 |
| Scotland | Troy Medicare | Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $31.30 | $615.00 | Enhanced | H4676 | 002 |
| Scotland | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Scotland | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Scotland | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Scotland | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Scotland | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Scotland | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $355.00 | Enhanced | H5253 | 189 |
| Scotland | Wellcare | Wellcare Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $25.80 | $395.00 | Basic | H1914 | 008 |
| Scotland | Wellcare | Wellcare Dual Access (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $32.20 | $385.00 | Basic | H4073 | 002 |
| Scotland | Wellcare | Wellcare Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $27.50 | $615.00 | Basic | H4073 | 003 |
| Scotland | Wellcare | Wellcare Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $425.00 | Basic | H4073 | 004 |
| Stanly | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Stanly | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Stanly | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $35.00 | $615.00 | Enhanced | H5299 | 006 |
| Stanly | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 009 |
| Stanly | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 013 |
| Stanly | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 015 |
| Stanly | Devoted Health | DEVOTED C-SNP PREMIUM 016 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 016 |
| Stanly | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Stanly | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Stanly | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Stanly | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Stanly | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Stanly | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Stanly | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Stanly | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Stanly | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Stanly | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Stanly | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Stanly | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $355.00 | Enhanced | H5253 | 189 |
| Stanly | Wellcare | Wellcare Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $25.80 | $395.00 | Basic | H1914 | 008 |
| Stanly | Wellcare | Wellcare Dual Access (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $32.20 | $385.00 | Basic | H4073 | 002 |
| Stanly | Wellcare | Wellcare Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $27.50 | $615.00 | Basic | H4073 | 003 |
| Stanly | Wellcare | Wellcare Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $425.00 | Basic | H4073 | 004 |
| Stokes | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Stokes | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Stokes | Cigna HealthCare | HealthSpring TotalCare (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $19.70 | $615.00 | Enhanced | H9725 | 003 |
| Stokes | Cigna HealthCare | HealthSpring TotalCare Plus (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $28.20 | $615.00 | Enhanced | H9725 | 013 |
| Stokes | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $35.00 | $615.00 | Enhanced | H5299 | 006 |
| Stokes | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 009 |
| Stokes | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 013 |
| Stokes | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 015 |
| Stokes | Devoted Health | DEVOTED C-SNP PREMIUM 017 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 017 |
| Stokes | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Stokes | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Stokes | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Stokes | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Stokes | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Stokes | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Stokes | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H6351 | 001 |
| Stokes | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $0.00 | Enhanced | H6351 | 004 |
| Stokes | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.70 | $615.00 | Basic | H6351 | 005 |
| Stokes | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H5374 | 001 |
| Stokes | UnitedHealthcare | UHC Nursing Home Plan NC-F001 (PPO I-SNP) | PPO I-SNP | Institutional | $36.20 | $615.00 | Basic | H0710 | 034 |
| Stokes | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Stokes | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Stokes | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Stokes | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Stokes | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Stokes | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $355.00 | Enhanced | H5253 | 189 |
| Stokes | Wellcare | Wellcare Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $25.80 | $395.00 | Basic | H1914 | 008 |
| Stokes | Wellcare | Wellcare Dual Access (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $32.20 | $385.00 | Basic | H4073 | 002 |
| Stokes | Wellcare | Wellcare Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $27.50 | $615.00 | Basic | H4073 | 003 |
| Stokes | Wellcare | Wellcare Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $425.00 | Basic | H4073 | 004 |
| Surry | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Surry | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Surry | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Surry | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Surry | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Surry | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Surry | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Surry | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Surry | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H5374 | 001 |
| Surry | PruittHealth Premier | PruittHealth Premier (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H6345 | 001 |
| Surry | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Surry | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Surry | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Surry | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Surry | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Surry | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $355.00 | Enhanced | H5253 | 189 |
