Special Needs Plans Landscapes 2027
How to use this table
- Find plans in your county: Enter your county name in the Search box. The table will automatically filter the results.
- View all results: The table displays up to 50 results at a time. If your search returns more than 50 results, use the page controls at the bottom of the table or select a larger number from the entries per page menu.
- Sort the results: Select any column heading to sort the table by that category. Select it again to reverse the sort order.
- Clear your search: Delete the text from the Search box to return to the full list.
| County Name | Contract Plan Segment ID | Organization Marketing Name | Plan Name | Plan Type | SNP Type | Drug Benefit Category | Total Monthly Premium | Annual Part D Deductible Amount | In-Network Maximum Out-of-Pocket (MOOP) Amount |
|---|---|---|---|---|---|---|---|---|---|
| Alamance | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Alamance | H3146_022_0 | Aetna Medicare | Aetna Medicare Full Dual Care (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Alamance | H8212_001_0 | AmeriHealth Caritas VIP Care | AmeriHealth Caritas VIP Care (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $1.90 | $450.00 | $9,850.00 |
| Alamance | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Alamance | H5299_006_0 | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Alamance | H5299_009_0 | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $6,750.00 |
| Alamance | H5299_013_0 | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Alamance | H5299_015_0 | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $9,850.00 |
| Alamance | H5299_017_0 | Devoted Health | DEVOTED C-SNP ENHANCED 017 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $4,800.00 |
| Alamance | H5299_032_0 | Devoted Health | DEVOTED C-SNP GIVEBACK EXTRAS 032 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $700.00 | $5,700.00 |
| Alamance | H9725_003_0 | HealthSpring | HealthSpring TotalCare (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Alamance | H9725_013_0 | HealthSpring | HealthSpring TotalCare Plus (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Alamance | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Alamance | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Alamance | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Alamance | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Alamance | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Alamance | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Alamance | H6351_001_0 | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $6,800.00 |
| Alamance | H6351_004_0 | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $0.00 | $3,800.00 |
| Alamance | H6351_005_0 | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Basic | $17.50 | $700.00 | $7,550.00 |
| Alamance | H5374_001_0 | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Alamance | H4172_001_0 | NHC Advantage | NHC Advantage (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $12.20 | $700.00 | $9,850.00 |
| Alamance | H4172_003_0 | NHC Advantage | Senior Care (HMO I-SNP) | HMO I-SNP | Institutional | Enhanced | $0.00 | $500.00 | $5,000.00 |
| Alamance | H0710_034_0 | UnitedHealthcare | UHC Nursing Home Plan NC-F001 (PPO I-SNP) | PPO I-SNP | Institutional | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Alamance | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Alamance | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Alamance | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Alamance | H5253_189_0 | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $595.00 | $4,450.00 |
| Alamance | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Alamance | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Alamance | H1914_008_0 | Wellcare | Wellcare Carolina Complete Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Alamance | H4073_003_0 | Wellcare | Wellcare Carolina Complete Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,250.00 |
| Alamance | H4073_004_0 | Wellcare | Wellcare Carolina Complete Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Alexander | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Alexander | H3146_022_0 | Aetna Medicare | Aetna Medicare Full Dual Care (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Alexander | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Alexander | H5299_006_0 | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Alexander | H5299_009_0 | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $6,750.00 |
| Alexander | H5299_013_0 | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Alexander | H5299_015_0 | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $9,850.00 |
| Alexander | H5299_016_0 | Devoted Health | DEVOTED C-SNP ENHANCED 016 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $5,400.00 |
| Alexander | H5299_031_0 | Devoted Health | DEVOTED C-SNP GIVEBACK EXTRAS 031 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $700.00 | $7,050.00 |
| Alexander | H9725_003_0 | HealthSpring | HealthSpring TotalCare (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Alexander | H9725_013_0 | HealthSpring | HealthSpring TotalCare Plus (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Alexander | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Alexander | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Alexander | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Alexander | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Alexander | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Alexander | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Alexander | H4676_002_0 | Troy Medicare | Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Alexander | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Alexander | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Alexander | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Alexander | H5253_189_0 | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $595.00 | $4,450.00 |
| Alexander | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Alexander | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Alexander | H1914_008_0 | Wellcare | Wellcare Carolina Complete Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Alexander | H4073_003_0 | Wellcare | Wellcare Carolina Complete Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,250.00 |
| Alexander | H4073_004_0 | Wellcare | Wellcare Carolina Complete Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Alleghany | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Alleghany | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Alleghany | H5299_006_0 | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Alleghany | H5299_009_0 | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $6,750.00 |
| Alleghany | H5299_013_0 | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Alleghany | H5299_014_0 | Devoted Health | DEVOTED C-SNP ENHANCED 014 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $6,200.00 |
| Alleghany | H5299_015_0 | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $9,850.00 |
| Alleghany | H5299_045_0 | Devoted Health | DEVOTED C-SNP GIVEBACK EXTRAS 045 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $700.00 | $6,750.00 |
| Alleghany | H9725_003_0 | HealthSpring | HealthSpring TotalCare (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Alleghany | H9725_013_0 | HealthSpring | HealthSpring TotalCare Plus (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Alleghany | H9725_020_0 | HealthSpring | HealthSpring Achieve (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $500.00 | $4,450.00 |
| Alleghany | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Alleghany | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Alleghany | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Alleghany | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Alleghany | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Alleghany | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Alleghany | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Alleghany | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Alleghany | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Alleghany | H5253_186_0 | UnitedHealthcare | UHC Complete Care NC-25 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $685.00 | $6,400.00 |
| Alleghany | H5253_216_2 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Alleghany | H5253_217_2 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Alleghany | H1914_008_0 | Wellcare | Wellcare Carolina Complete Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Alleghany | H4073_003_0 | Wellcare | Wellcare Carolina Complete Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,250.00 |
| Alleghany | H4073_004_0 | Wellcare | Wellcare Carolina Complete Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Anson | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Anson | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Anson | H5299_006_0 | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Anson | H5299_009_0 | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $6,750.00 |
| Anson | H5299_013_0 | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Anson | H5299_015_0 | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $9,850.00 |
| Anson | H5299_016_0 | Devoted Health | DEVOTED C-SNP ENHANCED 016 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $5,400.00 |
| Anson | H5299_031_0 | Devoted Health | DEVOTED C-SNP GIVEBACK EXTRAS 031 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $700.00 | $7,050.00 |
| Anson | H9725_003_0 | HealthSpring | HealthSpring TotalCare (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Anson | H9725_013_0 | HealthSpring | HealthSpring TotalCare Plus (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Anson | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Anson | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Anson | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Anson | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Anson | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Anson | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Anson | H5374_001_0 | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Anson | H4676_002_0 | Troy Medicare | Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Anson | H0710_034_0 | UnitedHealthcare | UHC Nursing Home Plan NC-F001 (PPO I-SNP) | PPO I-SNP | Institutional | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Anson | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Anson | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Anson | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Anson | H5253_189_0 | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $595.00 | $4,450.00 |
| Anson | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Anson | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Anson | H1914_008_0 | Wellcare | Wellcare Carolina Complete Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Anson | H4073_003_0 | Wellcare | Wellcare Carolina Complete Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,250.00 |
| Anson | H4073_004_0 | Wellcare | Wellcare Carolina Complete Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Ashe | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Ashe | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Ashe | H5299_006_0 | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Ashe | H5299_009_0 | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $6,750.00 |
| Ashe | H5299_013_0 | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Ashe | H5299_014_0 | Devoted Health | DEVOTED C-SNP ENHANCED 014 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $6,200.00 |
| Ashe | H5299_015_0 | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $9,850.00 |
| Ashe | H5299_045_0 | Devoted Health | DEVOTED C-SNP GIVEBACK EXTRAS 045 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $700.00 | $6,750.00 |
| Ashe | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Ashe | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Ashe | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Ashe | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Ashe | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Ashe | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Ashe | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Ashe | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Ashe | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Ashe | H5253_186_0 | UnitedHealthcare | UHC Complete Care NC-25 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $685.00 | $6,400.00 |
| Ashe | H5253_216_2 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Ashe | H5253_217_2 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Ashe | H1914_008_0 | Wellcare | Wellcare Carolina Complete Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Ashe | H4073_003_0 | Wellcare | Wellcare Carolina Complete Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,250.00 |
| Ashe | H4073_004_0 | Wellcare | Wellcare Carolina Complete Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Avery | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Avery | H5296_004_0 | Alignment Health Plan | Alignment Health Duals+ 004 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Avery | H5296_009_0 | Alignment Health Plan | Alignment Health Heart & Diabetes Plus 009 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $4.80 | $700.00 | $9,850.00 |
| Avery | H5296_011_0 | Alignment Health Plan | Alignment Health Heart & Diabetes 011 (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $250.00 | $3,400.00 |
| Avery | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Avery | H5299_006_0 | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Avery | H5299_009_0 | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $6,750.00 |
| Avery | H5299_013_0 | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Avery | H5299_015_0 | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $9,850.00 |
| Avery | H5299_018_0 | Devoted Health | DEVOTED C-SNP ENHANCED 018 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $5,600.00 |
| Avery | H5299_034_0 | Devoted Health | DEVOTED C-SNP GIVEBACK EXTRAS 034 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $700.00 | $7,150.00 |
| Avery | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Avery | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Avery | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Avery | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Avery | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Avery | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Avery | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Avery | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Avery | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Avery | H5253_186_0 | UnitedHealthcare | UHC Complete Care NC-25 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $685.00 | $6,400.00 |
| Avery | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Avery | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Avery | H1914_008_0 | Wellcare | Wellcare Carolina Complete Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Avery | H4073_003_0 | Wellcare | Wellcare Carolina Complete Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,250.00 |
| Avery | H4073_004_0 | Wellcare | Wellcare Carolina Complete Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Beaufort | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Beaufort | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Beaufort | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Beaufort | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Beaufort | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Beaufort | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Beaufort | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Beaufort | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Beaufort | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Beaufort | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Beaufort | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Beaufort | H5253_188_0 | UnitedHealthcare | UHC Complete Care NC-27 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $685.00 | $5,900.00 |
| Beaufort | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Beaufort | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Bertie | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Bertie | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Bertie | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Bertie | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Bertie | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Bertie | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Bertie | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Bertie | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Bertie | H6351_001_0 | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $6,800.00 |
| Bertie | H6351_004_0 | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $0.00 | $3,800.00 |
| Bertie | H6351_005_0 | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Basic | $17.50 | $700.00 | $7,550.00 |
| Bertie | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Bertie | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Bertie | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Bertie | H5253_188_0 | UnitedHealthcare | UHC Complete Care NC-27 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $685.00 | $5,900.00 |
| Bertie | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Bertie | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Bladen | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Bladen | H8212_001_0 | AmeriHealth Caritas VIP Care | AmeriHealth Caritas VIP Care (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $1.90 | $450.00 | $9,850.00 |
| Bladen | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Bladen | H5299_006_0 | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Bladen | H5299_009_0 | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $6,750.00 |
| Bladen | H5299_013_0 | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Bladen | H5299_014_0 | Devoted Health | DEVOTED C-SNP ENHANCED 014 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $6,200.00 |
| Bladen | H5299_015_0 | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $9,850.00 |
| Bladen | H5299_033_0 | Devoted Health | DEVOTED C-SNP GIVEBACK EXTRAS 033 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $700.00 | $7,100.00 |
| Bladen | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Bladen | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Bladen | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Bladen | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Bladen | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Bladen | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Bladen | H6351_001_0 | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $6,800.00 |
| Bladen | H6351_004_0 | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $0.00 | $3,800.00 |
| Bladen | H6351_005_0 | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Basic | $17.50 | $700.00 | $7,550.00 |
| Bladen | H4676_002_0 | Troy Medicare | Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Bladen | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Bladen | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Bladen | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Bladen | H5253_188_0 | UnitedHealthcare | UHC Complete Care NC-27 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $685.00 | $5,900.00 |
| Bladen | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Bladen | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Bladen | H1914_008_0 | Wellcare | Wellcare Carolina Complete Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Bladen | H4073_003_0 | Wellcare | Wellcare Carolina Complete Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,250.00 |
| Bladen | H4073_004_0 | Wellcare | Wellcare Carolina Complete Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Brunswick | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Brunswick | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Brunswick | H5299_006_0 | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Brunswick | H5299_009_0 | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $6,750.00 |
| Brunswick | H5299_013_0 | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Brunswick | H5299_014_0 | Devoted Health | DEVOTED C-SNP ENHANCED 014 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $6,200.00 |
| Brunswick | H5299_015_0 | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $9,850.00 |
| Brunswick | H5299_033_0 | Devoted Health | DEVOTED C-SNP GIVEBACK EXTRAS 033 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $700.00 | $7,100.00 |
| Brunswick | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Brunswick | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Brunswick | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Brunswick | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Brunswick | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Brunswick | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Brunswick | H6351_001_0 | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $6,800.00 |
| Brunswick | H6351_004_0 | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $0.00 | $3,800.00 |
| Brunswick | H6351_005_0 | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Basic | $17.50 | $700.00 | $7,550.00 |
| Brunswick | H5374_001_0 | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Brunswick | H0710_034_0 | UnitedHealthcare | UHC Nursing Home Plan NC-F001 (PPO I-SNP) | PPO I-SNP | Institutional | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Brunswick | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Brunswick | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Brunswick | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Brunswick | H5253_188_0 | UnitedHealthcare | UHC Complete Care NC-27 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $685.00 | $5,900.00 |
| Brunswick | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Brunswick | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Buncombe | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Buncombe | H3146_022_0 | Aetna Medicare | Aetna Medicare Full Dual Care (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Buncombe | H5296_004_0 | Alignment Health Plan | Alignment Health Duals+ 004 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Buncombe | H5296_009_0 | Alignment Health Plan | Alignment Health Heart & Diabetes Plus 009 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $4.80 | $700.00 | $9,850.00 |
| Buncombe | H5296_011_0 | Alignment Health Plan | Alignment Health Heart & Diabetes 011 (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $250.00 | $3,400.00 |
| Buncombe | H8212_001_0 | AmeriHealth Caritas VIP Care | AmeriHealth Caritas VIP Care (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $1.90 | $450.00 | $9,850.00 |
| Buncombe | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Buncombe | H5299_006_0 | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Buncombe | H5299_009_0 | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $6,750.00 |
| Buncombe | H5299_013_0 | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Buncombe | H5299_015_0 | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $9,850.00 |
| Buncombe | H5299_018_0 | Devoted Health | DEVOTED C-SNP ENHANCED 018 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $5,600.00 |
| Buncombe | H5299_034_0 | Devoted Health | DEVOTED C-SNP GIVEBACK EXTRAS 034 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $700.00 | $7,150.00 |
| Buncombe | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Buncombe | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Buncombe | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Buncombe | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Buncombe | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Buncombe | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Buncombe | H6622_027_0 | Humana | Humana Dual Select H6622-027 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $4.10 | $700.00 | $9,850.00 |
| Buncombe | H6351_001_0 | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $6,800.00 |
| Buncombe | H6351_004_0 | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $0.00 | $3,800.00 |
| Buncombe | H6351_005_0 | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Basic | $17.50 | $700.00 | $7,550.00 |
| Buncombe | H5374_001_0 | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Buncombe | H4676_002_0 | Troy Medicare | Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Buncombe | H0710_034_0 | UnitedHealthcare | UHC Nursing Home Plan NC-F001 (PPO I-SNP) | PPO I-SNP | Institutional | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Buncombe | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Buncombe | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Buncombe | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Buncombe | H5253_186_0 | UnitedHealthcare | UHC Complete Care NC-25 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $685.00 | $6,400.00 |
| Buncombe | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Buncombe | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Buncombe | H1914_008_0 | Wellcare | Wellcare Carolina Complete Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Buncombe | H4073_003_0 | Wellcare | Wellcare Carolina Complete Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,250.00 |
| Buncombe | H4073_004_0 | Wellcare | Wellcare Carolina Complete Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Burke | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Burke | H3146_022_0 | Aetna Medicare | Aetna Medicare Full Dual Care (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Burke | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Burke | H5299_006_0 | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Burke | H5299_009_0 | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $6,750.00 |
| Burke | H5299_013_0 | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Burke | H5299_015_0 | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $9,850.00 |
| Burke | H5299_018_0 | Devoted Health | DEVOTED C-SNP ENHANCED 018 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $5,600.00 |
| Burke | H5299_034_0 | Devoted Health | DEVOTED C-SNP GIVEBACK EXTRAS 034 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $700.00 | $7,150.00 |
| Burke | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Burke | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Burke | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Burke | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Burke | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Burke | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Burke | H6351_001_0 | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $6,800.00 |
| Burke | H6351_004_0 | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $0.00 | $3,800.00 |
| Burke | H6351_005_0 | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Basic | $17.50 | $700.00 | $7,550.00 |
| Burke | H5374_001_0 | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Burke | H4676_002_0 | Troy Medicare | Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Burke | H0710_034_0 | UnitedHealthcare | UHC Nursing Home Plan NC-F001 (PPO I-SNP) | PPO I-SNP | Institutional | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Burke | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Burke | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Burke | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Burke | H5253_186_0 | UnitedHealthcare | UHC Complete Care NC-25 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $685.00 | $6,400.00 |
| Burke | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Burke | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Burke | H1914_008_0 | Wellcare | Wellcare Carolina Complete Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Burke | H4073_003_0 | Wellcare | Wellcare Carolina Complete Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,250.00 |
| Burke | H4073_004_0 | Wellcare | Wellcare Carolina Complete Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Cabarrus | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Cabarrus | H3146_022_0 | Aetna Medicare | Aetna Medicare Full Dual Care (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Cabarrus | H3146_037_0 | Aetna Medicare | Aetna Medicare Chronic Care (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $700.00 | $6,750.00 |
| Cabarrus | H3146_044_0 | Aetna Medicare | Aetna Medicare Chronic Care Value (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $700.00 | $9,250.00 |
| Cabarrus | H5296_004_0 | Alignment Health Plan | Alignment Health Duals+ 004 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Cabarrus | H5296_009_0 | Alignment Health Plan | Alignment Health Heart & Diabetes Plus 009 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $4.80 | $700.00 | $9,850.00 |
| Cabarrus | H5296_011_0 | Alignment Health Plan | Alignment Health Heart & Diabetes 011 (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $250.00 | $3,400.00 |
| Cabarrus | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Cabarrus | H5299_006_0 | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Cabarrus | H5299_009_0 | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $6,750.00 |
| Cabarrus | H5299_013_0 | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Cabarrus | H5299_015_0 | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $9,850.00 |
| Cabarrus | H5299_016_0 | Devoted Health | DEVOTED C-SNP ENHANCED 016 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $5,400.00 |
| Cabarrus | H5299_031_0 | Devoted Health | DEVOTED C-SNP GIVEBACK EXTRAS 031 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $700.00 | $7,050.00 |
| Cabarrus | H9725_003_0 | HealthSpring | HealthSpring TotalCare (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Cabarrus | H9725_013_0 | HealthSpring | HealthSpring TotalCare Plus (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Cabarrus | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Cabarrus | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Cabarrus | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Cabarrus | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Cabarrus | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Cabarrus | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Cabarrus | H6351_001_0 | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $6,800.00 |
| Cabarrus | H6351_004_0 | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $0.00 | $3,800.00 |
| Cabarrus | H6351_005_0 | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Basic | $17.50 | $700.00 | $7,550.00 |
| Cabarrus | H5374_001_0 | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Cabarrus | H4439_001_0 | Provider Partners Health Plans | Provider Partners North Carolina Advantage Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Cabarrus | H4439_004_0 | Provider Partners Health Plans | Provider Partners North Carolina Community Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $0.00 | $700.00 | $3,750.00 |
| Cabarrus | H4439_005_0 | Provider Partners Health Plans | Provider Partners North Carolina Essential Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Cabarrus | H6345_001_0 | PruittHealth Premier | PruittHealth Premier (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Cabarrus | H6345_003_0 | PruittHealth Premier | PruittHealth Premier (HMO I-SNP) | HMO I-SNP | Institutional | Enhanced | $0.00 | $350.00 | $5,900.00 |
| Cabarrus | H0710_034_0 | UnitedHealthcare | UHC Nursing Home Plan NC-F001 (PPO I-SNP) | PPO I-SNP | Institutional | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Cabarrus | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Cabarrus | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Cabarrus | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Cabarrus | H5253_189_0 | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $595.00 | $4,450.00 |
| Cabarrus | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Cabarrus | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Cabarrus | H1914_008_0 | Wellcare | Wellcare Carolina Complete Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Cabarrus | H4073_003_0 | Wellcare | Wellcare Carolina Complete Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,250.00 |
| Cabarrus | H4073_004_0 | Wellcare | Wellcare Carolina Complete Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Caldwell | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Caldwell | H3146_022_0 | Aetna Medicare | Aetna Medicare Full Dual Care (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Caldwell | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Caldwell | H5299_006_0 | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Caldwell | H5299_009_0 | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $6,750.00 |
| Caldwell | H5299_013_0 | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Caldwell | H5299_015_0 | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $9,850.00 |