| Surry | Wellcare | Wellcare Dual Access (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $32.20 | $385.00 | Basic | H4073 | 002 |
| Surry | Wellcare | Wellcare Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $27.50 | $615.00 | Basic | H4073 | 003 |
| Surry | Wellcare | Wellcare Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $425.00 | Basic | H4073 | 004 |
| Swain | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Swain | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Swain | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $35.00 | $615.00 | Enhanced | H5299 | 006 |
| Swain | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 009 |
| Swain | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 013 |
| Swain | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 015 |
| Swain | Devoted Health | DEVOTED C-SNP PREMIUM 018 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 018 |
| Swain | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Swain | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Swain | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Swain | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Swain | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Swain | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Swain | Humana | Humana Dual Select H6622-027 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $29.00 | $615.00 | Enhanced | H6622 | 027 |
| Swain | Troy Medicare | Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $31.30 | $615.00 | Enhanced | H4676 | 002 |
| Swain | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Swain | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Swain | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Swain | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Swain | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Swain | UnitedHealthcare | UHC Complete Care NC-25 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $520.00 | Enhanced | H5253 | 186 |
| Swain | Wellcare | Wellcare Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $25.80 | $395.00 | Basic | H1914 | 008 |
| Swain | Wellcare | Wellcare Dual Access (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $32.20 | $385.00 | Basic | H4073 | 002 |
| Swain | Wellcare | Wellcare Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $27.50 | $615.00 | Basic | H4073 | 003 |
| Swain | Wellcare | Wellcare Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $425.00 | Basic | H4073 | 004 |
| Transylvania | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Transylvania | Alignment Health Plan | Alignment Health NC Duals (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5296 | 004 |
| Transylvania | Alignment Health Plan | Alignment Health Heart & Diabetes NCPlus (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $36.20 | $615.00 | Enhanced | H5296 | 009 |
| Transylvania | Alignment Health Plan | Alignment Health Heart & Diabetes Care (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $250.00 | Enhanced | H5296 | 011 |
| Transylvania | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Transylvania | Cigna HealthCare | HealthSpring TotalCare (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $19.70 | $615.00 | Enhanced | H9725 | 003 |
| Transylvania | Cigna HealthCare | HealthSpring TotalCare Plus (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $28.20 | $615.00 | Enhanced | H9725 | 013 |
| Transylvania | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $35.00 | $615.00 | Enhanced | H5299 | 006 |
| Transylvania | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 009 |
| Transylvania | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 013 |
| Transylvania | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 015 |
| Transylvania | Devoted Health | DEVOTED C-SNP PREMIUM 018 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 018 |
| Transylvania | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Transylvania | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Transylvania | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Transylvania | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Transylvania | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Transylvania | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Transylvania | Humana | Humana Dual Select H6622-027 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $29.00 | $615.00 | Enhanced | H6622 | 027 |
| Transylvania | PruittHealth Premier | PruittHealth Premier (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H6345 | 001 |
| Transylvania | Troy Medicare | Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $31.30 | $615.00 | Enhanced | H4676 | 002 |
| Transylvania | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Transylvania | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Transylvania | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Transylvania | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Transylvania | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Transylvania | UnitedHealthcare | UHC Complete Care NC-25 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $520.00 | Enhanced | H5253 | 186 |
| Transylvania | Wellcare | Wellcare Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $25.80 | $395.00 | Basic | H1914 | 008 |
| Transylvania | Wellcare | Wellcare Dual Access (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $32.20 | $385.00 | Basic | H4073 | 002 |
| Transylvania | Wellcare | Wellcare Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $27.50 | $615.00 | Basic | H4073 | 003 |
| Transylvania | Wellcare | Wellcare Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $425.00 | Basic | H4073 | 004 |
| Tyrrell | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Tyrrell | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Tyrrell | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Tyrrell | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Tyrrell | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Tyrrell | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Tyrrell | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Tyrrell | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Tyrrell | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Tyrrell | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Tyrrell | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Tyrrell | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Tyrrell | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Tyrrell | UnitedHealthcare | UHC Complete Care NC-27 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $440.00 | Enhanced | H5253 | 188 |