| Caldwell | H5299_016_0 | Devoted Health | DEVOTED C-SNP ENHANCED 016 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $5,400.00 |
| Caldwell | H5299_031_0 | Devoted Health | DEVOTED C-SNP GIVEBACK EXTRAS 031 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $700.00 | $7,050.00 |
| Caldwell | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Caldwell | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Caldwell | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Caldwell | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Caldwell | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Caldwell | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Caldwell | H6351_001_0 | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $6,800.00 |
| Caldwell | H6351_004_0 | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $0.00 | $3,800.00 |
| Caldwell | H6351_005_0 | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Basic | $17.50 | $700.00 | $7,550.00 |
| Caldwell | H4676_002_0 | Troy Medicare | Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Caldwell | H0710_034_0 | UnitedHealthcare | UHC Nursing Home Plan NC-F001 (PPO I-SNP) | PPO I-SNP | Institutional | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Caldwell | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Caldwell | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Caldwell | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Caldwell | H5253_186_0 | UnitedHealthcare | UHC Complete Care NC-25 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $685.00 | $6,400.00 |
| Caldwell | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Caldwell | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Caldwell | H1914_008_0 | Wellcare | Wellcare Carolina Complete Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Caldwell | H4073_003_0 | Wellcare | Wellcare Carolina Complete Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,250.00 |
| Caldwell | H4073_004_0 | Wellcare | Wellcare Carolina Complete Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Camden | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Camden | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Camden | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Camden | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Camden | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Camden | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Camden | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Camden | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Camden | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Camden | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Camden | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Camden | H5253_188_0 | UnitedHealthcare | UHC Complete Care NC-27 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $685.00 | $5,900.00 |
| Camden | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Camden | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Carteret | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Carteret | H6345_001_0 | PruittHealth Premier | PruittHealth Premier (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Carteret | H6345_003_0 | PruittHealth Premier | PruittHealth Premier (HMO I-SNP) | HMO I-SNP | Institutional | Enhanced | $0.00 | $350.00 | $5,900.00 |
| Carteret | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Carteret | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Carteret | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Carteret | H5253_188_0 | UnitedHealthcare | UHC Complete Care NC-27 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $685.00 | $5,900.00 |
| Carteret | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Carteret | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Caswell | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Caswell | H8212_001_0 | AmeriHealth Caritas VIP Care | AmeriHealth Caritas VIP Care (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $1.90 | $450.00 | $9,850.00 |
| Caswell | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Caswell | H5299_006_0 | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Caswell | H5299_009_0 | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $6,750.00 |
| Caswell | H5299_013_0 | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Caswell | H5299_015_0 | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $9,850.00 |
| Caswell | H5299_017_0 | Devoted Health | DEVOTED C-SNP ENHANCED 017 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $4,800.00 |
| Caswell | H5299_032_0 | Devoted Health | DEVOTED C-SNP GIVEBACK EXTRAS 032 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $700.00 | $5,700.00 |
| Caswell | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Caswell | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Caswell | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Caswell | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Caswell | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Caswell | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Caswell | H5374_001_0 | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Caswell | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Caswell | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Caswell | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Caswell | H5253_189_0 | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $595.00 | $4,450.00 |
| Caswell | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Caswell | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Caswell | H1914_008_0 | Wellcare | Wellcare Carolina Complete Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Caswell | H4073_003_0 | Wellcare | Wellcare Carolina Complete Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,250.00 |
| Caswell | H4073_004_0 | Wellcare | Wellcare Carolina Complete Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Catawba | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Catawba | H3146_022_0 | Aetna Medicare | Aetna Medicare Full Dual Care (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Catawba | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Catawba | H5299_006_0 | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Catawba | H5299_009_0 | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $6,750.00 |
| Catawba | H5299_013_0 | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Catawba | H5299_015_0 | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $9,850.00 |
| Catawba | H5299_016_0 | Devoted Health | DEVOTED C-SNP ENHANCED 016 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $5,400.00 |
| Catawba | H5299_031_0 | Devoted Health | DEVOTED C-SNP GIVEBACK EXTRAS 031 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $700.00 | $7,050.00 |
| Catawba | H9725_003_0 | HealthSpring | HealthSpring TotalCare (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Catawba | H9725_013_0 | HealthSpring | HealthSpring TotalCare Plus (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Catawba | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Catawba | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Catawba | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Catawba | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Catawba | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Catawba | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Catawba | H6351_001_0 | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $6,800.00 |
| Catawba | H6351_004_0 | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $0.00 | $3,800.00 |
| Catawba | H6351_005_0 | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Basic | $17.50 | $700.00 | $7,550.00 |
| Catawba | H5374_001_0 | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Catawba | H4439_001_0 | Provider Partners Health Plans | Provider Partners North Carolina Advantage Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Catawba | H4439_004_0 | Provider Partners Health Plans | Provider Partners North Carolina Community Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $0.00 | $700.00 | $3,750.00 |
| Catawba | H4439_005_0 | Provider Partners Health Plans | Provider Partners North Carolina Essential Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Catawba | H4676_002_0 | Troy Medicare | Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Catawba | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Catawba | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Catawba | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Catawba | H5253_189_0 | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $595.00 | $4,450.00 |
| Catawba | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Catawba | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Catawba | H1914_008_0 | Wellcare | Wellcare Carolina Complete Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Catawba | H4073_003_0 | Wellcare | Wellcare Carolina Complete Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,250.00 |
| Catawba | H4073_004_0 | Wellcare | Wellcare Carolina Complete Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Chatham | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Chatham | H3146_022_0 | Aetna Medicare | Aetna Medicare Full Dual Care (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Chatham | H5296_004_0 | Alignment Health Plan | Alignment Health Duals+ 004 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Chatham | H5296_009_0 | Alignment Health Plan | Alignment Health Heart & Diabetes Plus 009 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $4.80 | $700.00 | $9,850.00 |
| Chatham | H5296_011_0 | Alignment Health Plan | Alignment Health Heart & Diabetes 011 (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $250.00 | $3,400.00 |
| Chatham | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Chatham | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Chatham | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Chatham | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Chatham | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Chatham | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Chatham | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Chatham | H6351_001_0 | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $6,800.00 |
| Chatham | H6351_004_0 | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $0.00 | $3,800.00 |
| Chatham | H6351_005_0 | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Basic | $17.50 | $700.00 | $7,550.00 |
| Chatham | H4676_002_0 | Troy Medicare | Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Chatham | H0710_034_0 | UnitedHealthcare | UHC Nursing Home Plan NC-F001 (PPO I-SNP) | PPO I-SNP | Institutional | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Chatham | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Chatham | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Chatham | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Chatham | H5253_189_0 | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $595.00 | $4,450.00 |
| Chatham | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Chatham | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Chatham | H1914_008_0 | Wellcare | Wellcare Carolina Complete Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Chatham | H4073_003_0 | Wellcare | Wellcare Carolina Complete Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,250.00 |
| Chatham | H4073_004_0 | Wellcare | Wellcare Carolina Complete Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Cherokee | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Cherokee | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Cherokee | H5299_006_0 | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Cherokee | H5299_009_0 | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $6,750.00 |
| Cherokee | H5299_013_0 | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Cherokee | H5299_015_0 | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $9,850.00 |
| Cherokee | H5299_018_0 | Devoted Health | DEVOTED C-SNP ENHANCED 018 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $5,600.00 |
| Cherokee | H5299_034_0 | Devoted Health | DEVOTED C-SNP GIVEBACK EXTRAS 034 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $700.00 | $7,150.00 |
| Cherokee | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Cherokee | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Cherokee | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Cherokee | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Cherokee | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Cherokee | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Cherokee | H6622_027_0 | Humana | Humana Dual Select H6622-027 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $4.10 | $700.00 | $9,850.00 |
| Cherokee | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Cherokee | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Cherokee | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Cherokee | H5253_186_0 | UnitedHealthcare | UHC Complete Care NC-25 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $685.00 | $6,400.00 |
| Cherokee | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Cherokee | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Chowan | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Chowan | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Chowan | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Chowan | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Chowan | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Chowan | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Chowan | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Chowan | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Chowan | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Chowan | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Chowan | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Chowan | H5253_188_0 | UnitedHealthcare | UHC Complete Care NC-27 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $685.00 | $5,900.00 |
| Chowan | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Chowan | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Clay | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Clay | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Clay | H5299_006_0 | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Clay | H5299_009_0 | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $6,750.00 |
| Clay | H5299_013_0 | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Clay | H5299_015_0 | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $9,850.00 |
| Clay | H5299_018_0 | Devoted Health | DEVOTED C-SNP ENHANCED 018 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $5,600.00 |
| Clay | H5299_034_0 | Devoted Health | DEVOTED C-SNP GIVEBACK EXTRAS 034 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $700.00 | $7,150.00 |
| Clay | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Clay | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Clay | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Clay | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Clay | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Clay | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Clay | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Clay | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Clay | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Clay | H5253_186_0 | UnitedHealthcare | UHC Complete Care NC-25 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $685.00 | $6,400.00 |
| Clay | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Clay | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Clay | H1914_008_0 | Wellcare | Wellcare Carolina Complete Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Clay | H4073_003_0 | Wellcare | Wellcare Carolina Complete Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,250.00 |
| Clay | H4073_004_0 | Wellcare | Wellcare Carolina Complete Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Cleveland | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Cleveland | H3146_022_0 | Aetna Medicare | Aetna Medicare Full Dual Care (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Cleveland | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Cleveland | H5299_006_0 | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Cleveland | H5299_009_0 | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $6,750.00 |
| Cleveland | H5299_013_0 | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Cleveland | H5299_015_0 | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $9,850.00 |
| Cleveland | H5299_016_0 | Devoted Health | DEVOTED C-SNP ENHANCED 016 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $5,400.00 |
| Cleveland | H5299_031_0 | Devoted Health | DEVOTED C-SNP GIVEBACK EXTRAS 031 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $700.00 | $7,050.00 |
| Cleveland | H9725_003_0 | HealthSpring | HealthSpring TotalCare (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Cleveland | H9725_013_0 | HealthSpring | HealthSpring TotalCare Plus (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Cleveland | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Cleveland | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Cleveland | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Cleveland | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Cleveland | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Cleveland | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Cleveland | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Cleveland | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Cleveland | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Cleveland | H5253_186_0 | UnitedHealthcare | UHC Complete Care NC-25 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $685.00 | $6,400.00 |
| Cleveland | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Cleveland | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Cleveland | H1914_008_0 | Wellcare | Wellcare Carolina Complete Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Cleveland | H4073_003_0 | Wellcare | Wellcare Carolina Complete Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,250.00 |
| Cleveland | H4073_004_0 | Wellcare | Wellcare Carolina Complete Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Columbus | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Columbus | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Columbus | H5299_006_0 | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Columbus | H5299_009_0 | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $6,750.00 |
| Columbus | H5299_013_0 | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Columbus | H5299_014_0 | Devoted Health | DEVOTED C-SNP ENHANCED 014 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $6,200.00 |
| Columbus | H5299_015_0 | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $9,850.00 |
| Columbus | H5299_033_0 | Devoted Health | DEVOTED C-SNP GIVEBACK EXTRAS 033 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $700.00 | $7,100.00 |
| Columbus | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Columbus | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Columbus | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Columbus | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Columbus | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Columbus | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Columbus | H6351_001_0 | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $6,800.00 |
| Columbus | H6351_004_0 | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $0.00 | $3,800.00 |
| Columbus | H6351_005_0 | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Basic | $17.50 | $700.00 | $7,550.00 |
| Columbus | H4676_002_0 | Troy Medicare | Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Columbus | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Columbus | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Columbus | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Columbus | H5253_188_0 | UnitedHealthcare | UHC Complete Care NC-27 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $685.00 | $5,900.00 |
| Columbus | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Columbus | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Columbus | H1914_008_0 | Wellcare | Wellcare Carolina Complete Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Columbus | H4073_003_0 | Wellcare | Wellcare Carolina Complete Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,250.00 |
| Columbus | H4073_004_0 | Wellcare | Wellcare Carolina Complete Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Craven | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Craven | H6345_001_0 | PruittHealth Premier | PruittHealth Premier (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Craven | H6345_003_0 | PruittHealth Premier | PruittHealth Premier (HMO I-SNP) | HMO I-SNP | Institutional | Enhanced | $0.00 | $350.00 | $5,900.00 |
| Craven | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Craven | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Craven | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Craven | H5253_188_0 | UnitedHealthcare | UHC Complete Care NC-27 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $685.00 | $5,900.00 |
| Craven | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Craven | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Cumberland | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Cumberland | H3146_022_0 | Aetna Medicare | Aetna Medicare Full Dual Care (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Cumberland | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Cumberland | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Cumberland | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Cumberland | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Cumberland | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Cumberland | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Cumberland | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Cumberland | H6351_001_0 | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $6,800.00 |
| Cumberland | H6351_004_0 | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $0.00 | $3,800.00 |
| Cumberland | H6351_005_0 | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Basic | $17.50 | $700.00 | $7,550.00 |
| Cumberland | H5374_001_0 | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Cumberland | H4676_002_0 | Troy Medicare | Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Cumberland | H0710_034_0 | UnitedHealthcare | UHC Nursing Home Plan NC-F001 (PPO I-SNP) | PPO I-SNP | Institutional | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Cumberland | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Cumberland | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Cumberland | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Cumberland | H5253_189_0 | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $595.00 | $4,450.00 |
| Cumberland | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Cumberland | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Cumberland | H1914_008_0 | Wellcare | Wellcare Carolina Complete Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Cumberland | H4073_003_0 | Wellcare | Wellcare Carolina Complete Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,250.00 |
| Cumberland | H4073_004_0 | Wellcare | Wellcare Carolina Complete Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Currituck | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Currituck | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Currituck | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Currituck | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Currituck | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Currituck | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Currituck | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Currituck | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Currituck | H0710_034_0 | UnitedHealthcare | UHC Nursing Home Plan NC-F001 (PPO I-SNP) | PPO I-SNP | Institutional | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Currituck | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Currituck | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Currituck | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Currituck | H5253_188_0 | UnitedHealthcare | UHC Complete Care NC-27 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $685.00 | $5,900.00 |
| Currituck | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Currituck | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Dare | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Dare | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Dare | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Dare | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Dare | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Dare | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Dare | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Dare | H5253_188_0 | UnitedHealthcare | UHC Complete Care NC-27 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $685.00 | $5,900.00 |
| Dare | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Dare | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Davidson | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Davidson | H3146_022_0 | Aetna Medicare | Aetna Medicare Full Dual Care (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Davidson | H3146_053_0 | Aetna Medicare | Aetna Medicare Chronic Care (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $700.00 | $6,750.00 |
| Davidson | H5296_004_0 | Alignment Health Plan | Alignment Health Duals+ 004 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Davidson | H5296_009_0 | Alignment Health Plan | Alignment Health Heart & Diabetes Plus 009 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $4.80 | $700.00 | $9,850.00 |
| Davidson | H5296_011_0 | Alignment Health Plan | Alignment Health Heart & Diabetes 011 (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $250.00 | $3,400.00 |
| Davidson | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Davidson | H5299_006_0 | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Davidson | H5299_009_0 | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $6,750.00 |
| Davidson | H5299_013_0 | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Davidson | H5299_015_0 | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $9,850.00 |
| Davidson | H5299_017_0 | Devoted Health | DEVOTED C-SNP ENHANCED 017 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $4,800.00 |
| Davidson | H5299_032_0 | Devoted Health | DEVOTED C-SNP GIVEBACK EXTRAS 032 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $700.00 | $5,700.00 |
| Davidson | H9725_003_0 | HealthSpring | HealthSpring TotalCare (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Davidson | H9725_013_0 | HealthSpring | HealthSpring TotalCare Plus (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Davidson | H9725_020_0 | HealthSpring | HealthSpring Achieve (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $500.00 | $4,450.00 |
| Davidson | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Davidson | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Davidson | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Davidson | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Davidson | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Davidson | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Davidson | H6351_001_0 | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $6,800.00 |
| Davidson | H6351_004_0 | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $0.00 | $3,800.00 |
| Davidson | H6351_005_0 | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Basic | $17.50 | $700.00 | $7,550.00 |
| Davidson | H5374_001_0 | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Davidson | H4439_001_0 | Provider Partners Health Plans | Provider Partners North Carolina Advantage Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Davidson | H4439_004_0 | Provider Partners Health Plans | Provider Partners North Carolina Community Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $0.00 | $700.00 | $3,750.00 |
| Davidson | H4439_005_0 | Provider Partners Health Plans | Provider Partners North Carolina Essential Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Davidson | H0710_034_0 | UnitedHealthcare | UHC Nursing Home Plan NC-F001 (PPO I-SNP) | PPO I-SNP | Institutional | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Davidson | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Davidson | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Davidson | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Davidson | H5253_189_0 | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $595.00 | $4,450.00 |
| Davidson | H5253_216_2 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Davidson | H5253_217_2 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Davidson | H1914_008_0 | Wellcare | Wellcare Carolina Complete Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Davidson | H4073_003_0 | Wellcare | Wellcare Carolina Complete Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,250.00 |
| Davidson | H4073_004_0 | Wellcare | Wellcare Carolina Complete Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Davie | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Davie | H5296_004_0 | Alignment Health Plan | Alignment Health Duals+ 004 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Davie | H5296_009_0 | Alignment Health Plan | Alignment Health Heart & Diabetes Plus 009 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $4.80 | $700.00 | $9,850.00 |
| Davie | H5296_011_0 | Alignment Health Plan | Alignment Health Heart & Diabetes 011 (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $250.00 | $3,400.00 |
| Davie | H8212_001_0 | AmeriHealth Caritas VIP Care | AmeriHealth Caritas VIP Care (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $1.90 | $450.00 | $9,850.00 |
| Davie | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Davie | H5299_006_0 | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Davie | H5299_009_0 | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $6,750.00 |
| Davie | H5299_013_0 | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Davie | H5299_015_0 | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $9,850.00 |
| Davie | H5299_017_0 | Devoted Health | DEVOTED C-SNP ENHANCED 017 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $4,800.00 |
| Davie | H5299_032_0 | Devoted Health | DEVOTED C-SNP GIVEBACK EXTRAS 032 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $700.00 | $5,700.00 |
| Davie | H9725_003_0 | HealthSpring | HealthSpring TotalCare (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Davie | H9725_013_0 | HealthSpring | HealthSpring TotalCare Plus (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Davie | H9725_020_0 | HealthSpring | HealthSpring Achieve (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $500.00 | $4,450.00 |
| Davie | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Davie | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Davie | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Davie | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Davie | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Davie | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Davie | H6351_001_0 | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $6,800.00 |
| Davie | H6351_004_0 | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $0.00 | $3,800.00 |
| Davie | H6351_005_0 | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Basic | $17.50 | $700.00 | $7,550.00 |
| Davie | H5374_001_0 | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Davie | H4439_001_0 | Provider Partners Health Plans | Provider Partners North Carolina Advantage Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Davie | H4439_004_0 | Provider Partners Health Plans | Provider Partners North Carolina Community Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $0.00 | $700.00 | $3,750.00 |
| Davie | H4439_005_0 | Provider Partners Health Plans | Provider Partners North Carolina Essential Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Davie | H0710_034_0 | UnitedHealthcare | UHC Nursing Home Plan NC-F001 (PPO I-SNP) | PPO I-SNP | Institutional | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Davie | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Davie | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Davie | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Davie | H5253_189_0 | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $595.00 | $4,450.00 |
| Davie | H5253_216_2 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Davie | H5253_217_2 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Davie | H1914_008_0 | Wellcare | Wellcare Carolina Complete Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Davie | H4073_003_0 | Wellcare | Wellcare Carolina Complete Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,250.00 |