| Tyrrell | Wellcare | Wellcare Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $25.80 | $395.00 | Basic | H1914 | 008 |
| Union | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Union | Aetna Medicare | Aetna Medicare Full Dual Care (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $28.20 | $615.00 | Enhanced | H3146 | 022 |
| Union | Aetna Medicare | Aetna Medicare Chronic Condition ConditionCare (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $615.00 | Enhanced | H3146 | 037 |
| Union | Aetna Medicare | Aetna Medicare Chronic Condition ConditionCare Value (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Enhanced | H3146 | 044 |
| Union | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Union | Cigna HealthCare | HealthSpring TotalCare (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $19.70 | $615.00 | Enhanced | H9725 | 003 |
| Union | Cigna HealthCare | HealthSpring TotalCare Plus (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $28.20 | $615.00 | Enhanced | H9725 | 013 |
| Union | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $35.00 | $615.00 | Enhanced | H5299 | 006 |
| Union | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 009 |
| Union | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 013 |
| Union | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 015 |
| Union | Devoted Health | DEVOTED C-SNP PREMIUM 016 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 016 |
| Union | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Union | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Union | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Union | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Union | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Union | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Union | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H6351 | 001 |
| Union | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $0.00 | Enhanced | H6351 | 004 |
| Union | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.70 | $615.00 | Basic | H6351 | 005 |
| Union | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H5374 | 001 |
| Union | Provider Partners Health Plans | Provider Partners North Carolina Advantage Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H4439 | 001 |
| Union | Provider Partners Health Plans | Provider Partners North Carolina Community Plan (HMO I-SNP) | HMO I-SNP | Institutional | $0.00 | $615.00 | Basic | H4439 | 002 |
| Union | Provider Partners Health Plans | Provider Partners North Carolina Essential Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H4439 | 003 |
| Union | PruittHealth Premier | PruittHealth Premier (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H6345 | 001 |
| Union | UnitedHealthcare | UHC Nursing Home Plan NC-F001 (PPO I-SNP) | PPO I-SNP | Institutional | $36.20 | $615.00 | Basic | H0710 | 034 |
| Union | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Union | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Union | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Union | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Union | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Union | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $355.00 | Enhanced | H5253 | 189 |
| Union | Wellcare | Wellcare Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $25.80 | $395.00 | Basic | H1914 | 008 |
| Union | Wellcare | Wellcare Dual Access (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $32.20 | $385.00 | Basic | H4073 | 002 |
| Union | Wellcare | Wellcare Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $27.50 | $615.00 | Basic | H4073 | 003 |
| Union | Wellcare | Wellcare Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $425.00 | Basic | H4073 | 004 |
| Vance | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Vance | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Vance | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Vance | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Vance | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Vance | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Vance | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Vance | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Vance | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H6351 | 001 |
| Vance | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $0.00 | Enhanced | H6351 | 004 |
| Vance | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.70 | $615.00 | Basic | H6351 | 005 |
| Vance | Troy Medicare | Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $31.30 | $615.00 | Enhanced | H4676 | 002 |
| Vance | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Vance | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Vance | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Vance | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Vance | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Vance | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $355.00 | Enhanced | H5253 | 189 |
| Vance | Wellcare | Wellcare Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $25.80 | $395.00 | Basic | H1914 | 008 |
| Vance | Wellcare | Wellcare Dual Access (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $32.20 | $385.00 | Basic | H4073 | 002 |
| Vance | Wellcare | Wellcare Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $27.50 | $615.00 | Basic | H4073 | 003 |
| Vance | Wellcare | Wellcare Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $425.00 | Basic | H4073 | 004 |
| Wake | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Wake | Aetna Medicare | Aetna Medicare Full Dual Care (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $28.20 | $615.00 | Enhanced | H3146 | 022 |
| Wake | Alignment Health Plan | Alignment Health NC Duals (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5296 | 004 |