| Davie | H4073_004_0 | Wellcare | Wellcare Carolina Complete Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Duplin | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Duplin | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Duplin | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Duplin | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Duplin | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Duplin | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Duplin | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Duplin | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Duplin | H5374_001_0 | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Duplin | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Duplin | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Duplin | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Duplin | H5253_188_0 | UnitedHealthcare | UHC Complete Care NC-27 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $685.00 | $5,900.00 |
| Duplin | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Duplin | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Duplin | H1914_008_0 | Wellcare | Wellcare Carolina Complete Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Duplin | H4073_003_0 | Wellcare | Wellcare Carolina Complete Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,250.00 |
| Duplin | H4073_004_0 | Wellcare | Wellcare Carolina Complete Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Durham | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Durham | H3146_022_0 | Aetna Medicare | Aetna Medicare Full Dual Care (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Durham | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Durham | H9725_003_0 | HealthSpring | HealthSpring TotalCare (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Durham | H9725_013_0 | HealthSpring | HealthSpring TotalCare Plus (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Durham | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Durham | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Durham | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Durham | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Durham | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Durham | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Durham | H6351_001_0 | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $6,800.00 |
| Durham | H6351_004_0 | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $0.00 | $3,800.00 |
| Durham | H6351_005_0 | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Basic | $17.50 | $700.00 | $7,550.00 |
| Durham | H5374_001_0 | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Durham | H6345_001_0 | PruittHealth Premier | PruittHealth Premier (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Durham | H6345_003_0 | PruittHealth Premier | PruittHealth Premier (HMO I-SNP) | HMO I-SNP | Institutional | Enhanced | $0.00 | $350.00 | $5,900.00 |
| Durham | H4676_002_0 | Troy Medicare | Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Durham | H0710_034_0 | UnitedHealthcare | UHC Nursing Home Plan NC-F001 (PPO I-SNP) | PPO I-SNP | Institutional | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Durham | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Durham | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Durham | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Durham | H5253_189_0 | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $595.00 | $4,450.00 |
| Durham | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Durham | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Durham | H1914_008_0 | Wellcare | Wellcare Carolina Complete Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Durham | H4073_003_0 | Wellcare | Wellcare Carolina Complete Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,250.00 |
| Durham | H4073_004_0 | Wellcare | Wellcare Carolina Complete Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Edgecombe | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Edgecombe | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Edgecombe | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Edgecombe | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Edgecombe | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Edgecombe | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Edgecombe | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Edgecombe | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Edgecombe | H5374_001_0 | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Edgecombe | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Edgecombe | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Edgecombe | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Edgecombe | H5253_188_0 | UnitedHealthcare | UHC Complete Care NC-27 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $685.00 | $5,900.00 |
| Edgecombe | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Edgecombe | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Forsyth | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Forsyth | H3146_022_0 | Aetna Medicare | Aetna Medicare Full Dual Care (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Forsyth | H3146_053_0 | Aetna Medicare | Aetna Medicare Chronic Care (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $700.00 | $6,750.00 |
| Forsyth | H5296_004_0 | Alignment Health Plan | Alignment Health Duals+ 004 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Forsyth | H5296_009_0 | Alignment Health Plan | Alignment Health Heart & Diabetes Plus 009 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $4.80 | $700.00 | $9,850.00 |
| Forsyth | H5296_011_0 | Alignment Health Plan | Alignment Health Heart & Diabetes 011 (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $250.00 | $3,400.00 |
| Forsyth | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Forsyth | H5299_006_0 | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Forsyth | H5299_009_0 | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $6,750.00 |
| Forsyth | H5299_013_0 | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Forsyth | H5299_015_0 | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $9,850.00 |
| Forsyth | H5299_017_0 | Devoted Health | DEVOTED C-SNP ENHANCED 017 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $4,800.00 |
| Forsyth | H5299_032_0 | Devoted Health | DEVOTED C-SNP GIVEBACK EXTRAS 032 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $700.00 | $5,700.00 |
| Forsyth | H9725_003_0 | HealthSpring | HealthSpring TotalCare (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Forsyth | H9725_013_0 | HealthSpring | HealthSpring TotalCare Plus (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Forsyth | H9725_020_0 | HealthSpring | HealthSpring Achieve (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $500.00 | $4,450.00 |
| Forsyth | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Forsyth | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Forsyth | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Forsyth | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Forsyth | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Forsyth | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Forsyth | H6351_001_0 | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $6,800.00 |
| Forsyth | H6351_004_0 | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $0.00 | $3,800.00 |
| Forsyth | H6351_005_0 | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Basic | $17.50 | $700.00 | $7,550.00 |
| Forsyth | H5374_001_0 | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Forsyth | H4439_001_0 | Provider Partners Health Plans | Provider Partners North Carolina Advantage Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Forsyth | H4439_004_0 | Provider Partners Health Plans | Provider Partners North Carolina Community Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $0.00 | $700.00 | $3,750.00 |
| Forsyth | H4439_005_0 | Provider Partners Health Plans | Provider Partners North Carolina Essential Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Forsyth | H6345_001_0 | PruittHealth Premier | PruittHealth Premier (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Forsyth | H6345_003_0 | PruittHealth Premier | PruittHealth Premier (HMO I-SNP) | HMO I-SNP | Institutional | Enhanced | $0.00 | $350.00 | $5,900.00 |
| Forsyth | H0710_034_0 | UnitedHealthcare | UHC Nursing Home Plan NC-F001 (PPO I-SNP) | PPO I-SNP | Institutional | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Forsyth | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Forsyth | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Forsyth | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Forsyth | H5253_189_0 | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $595.00 | $4,450.00 |
| Forsyth | H5253_216_2 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Forsyth | H5253_217_2 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Forsyth | H1914_008_0 | Wellcare | Wellcare Carolina Complete Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Forsyth | H4073_003_0 | Wellcare | Wellcare Carolina Complete Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,250.00 |
| Forsyth | H4073_004_0 | Wellcare | Wellcare Carolina Complete Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Franklin | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Franklin | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Franklin | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Franklin | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Franklin | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Franklin | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Franklin | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Franklin | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Franklin | H6351_001_0 | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $6,800.00 |
| Franklin | H6351_004_0 | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $0.00 | $3,800.00 |
| Franklin | H6351_005_0 | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Basic | $17.50 | $700.00 | $7,550.00 |
| Franklin | H5374_001_0 | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Franklin | H4676_002_0 | Troy Medicare | Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Franklin | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Franklin | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Franklin | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Franklin | H5253_189_0 | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $595.00 | $4,450.00 |
| Franklin | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Franklin | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Franklin | H1914_008_0 | Wellcare | Wellcare Carolina Complete Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Franklin | H4073_003_0 | Wellcare | Wellcare Carolina Complete Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,250.00 |
| Franklin | H4073_004_0 | Wellcare | Wellcare Carolina Complete Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Gaston | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Gaston | H3146_022_0 | Aetna Medicare | Aetna Medicare Full Dual Care (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Gaston | H3146_037_0 | Aetna Medicare | Aetna Medicare Chronic Care (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $700.00 | $6,750.00 |
| Gaston | H3146_044_0 | Aetna Medicare | Aetna Medicare Chronic Care Value (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $700.00 | $9,250.00 |
| Gaston | H5296_004_0 | Alignment Health Plan | Alignment Health Duals+ 004 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Gaston | H5296_009_0 | Alignment Health Plan | Alignment Health Heart & Diabetes Plus 009 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $4.80 | $700.00 | $9,850.00 |
| Gaston | H5296_011_0 | Alignment Health Plan | Alignment Health Heart & Diabetes 011 (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $250.00 | $3,400.00 |
| Gaston | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Gaston | H5299_006_0 | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Gaston | H5299_009_0 | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $6,750.00 |
| Gaston | H5299_013_0 | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Gaston | H5299_015_0 | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $9,850.00 |
| Gaston | H5299_016_0 | Devoted Health | DEVOTED C-SNP ENHANCED 016 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $5,400.00 |
| Gaston | H5299_031_0 | Devoted Health | DEVOTED C-SNP GIVEBACK EXTRAS 031 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $700.00 | $7,050.00 |
| Gaston | H9725_003_0 | HealthSpring | HealthSpring TotalCare (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Gaston | H9725_013_0 | HealthSpring | HealthSpring TotalCare Plus (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Gaston | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Gaston | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Gaston | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Gaston | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Gaston | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Gaston | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Gaston | H5374_001_0 | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Gaston | H4439_001_0 | Provider Partners Health Plans | Provider Partners North Carolina Advantage Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Gaston | H4439_004_0 | Provider Partners Health Plans | Provider Partners North Carolina Community Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $0.00 | $700.00 | $3,750.00 |
| Gaston | H4439_005_0 | Provider Partners Health Plans | Provider Partners North Carolina Essential Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Gaston | H0710_034_0 | UnitedHealthcare | UHC Nursing Home Plan NC-F001 (PPO I-SNP) | PPO I-SNP | Institutional | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Gaston | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Gaston | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Gaston | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Gaston | H5253_189_0 | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $595.00 | $4,450.00 |
| Gaston | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Gaston | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Gaston | H1914_008_0 | Wellcare | Wellcare Carolina Complete Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Gaston | H4073_003_0 | Wellcare | Wellcare Carolina Complete Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,250.00 |
| Gaston | H4073_004_0 | Wellcare | Wellcare Carolina Complete Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Gates | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Gates | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Gates | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Gates | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Gates | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Gates | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Gates | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Gates | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Gates | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Gates | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Gates | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Gates | H5253_188_0 | UnitedHealthcare | UHC Complete Care NC-27 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $685.00 | $5,900.00 |
| Gates | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Gates | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Graham | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Graham | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Graham | H5299_006_0 | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Graham | H5299_009_0 | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $6,750.00 |
| Graham | H5299_013_0 | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Graham | H5299_015_0 | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $9,850.00 |
| Graham | H5299_018_0 | Devoted Health | DEVOTED C-SNP ENHANCED 018 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $5,600.00 |
| Graham | H5299_034_0 | Devoted Health | DEVOTED C-SNP GIVEBACK EXTRAS 034 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $700.00 | $7,150.00 |
| Graham | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Graham | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Graham | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Graham | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Graham | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Graham | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Graham | H6622_027_0 | Humana | Humana Dual Select H6622-027 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $4.10 | $700.00 | $9,850.00 |
| Graham | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Graham | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Graham | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Graham | H5253_186_0 | UnitedHealthcare | UHC Complete Care NC-25 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $685.00 | $6,400.00 |
| Graham | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Graham | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Graham | H1914_008_0 | Wellcare | Wellcare Carolina Complete Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Graham | H4073_003_0 | Wellcare | Wellcare Carolina Complete Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,250.00 |
| Graham | H4073_004_0 | Wellcare | Wellcare Carolina Complete Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Granville | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Granville | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Granville | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Granville | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Granville | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Granville | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Granville | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Granville | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Granville | H6351_001_0 | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $6,800.00 |
| Granville | H6351_004_0 | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $0.00 | $3,800.00 |
| Granville | H6351_005_0 | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Basic | $17.50 | $700.00 | $7,550.00 |
| Granville | H4676_002_0 | Troy Medicare | Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Granville | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Granville | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Granville | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Granville | H5253_189_0 | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $595.00 | $4,450.00 |
| Granville | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Granville | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Granville | H1914_008_0 | Wellcare | Wellcare Carolina Complete Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Granville | H4073_003_0 | Wellcare | Wellcare Carolina Complete Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,250.00 |
| Granville | H4073_004_0 | Wellcare | Wellcare Carolina Complete Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Greene | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Greene | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Greene | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Greene | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Greene | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Greene | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Greene | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Greene | H6351_001_0 | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $6,800.00 |
| Greene | H6351_004_0 | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $0.00 | $3,800.00 |
| Greene | H6351_005_0 | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Basic | $17.50 | $700.00 | $7,550.00 |
| Greene | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Greene | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Greene | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Greene | H5253_188_0 | UnitedHealthcare | UHC Complete Care NC-27 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $685.00 | $5,900.00 |
| Greene | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Greene | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Greene | H1914_008_0 | Wellcare | Wellcare Carolina Complete Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Greene | H4073_003_0 | Wellcare | Wellcare Carolina Complete Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,250.00 |
| Greene | H4073_004_0 | Wellcare | Wellcare Carolina Complete Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Guilford | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Guilford | H3146_022_0 | Aetna Medicare | Aetna Medicare Full Dual Care (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Guilford | H3146_053_0 | Aetna Medicare | Aetna Medicare Chronic Care (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $700.00 | $6,750.00 |
| Guilford | H5296_004_0 | Alignment Health Plan | Alignment Health Duals+ 004 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Guilford | H5296_009_0 | Alignment Health Plan | Alignment Health Heart & Diabetes Plus 009 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $4.80 | $700.00 | $9,850.00 |
| Guilford | H5296_011_0 | Alignment Health Plan | Alignment Health Heart & Diabetes 011 (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $250.00 | $3,400.00 |
| Guilford | H8212_001_0 | AmeriHealth Caritas VIP Care | AmeriHealth Caritas VIP Care (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $1.90 | $450.00 | $9,850.00 |
| Guilford | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Guilford | H5299_006_0 | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Guilford | H5299_009_0 | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $6,750.00 |
| Guilford | H5299_013_0 | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Guilford | H5299_015_0 | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $9,850.00 |
| Guilford | H5299_017_0 | Devoted Health | DEVOTED C-SNP ENHANCED 017 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $4,800.00 |
| Guilford | H5299_032_0 | Devoted Health | DEVOTED C-SNP GIVEBACK EXTRAS 032 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $700.00 | $5,700.00 |
| Guilford | H9725_003_0 | HealthSpring | HealthSpring TotalCare (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Guilford | H9725_013_0 | HealthSpring | HealthSpring TotalCare Plus (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Guilford | H9725_020_0 | HealthSpring | HealthSpring Achieve (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $500.00 | $4,450.00 |
| Guilford | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Guilford | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Guilford | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Guilford | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Guilford | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Guilford | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Guilford | H6351_001_0 | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $6,800.00 |
| Guilford | H6351_004_0 | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $0.00 | $3,800.00 |
| Guilford | H6351_005_0 | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Basic | $17.50 | $700.00 | $7,550.00 |
| Guilford | H5374_001_0 | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Guilford | H4439_001_0 | Provider Partners Health Plans | Provider Partners North Carolina Advantage Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Guilford | H4439_004_0 | Provider Partners Health Plans | Provider Partners North Carolina Community Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $0.00 | $700.00 | $3,750.00 |
| Guilford | H4439_005_0 | Provider Partners Health Plans | Provider Partners North Carolina Essential Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Guilford | H0710_034_0 | UnitedHealthcare | UHC Nursing Home Plan NC-F001 (PPO I-SNP) | PPO I-SNP | Institutional | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Guilford | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Guilford | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Guilford | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Guilford | H5253_189_0 | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $595.00 | $4,450.00 |
| Guilford | H5253_216_2 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Guilford | H5253_217_2 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Guilford | H1914_008_0 | Wellcare | Wellcare Carolina Complete Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Guilford | H4073_003_0 | Wellcare | Wellcare Carolina Complete Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,250.00 |
| Guilford | H4073_004_0 | Wellcare | Wellcare Carolina Complete Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Halifax | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Halifax | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Halifax | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Halifax | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Halifax | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Halifax | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Halifax | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Halifax | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Halifax | H6351_001_0 | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $6,800.00 |
| Halifax | H6351_004_0 | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $0.00 | $3,800.00 |
| Halifax | H6351_005_0 | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Basic | $17.50 | $700.00 | $7,550.00 |
| Halifax | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Halifax | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Halifax | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Halifax | H5253_188_0 | UnitedHealthcare | UHC Complete Care NC-27 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $685.00 | $5,900.00 |
| Halifax | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Halifax | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Harnett | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Harnett | H3146_022_0 | Aetna Medicare | Aetna Medicare Full Dual Care (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Harnett | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Harnett | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Harnett | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Harnett | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Harnett | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Harnett | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Harnett | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Harnett | H6351_001_0 | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $6,800.00 |
| Harnett | H6351_004_0 | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $0.00 | $3,800.00 |
| Harnett | H6351_005_0 | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Basic | $17.50 | $700.00 | $7,550.00 |
| Harnett | H5374_001_0 | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Harnett | H4676_002_0 | Troy Medicare | Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Harnett | H0710_034_0 | UnitedHealthcare | UHC Nursing Home Plan NC-F001 (PPO I-SNP) | PPO I-SNP | Institutional | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Harnett | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Harnett | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Harnett | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Harnett | H5253_189_0 | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $595.00 | $4,450.00 |
| Harnett | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Harnett | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Harnett | H1914_008_0 | Wellcare | Wellcare Carolina Complete Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Harnett | H4073_003_0 | Wellcare | Wellcare Carolina Complete Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,250.00 |
| Harnett | H4073_004_0 | Wellcare | Wellcare Carolina Complete Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Haywood | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Haywood | H3146_022_0 | Aetna Medicare | Aetna Medicare Full Dual Care (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Haywood | H8212_001_0 | AmeriHealth Caritas VIP Care | AmeriHealth Caritas VIP Care (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $1.90 | $450.00 | $9,850.00 |
| Haywood | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Haywood | H5299_006_0 | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Haywood | H5299_009_0 | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $6,750.00 |
| Haywood | H5299_013_0 | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Haywood | H5299_015_0 | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $9,850.00 |
| Haywood | H5299_018_0 | Devoted Health | DEVOTED C-SNP ENHANCED 018 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $5,600.00 |
| Haywood | H5299_034_0 | Devoted Health | DEVOTED C-SNP GIVEBACK EXTRAS 034 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $700.00 | $7,150.00 |
| Haywood | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Haywood | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Haywood | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Haywood | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Haywood | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Haywood | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Haywood | H6622_027_0 | Humana | Humana Dual Select H6622-027 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $4.10 | $700.00 | $9,850.00 |
| Haywood | H6351_001_0 | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $6,800.00 |
| Haywood | H6351_004_0 | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $0.00 | $3,800.00 |
| Haywood | H6351_005_0 | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Basic | $17.50 | $700.00 | $7,550.00 |
| Haywood | H5374_001_0 | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Haywood | H4676_002_0 | Troy Medicare | Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Haywood | H0710_034_0 | UnitedHealthcare | UHC Nursing Home Plan NC-F001 (PPO I-SNP) | PPO I-SNP | Institutional | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Haywood | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Haywood | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Haywood | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Haywood | H5253_186_0 | UnitedHealthcare | UHC Complete Care NC-25 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $685.00 | $6,400.00 |
| Haywood | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Haywood | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Haywood | H1914_008_0 | Wellcare | Wellcare Carolina Complete Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Haywood | H4073_003_0 | Wellcare | Wellcare Carolina Complete Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,250.00 |
| Haywood | H4073_004_0 | Wellcare | Wellcare Carolina Complete Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Henderson | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Henderson | H5296_004_0 | Alignment Health Plan | Alignment Health Duals+ 004 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Henderson | H5296_009_0 | Alignment Health Plan | Alignment Health Heart & Diabetes Plus 009 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $4.80 | $700.00 | $9,850.00 |
| Henderson | H5296_011_0 | Alignment Health Plan | Alignment Health Heart & Diabetes 011 (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $250.00 | $3,400.00 |
| Henderson | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Henderson | H5299_006_0 | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Henderson | H5299_009_0 | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $6,750.00 |
| Henderson | H5299_013_0 | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Henderson | H5299_015_0 | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $9,850.00 |
| Henderson | H5299_018_0 | Devoted Health | DEVOTED C-SNP ENHANCED 018 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $5,600.00 |
| Henderson | H5299_034_0 | Devoted Health | DEVOTED C-SNP GIVEBACK EXTRAS 034 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $700.00 | $7,150.00 |
| Henderson | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Henderson | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Henderson | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Henderson | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Henderson | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Henderson | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Henderson | H6622_027_0 | Humana | Humana Dual Select H6622-027 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $4.10 | $700.00 | $9,850.00 |
| Henderson | H6351_001_0 | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $6,800.00 |
| Henderson | H6351_004_0 | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $0.00 | $3,800.00 |