| Wake | Alignment Health Plan | Alignment Health Heart & Diabetes NCPlus (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $36.20 | $615.00 | Enhanced | H5296 | 009 |
| Wake | Alignment Health Plan | Alignment Health Heart & Diabetes Care (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $250.00 | Enhanced | H5296 | 011 |
| Wake | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Wake | Cigna HealthCare | HealthSpring TotalCare (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $19.70 | $615.00 | Enhanced | H9725 | 003 |
| Wake | Cigna HealthCare | HealthSpring TotalCare Plus (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $28.20 | $615.00 | Enhanced | H9725 | 013 |
| Wake | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Wake | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Wake | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Wake | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Wake | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Wake | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Wake | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H6351 | 001 |
| Wake | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $0.00 | Enhanced | H6351 | 004 |
| Wake | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.70 | $615.00 | Basic | H6351 | 005 |
| Wake | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H5374 | 001 |
| Wake | PruittHealth Premier | PruittHealth Premier (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H6345 | 001 |
| Wake | UnitedHealthcare | UHC Nursing Home Plan NC-F001 (PPO I-SNP) | PPO I-SNP | Institutional | $36.20 | $615.00 | Basic | H0710 | 034 |
| Wake | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Wake | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Wake | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Wake | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Wake | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Wake | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $355.00 | Enhanced | H5253 | 189 |
| Wake | Wellcare | Wellcare Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $25.80 | $395.00 | Basic | H1914 | 008 |
| Wake | Wellcare | Wellcare Dual Access (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $32.20 | $385.00 | Basic | H4073 | 002 |
| Wake | Wellcare | Wellcare Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $27.50 | $615.00 | Basic | H4073 | 003 |
| Wake | Wellcare | Wellcare Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $425.00 | Basic | H4073 | 004 |
| Warren | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Warren | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Warren | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Warren | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Warren | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Warren | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Warren | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Warren | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Warren | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H6351 | 001 |
| Warren | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $0.00 | Enhanced | H6351 | 004 |
| Warren | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.70 | $615.00 | Basic | H6351 | 005 |
| Warren | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Warren | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Warren | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Warren | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Warren | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Warren | UnitedHealthcare | UHC Complete Care NC-27 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $440.00 | Enhanced | H5253 | 188 |
| Warren | Wellcare | Wellcare Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $25.80 | $395.00 | Basic | H1914 | 008 |
| Warren | Wellcare | Wellcare Dual Access (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $32.20 | $385.00 | Basic | H4073 | 002 |
| Warren | Wellcare | Wellcare Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $27.50 | $615.00 | Basic | H4073 | 003 |
| Warren | Wellcare | Wellcare Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $425.00 | Basic | H4073 | 004 |
| Washington | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Washington | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Washington | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Washington | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Washington | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Washington | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Washington | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Washington | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Washington | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Washington | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Washington | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Washington | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Washington | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Washington | UnitedHealthcare | UHC Complete Care NC-27 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $440.00 | Enhanced | H5253 | 188 |
| Watauga | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Watauga | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Watauga | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Watauga | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Watauga | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Watauga | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Watauga | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Watauga | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Watauga | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H6351 | 001 |
| Watauga | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $0.00 | Enhanced | H6351 | 004 |
| Watauga | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.70 | $615.00 | Basic | H6351 | 005 |
| Watauga | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Watauga | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Watauga | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Watauga | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Watauga | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Watauga | UnitedHealthcare | UHC Complete Care NC-25 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $520.00 | Enhanced | H5253 | 186 |