| Henderson | H6351_005_0 | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Basic | $17.50 | $700.00 | $7,550.00 |
| Henderson | H5374_001_0 | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Henderson | H4676_002_0 | Troy Medicare | Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Henderson | H0710_034_0 | UnitedHealthcare | UHC Nursing Home Plan NC-F001 (PPO I-SNP) | PPO I-SNP | Institutional | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Henderson | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Henderson | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Henderson | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Henderson | H5253_186_0 | UnitedHealthcare | UHC Complete Care NC-25 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $685.00 | $6,400.00 |
| Henderson | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Henderson | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Henderson | H1914_008_0 | Wellcare | Wellcare Carolina Complete Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Henderson | H4073_003_0 | Wellcare | Wellcare Carolina Complete Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,250.00 |
| Henderson | H4073_004_0 | Wellcare | Wellcare Carolina Complete Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Hertford | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Hertford | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Hertford | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Hertford | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Hertford | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Hertford | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Hertford | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Hertford | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Hertford | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Hertford | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Hertford | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Hertford | H5253_188_0 | UnitedHealthcare | UHC Complete Care NC-27 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $685.00 | $5,900.00 |
| Hertford | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Hertford | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Hoke | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Hoke | H3146_022_0 | Aetna Medicare | Aetna Medicare Full Dual Care (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Hoke | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Hoke | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Hoke | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Hoke | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Hoke | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Hoke | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Hoke | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Hoke | H5374_001_0 | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Hoke | H4676_002_0 | Troy Medicare | Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Hoke | H0710_034_0 | UnitedHealthcare | UHC Nursing Home Plan NC-F001 (PPO I-SNP) | PPO I-SNP | Institutional | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Hoke | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Hoke | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Hoke | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Hoke | H5253_189_0 | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $595.00 | $4,450.00 |
| Hoke | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Hoke | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Hoke | H1914_008_0 | Wellcare | Wellcare Carolina Complete Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Hoke | H4073_003_0 | Wellcare | Wellcare Carolina Complete Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,250.00 |
| Hoke | H4073_004_0 | Wellcare | Wellcare Carolina Complete Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Hyde | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Hyde | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Hyde | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Hyde | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Hyde | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Hyde | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Hyde | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Hyde | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Hyde | H6351_001_0 | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $6,800.00 |
| Hyde | H6351_004_0 | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $0.00 | $3,800.00 |
| Hyde | H6351_005_0 | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Basic | $17.50 | $700.00 | $7,550.00 |
| Hyde | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Hyde | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Hyde | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Hyde | H5253_188_0 | UnitedHealthcare | UHC Complete Care NC-27 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $685.00 | $5,900.00 |
| Hyde | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Hyde | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Iredell | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Iredell | H3146_022_0 | Aetna Medicare | Aetna Medicare Full Dual Care (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Iredell | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Iredell | H5299_006_0 | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Iredell | H5299_009_0 | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $6,750.00 |
| Iredell | H5299_013_0 | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Iredell | H5299_015_0 | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $9,850.00 |
| Iredell | H5299_016_0 | Devoted Health | DEVOTED C-SNP ENHANCED 016 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $5,400.00 |
| Iredell | H5299_031_0 | Devoted Health | DEVOTED C-SNP GIVEBACK EXTRAS 031 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $700.00 | $7,050.00 |
| Iredell | H9725_003_0 | HealthSpring | HealthSpring TotalCare (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Iredell | H9725_013_0 | HealthSpring | HealthSpring TotalCare Plus (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Iredell | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Iredell | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Iredell | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Iredell | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Iredell | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Iredell | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Iredell | H5374_001_0 | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Iredell | H4676_002_0 | Troy Medicare | Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Iredell | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Iredell | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Iredell | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Iredell | H5253_189_0 | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $595.00 | $4,450.00 |
| Iredell | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Iredell | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Iredell | H1914_008_0 | Wellcare | Wellcare Carolina Complete Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Iredell | H4073_003_0 | Wellcare | Wellcare Carolina Complete Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,250.00 |
| Iredell | H4073_004_0 | Wellcare | Wellcare Carolina Complete Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Jackson | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Jackson | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Jackson | H5299_006_0 | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Jackson | H5299_009_0 | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $6,750.00 |
| Jackson | H5299_013_0 | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Jackson | H5299_015_0 | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $9,850.00 |
| Jackson | H5299_018_0 | Devoted Health | DEVOTED C-SNP ENHANCED 018 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $5,600.00 |
| Jackson | H5299_034_0 | Devoted Health | DEVOTED C-SNP GIVEBACK EXTRAS 034 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $700.00 | $7,150.00 |
| Jackson | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Jackson | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Jackson | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Jackson | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Jackson | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Jackson | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Jackson | H6622_027_0 | Humana | Humana Dual Select H6622-027 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $4.10 | $700.00 | $9,850.00 |
| Jackson | H4676_002_0 | Troy Medicare | Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Jackson | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Jackson | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Jackson | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Jackson | H5253_186_0 | UnitedHealthcare | UHC Complete Care NC-25 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $685.00 | $6,400.00 |
| Jackson | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Jackson | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Jackson | H1914_008_0 | Wellcare | Wellcare Carolina Complete Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Jackson | H4073_003_0 | Wellcare | Wellcare Carolina Complete Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,250.00 |
| Jackson | H4073_004_0 | Wellcare | Wellcare Carolina Complete Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Johnston | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Johnston | H3146_022_0 | Aetna Medicare | Aetna Medicare Full Dual Care (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Johnston | H5296_004_0 | Alignment Health Plan | Alignment Health Duals+ 004 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Johnston | H5296_009_0 | Alignment Health Plan | Alignment Health Heart & Diabetes Plus 009 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $4.80 | $700.00 | $9,850.00 |
| Johnston | H5296_011_0 | Alignment Health Plan | Alignment Health Heart & Diabetes 011 (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $250.00 | $3,400.00 |
| Johnston | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Johnston | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Johnston | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Johnston | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Johnston | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Johnston | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Johnston | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Johnston | H6351_001_0 | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $6,800.00 |
| Johnston | H6351_004_0 | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $0.00 | $3,800.00 |
| Johnston | H6351_005_0 | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Basic | $17.50 | $700.00 | $7,550.00 |
| Johnston | H5374_001_0 | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Johnston | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Johnston | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Johnston | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Johnston | H5253_189_0 | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $595.00 | $4,450.00 |
| Johnston | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Johnston | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Johnston | H1914_008_0 | Wellcare | Wellcare Carolina Complete Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Johnston | H4073_003_0 | Wellcare | Wellcare Carolina Complete Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,250.00 |
| Johnston | H4073_004_0 | Wellcare | Wellcare Carolina Complete Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Jones | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Jones | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Jones | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Jones | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Jones | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Jones | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Jones | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Jones | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Jones | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Jones | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Jones | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Jones | H5253_188_0 | UnitedHealthcare | UHC Complete Care NC-27 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $685.00 | $5,900.00 |
| Jones | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Jones | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Jones | H1914_008_0 | Wellcare | Wellcare Carolina Complete Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Lee | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Lee | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Lee | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Lee | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Lee | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Lee | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Lee | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Lee | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Lee | H6351_001_0 | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $6,800.00 |
| Lee | H6351_004_0 | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $0.00 | $3,800.00 |
| Lee | H6351_005_0 | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Basic | $17.50 | $700.00 | $7,550.00 |
| Lee | H4676_002_0 | Troy Medicare | Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Lee | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Lee | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Lee | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Lee | H5253_189_0 | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $595.00 | $4,450.00 |
| Lee | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Lee | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Lee | H4073_003_0 | Wellcare | Wellcare Carolina Complete Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,250.00 |
| Lee | H4073_004_0 | Wellcare | Wellcare Carolina Complete Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Lenoir | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Lenoir | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Lenoir | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Lenoir | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Lenoir | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Lenoir | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Lenoir | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Lenoir | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Lenoir | H6351_001_0 | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $6,800.00 |
| Lenoir | H6351_004_0 | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $0.00 | $3,800.00 |
| Lenoir | H6351_005_0 | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Basic | $17.50 | $700.00 | $7,550.00 |
| Lenoir | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Lenoir | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Lenoir | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Lenoir | H5253_188_0 | UnitedHealthcare | UHC Complete Care NC-27 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $685.00 | $5,900.00 |
| Lenoir | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Lenoir | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Lincoln | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Lincoln | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Lincoln | H5299_006_0 | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Lincoln | H5299_009_0 | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $6,750.00 |
| Lincoln | H5299_013_0 | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Lincoln | H5299_015_0 | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $9,850.00 |
| Lincoln | H5299_016_0 | Devoted Health | DEVOTED C-SNP ENHANCED 016 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $5,400.00 |
| Lincoln | H5299_031_0 | Devoted Health | DEVOTED C-SNP GIVEBACK EXTRAS 031 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $700.00 | $7,050.00 |