| Watauga | Wellcare | Wellcare Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $25.80 | $395.00 | Basic | H1914 | 008 |
| Watauga | Wellcare | Wellcare Dual Access (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $32.20 | $385.00 | Basic | H4073 | 002 |
| Watauga | Wellcare | Wellcare Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $27.50 | $615.00 | Basic | H4073 | 003 |
| Watauga | Wellcare | Wellcare Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $425.00 | Basic | H4073 | 004 |
| Wayne | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Wayne | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Wayne | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Wayne | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Wayne | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Wayne | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Wayne | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Wayne | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Wayne | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H6351 | 001 |
| Wayne | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $0.00 | Enhanced | H6351 | 004 |
| Wayne | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.70 | $615.00 | Basic | H6351 | 005 |
| Wayne | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H5374 | 001 |
| Wayne | UnitedHealthcare | UHC Nursing Home Plan NC-F001 (PPO I-SNP) | PPO I-SNP | Institutional | $36.20 | $615.00 | Basic | H0710 | 034 |
| Wayne | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Wayne | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Wayne | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Wayne | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Wayne | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Wayne | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $355.00 | Enhanced | H5253 | 189 |
| Wilkes | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Wilkes | Alignment Health Plan | Alignment Health NC Duals (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5296 | 004 |
| Wilkes | Alignment Health Plan | Alignment Health Heart & Diabetes NCPlus (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $36.20 | $615.00 | Enhanced | H5296 | 009 |
| Wilkes | Alignment Health Plan | Alignment Health Heart & Diabetes Care (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $250.00 | Enhanced | H5296 | 011 |
| Wilkes | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Wilkes | Cigna HealthCare | HealthSpring TotalCare (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $19.70 | $615.00 | Enhanced | H9725 | 003 |
| Wilkes | Cigna HealthCare | HealthSpring TotalCare Plus (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $28.20 | $615.00 | Enhanced | H9725 | 013 |
| Wilkes | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $35.00 | $615.00 | Enhanced | H5299 | 006 |
| Wilkes | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 009 |
| Wilkes | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 013 |
| Wilkes | Devoted Health | DEVOTED C-SNP PREMIUM 014 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 014 |
| Wilkes | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 015 |
| Wilkes | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Wilkes | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Wilkes | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Wilkes | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Wilkes | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Wilkes | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Wilkes | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H6351 | 001 |
| Wilkes | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $0.00 | Enhanced | H6351 | 004 |
| Wilkes | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.70 | $615.00 | Basic | H6351 | 005 |
| Wilkes | Provider Partners Health Plans | Provider Partners North Carolina Advantage Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H4439 | 001 |
| Wilkes | Provider Partners Health Plans | Provider Partners North Carolina Community Plan (HMO I-SNP) | HMO I-SNP | Institutional | $0.00 | $615.00 | Basic | H4439 | 002 |
| Wilkes | Provider Partners Health Plans | Provider Partners North Carolina Essential Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H4439 | 003 |
| Wilkes | UnitedHealthcare | UHC Nursing Home Plan NC-F001 (PPO I-SNP) | PPO I-SNP | Institutional | $36.20 | $615.00 | Basic | H0710 | 034 |
| Wilkes | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Wilkes | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Wilkes | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Wilkes | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Wilkes | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Wilkes | UnitedHealthcare | UHC Complete Care NC-25 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $520.00 | Enhanced | H5253 | 186 |
| Wilkes | Wellcare | Wellcare Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $25.80 | $395.00 | Basic | H1914 | 008 |
| Wilkes | Wellcare | Wellcare Dual Access (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $32.20 | $385.00 | Basic | H4073 | 002 |
| Wilkes | Wellcare | Wellcare Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $27.50 | $615.00 | Basic | H4073 | 003 |
| Wilkes | Wellcare | Wellcare Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $425.00 | Basic | H4073 | 004 |
| Wilson | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Wilson | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Wilson | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Wilson | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Wilson | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Wilson | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Wilson | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Wilson | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Wilson | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H6351 | 001 |
| Wilson | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $0.00 | Enhanced | H6351 | 004 |
| Wilson | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.70 | $615.00 | Basic | H6351 | 005 |
| Wilson | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H5374 | 001 |
| Wilson | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Wilson | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Wilson | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Wilson | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Wilson | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Wilson | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $355.00 | Enhanced | H5253 | 189 |
| Wilson | Wellcare | Wellcare Dual Access (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $32.20 | $385.00 | Basic | H4073 | 002 |
| Wilson | Wellcare | Wellcare Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $27.50 | $615.00 | Basic | H4073 | 003 |
| Wilson | Wellcare | Wellcare Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $425.00 | Basic | H4073 | 004 |
| Yadkin | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Yadkin | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Yadkin | Cigna HealthCare | HealthSpring TotalCare (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $19.70 | $615.00 | Enhanced | H9725 | 003 |
| Yadkin | Cigna HealthCare | HealthSpring TotalCare Plus (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $28.20 | $615.00 | Enhanced | H9725 | 013 |
| Yadkin | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $35.00 | $615.00 | Enhanced | H5299 | 006 |
| Yadkin | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 009 |
| Yadkin | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 013 |
| Yadkin | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 015 |
| Yadkin | Devoted Health | DEVOTED C-SNP PREMIUM 017 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 017 |
| Yadkin | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Yadkin | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Yadkin | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Yadkin | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Yadkin | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Yadkin | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Yadkin | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H6351 | 001 |
| Yadkin | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $0.00 | Enhanced | H6351 | 004 |
| Yadkin | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.70 | $615.00 | Basic | H6351 | 005 |
| Yadkin | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | $36.20 | $615.00 | Basic | H5374 | 001 |
| Yadkin | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Yadkin | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Yadkin | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Yadkin | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Yadkin | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Yadkin | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $355.00 | Enhanced | H5253 | 189 |
| Yadkin | Wellcare | Wellcare Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $25.80 | $395.00 | Basic | H1914 | 008 |
| Yadkin | Wellcare | Wellcare Dual Access (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $32.20 | $385.00 | Basic | H4073 | 002 |
| Yadkin | Wellcare | Wellcare Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $27.50 | $615.00 | Basic | H4073 | 003 |
| Yadkin | Wellcare | Wellcare Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $425.00 | Basic | H4073 | 004 |
| Yancey | Aetna Medicare | Aetna Medicare Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H3146 | 002 |
| Yancey | BCBS of NC | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $18.70 | $615.00 | Enhanced | H9147 | 001 |
| Yancey | Cigna HealthCare | HealthSpring TotalCare (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $19.70 | $615.00 | Enhanced | H9725 | 003 |
| Yancey | Cigna HealthCare | HealthSpring TotalCare Plus (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $28.20 | $615.00 | Enhanced | H9725 | 013 |
| Yancey | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $35.00 | $615.00 | Enhanced | H5299 | 006 |
| Yancey | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 009 |
| Yancey | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5299 | 013 |
| Yancey | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 015 |
| Yancey | Devoted Health | DEVOTED C-SNP PREMIUM 018 NC (HMO C-SNP) | HMO C-SNP | Chronic Condition | $36.20 | $615.00 | Basic | H5299 | 018 |
| Yancey | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $14.20 | $615.00 | Enhanced | H1036 | 167 |
| Yancey | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $13.00 | $615.00 | Enhanced | H1036 | 307 |
| Yancey | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic Condition | $0.00 | $450.00 | Enhanced | H1036 | 308 |
| Yancey | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $20.00 | $615.00 | Enhanced | H1036 | 331 |
| Yancey | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $30.40 | $615.00 | Enhanced | H5525 | 036 |
| Yancey | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $33.50 | $615.00 | Enhanced | H5525 | 072 |
| Yancey | Humana | Humana Dual Select H6622-027 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $29.00 | $615.00 | Enhanced | H6622 | 027 |
| Yancey | Troy Medicare | Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | HMO D-SNP | Dual-Eligible | $31.30 | $615.00 | Enhanced | H4676 | 002 |
| Yancey | UnitedHealthcare | UHC Dual Complete NC-S001 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 005 |
| Yancey | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H1889 | 034 |
| Yancey | UnitedHealthcare | UHC Dual Complete NC-D001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $25.30 | $615.00 | Enhanced | H5253 | 041 |
| Yancey | UnitedHealthcare | UHC Dual Complete NC-V001 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 116 |
| Yancey | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $615.00 | Enhanced | H5253 | 184 |
| Yancey | UnitedHealthcare | UHC Complete Care NC-25 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic Condition | $0.00 | $520.00 | Enhanced | H5253 | 186 |
| Yancey | Wellcare | Wellcare Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | $25.80 | $395.00 | Basic | H1914 | 008 |
| Yancey | Wellcare | Wellcare Dual Access (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $32.20 | $385.00 | Basic | H4073 | 002 |
| Yancey | Wellcare | Wellcare Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $27.50 | $615.00 | Basic | H4073 | 003 |
| Yancey | Wellcare | Wellcare Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | $36.20 | $425.00 | Basic | H4073 | 004 |
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