| Lincoln | H9725_003_0 | HealthSpring | HealthSpring TotalCare (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Lincoln | H9725_013_0 | HealthSpring | HealthSpring TotalCare Plus (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Lincoln | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Lincoln | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Lincoln | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Lincoln | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Lincoln | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Lincoln | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Lincoln | H5374_001_0 | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Lincoln | H4439_001_0 | Provider Partners Health Plans | Provider Partners North Carolina Advantage Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Lincoln | H4439_004_0 | Provider Partners Health Plans | Provider Partners North Carolina Community Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $0.00 | $700.00 | $3,750.00 |
| Lincoln | H4439_005_0 | Provider Partners Health Plans | Provider Partners North Carolina Essential Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Lincoln | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Lincoln | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Lincoln | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Lincoln | H5253_186_0 | UnitedHealthcare | UHC Complete Care NC-25 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $685.00 | $6,400.00 |
| Lincoln | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Lincoln | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Lincoln | H1914_008_0 | Wellcare | Wellcare Carolina Complete Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Lincoln | H4073_003_0 | Wellcare | Wellcare Carolina Complete Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,250.00 |
| Lincoln | H4073_004_0 | Wellcare | Wellcare Carolina Complete Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Macon | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Macon | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Macon | H5299_006_0 | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Macon | H5299_009_0 | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $6,750.00 |
| Macon | H5299_013_0 | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Macon | H5299_015_0 | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $9,850.00 |
| Macon | H5299_018_0 | Devoted Health | DEVOTED C-SNP ENHANCED 018 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $5,600.00 |
| Macon | H5299_034_0 | Devoted Health | DEVOTED C-SNP GIVEBACK EXTRAS 034 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $700.00 | $7,150.00 |
| Macon | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Macon | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Macon | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Macon | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Macon | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Macon | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Macon | H6622_027_0 | Humana | Humana Dual Select H6622-027 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $4.10 | $700.00 | $9,850.00 |
| Macon | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Macon | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Macon | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Macon | H5253_186_0 | UnitedHealthcare | UHC Complete Care NC-25 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $685.00 | $6,400.00 |
| Macon | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Macon | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Macon | H1914_008_0 | Wellcare | Wellcare Carolina Complete Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Macon | H4073_003_0 | Wellcare | Wellcare Carolina Complete Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,250.00 |
| Macon | H4073_004_0 | Wellcare | Wellcare Carolina Complete Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Madison | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Madison | H5296_004_0 | Alignment Health Plan | Alignment Health Duals+ 004 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Madison | H5296_009_0 | Alignment Health Plan | Alignment Health Heart & Diabetes Plus 009 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $4.80 | $700.00 | $9,850.00 |
| Madison | H5296_011_0 | Alignment Health Plan | Alignment Health Heart & Diabetes 011 (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $250.00 | $3,400.00 |
| Madison | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Madison | H5299_006_0 | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Madison | H5299_009_0 | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $6,750.00 |
| Madison | H5299_013_0 | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Madison | H5299_015_0 | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $9,850.00 |
| Madison | H5299_018_0 | Devoted Health | DEVOTED C-SNP ENHANCED 018 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $5,600.00 |
| Madison | H5299_034_0 | Devoted Health | DEVOTED C-SNP GIVEBACK EXTRAS 034 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $700.00 | $7,150.00 |
| Madison | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Madison | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Madison | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Madison | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Madison | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Madison | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Madison | H6622_027_0 | Humana | Humana Dual Select H6622-027 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $4.10 | $700.00 | $9,850.00 |
| Madison | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Madison | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Madison | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Madison | H5253_186_0 | UnitedHealthcare | UHC Complete Care NC-25 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $685.00 | $6,400.00 |
| Madison | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Madison | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Madison | H1914_008_0 | Wellcare | Wellcare Carolina Complete Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Madison | H4073_003_0 | Wellcare | Wellcare Carolina Complete Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,250.00 |
| Madison | H4073_004_0 | Wellcare | Wellcare Carolina Complete Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Martin | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Martin | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Martin | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Martin | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Martin | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Martin | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Martin | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Martin | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Martin | H6351_001_0 | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $6,800.00 |
| Martin | H6351_004_0 | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $0.00 | $3,800.00 |
| Martin | H6351_005_0 | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Basic | $17.50 | $700.00 | $7,550.00 |
| Martin | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Martin | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Martin | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Martin | H5253_188_0 | UnitedHealthcare | UHC Complete Care NC-27 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $685.00 | $5,900.00 |
| Martin | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Martin | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Martin | H1914_008_0 | Wellcare | Wellcare Carolina Complete Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| McDowell | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| McDowell | H5296_004_0 | Alignment Health Plan | Alignment Health Duals+ 004 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| McDowell | H5296_009_0 | Alignment Health Plan | Alignment Health Heart & Diabetes Plus 009 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $4.80 | $700.00 | $9,850.00 |
| McDowell | H5296_011_0 | Alignment Health Plan | Alignment Health Heart & Diabetes 011 (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $250.00 | $3,400.00 |
| McDowell | H8212_001_0 | AmeriHealth Caritas VIP Care | AmeriHealth Caritas VIP Care (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $1.90 | $450.00 | $9,850.00 |
| McDowell | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| McDowell | H5299_006_0 | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| McDowell | H5299_009_0 | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $6,750.00 |
| McDowell | H5299_013_0 | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| McDowell | H5299_015_0 | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $9,850.00 |
| McDowell | H5299_018_0 | Devoted Health | DEVOTED C-SNP ENHANCED 018 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $5,600.00 |
| McDowell | H5299_034_0 | Devoted Health | DEVOTED C-SNP GIVEBACK EXTRAS 034 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $700.00 | $7,150.00 |
| McDowell | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| McDowell | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| McDowell | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| McDowell | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| McDowell | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| McDowell | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| McDowell | H6622_027_0 | Humana | Humana Dual Select H6622-027 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $4.10 | $700.00 | $9,850.00 |
| McDowell | H5374_001_0 | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| McDowell | H4676_002_0 | Troy Medicare | Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| McDowell | H0710_034_0 | UnitedHealthcare | UHC Nursing Home Plan NC-F001 (PPO I-SNP) | PPO I-SNP | Institutional | Enhanced | $0.00 | $700.00 | $9,850.00 |
| McDowell | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| McDowell | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| McDowell | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| McDowell | H5253_186_0 | UnitedHealthcare | UHC Complete Care NC-25 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $685.00 | $6,400.00 |
| McDowell | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| McDowell | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| McDowell | H1914_008_0 | Wellcare | Wellcare Carolina Complete Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| McDowell | H4073_003_0 | Wellcare | Wellcare Carolina Complete Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,250.00 |
| McDowell | H4073_004_0 | Wellcare | Wellcare Carolina Complete Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Mecklenburg | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Mecklenburg | H3146_022_0 | Aetna Medicare | Aetna Medicare Full Dual Care (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Mecklenburg | H3146_037_0 | Aetna Medicare | Aetna Medicare Chronic Care (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $700.00 | $6,750.00 |
| Mecklenburg | H3146_044_0 | Aetna Medicare | Aetna Medicare Chronic Care Value (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $700.00 | $9,250.00 |
| Mecklenburg | H5296_004_0 | Alignment Health Plan | Alignment Health Duals+ 004 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Mecklenburg | H5296_009_0 | Alignment Health Plan | Alignment Health Heart & Diabetes Plus 009 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $4.80 | $700.00 | $9,850.00 |
| Mecklenburg | H5296_011_0 | Alignment Health Plan | Alignment Health Heart & Diabetes 011 (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $250.00 | $3,400.00 |
| Mecklenburg | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Mecklenburg | H5299_006_0 | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Mecklenburg | H5299_009_0 | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $6,750.00 |
| Mecklenburg | H5299_013_0 | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Mecklenburg | H5299_015_0 | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $9,850.00 |
| Mecklenburg | H5299_016_0 | Devoted Health | DEVOTED C-SNP ENHANCED 016 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $5,400.00 |
| Mecklenburg | H5299_031_0 | Devoted Health | DEVOTED C-SNP GIVEBACK EXTRAS 031 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $700.00 | $7,050.00 |
| Mecklenburg | H9725_003_0 | HealthSpring | HealthSpring TotalCare (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Mecklenburg | H9725_013_0 | HealthSpring | HealthSpring TotalCare Plus (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Mecklenburg | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Mecklenburg | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Mecklenburg | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Mecklenburg | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Mecklenburg | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Mecklenburg | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Mecklenburg | H6351_001_0 | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $6,800.00 |
| Mecklenburg | H6351_004_0 | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $0.00 | $3,800.00 |
| Mecklenburg | H6351_005_0 | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Basic | $17.50 | $700.00 | $7,550.00 |
| Mecklenburg | H5374_001_0 | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Mecklenburg | H4439_001_0 | Provider Partners Health Plans | Provider Partners North Carolina Advantage Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Mecklenburg | H4439_004_0 | Provider Partners Health Plans | Provider Partners North Carolina Community Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $0.00 | $700.00 | $3,750.00 |
| Mecklenburg | H4439_005_0 | Provider Partners Health Plans | Provider Partners North Carolina Essential Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Mecklenburg | H0710_034_0 | UnitedHealthcare | UHC Nursing Home Plan NC-F001 (PPO I-SNP) | PPO I-SNP | Institutional | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Mecklenburg | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Mecklenburg | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Mecklenburg | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Mecklenburg | H5253_189_0 | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $595.00 | $4,450.00 |
| Mecklenburg | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Mecklenburg | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Mecklenburg | H1914_008_0 | Wellcare | Wellcare Carolina Complete Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Mecklenburg | H4073_003_0 | Wellcare | Wellcare Carolina Complete Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,250.00 |
| Mecklenburg | H4073_004_0 | Wellcare | Wellcare Carolina Complete Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Mitchell | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Mitchell | H5296_004_0 | Alignment Health Plan | Alignment Health Duals+ 004 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Mitchell | H5296_009_0 | Alignment Health Plan | Alignment Health Heart & Diabetes Plus 009 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $4.80 | $700.00 | $9,850.00 |
| Mitchell | H5296_011_0 | Alignment Health Plan | Alignment Health Heart & Diabetes 011 (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $250.00 | $3,400.00 |
| Mitchell | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Mitchell | H5299_006_0 | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Mitchell | H5299_009_0 | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $6,750.00 |
| Mitchell | H5299_013_0 | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Mitchell | H5299_015_0 | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $9,850.00 |
| Mitchell | H5299_018_0 | Devoted Health | DEVOTED C-SNP ENHANCED 018 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $5,600.00 |
| Mitchell | H5299_034_0 | Devoted Health | DEVOTED C-SNP GIVEBACK EXTRAS 034 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $700.00 | $7,150.00 |
| Mitchell | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Mitchell | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Mitchell | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Mitchell | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Mitchell | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Mitchell | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Mitchell | H6622_027_0 | Humana | Humana Dual Select H6622-027 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $4.10 | $700.00 | $9,850.00 |
| Mitchell | H4439_001_0 | Provider Partners Health Plans | Provider Partners North Carolina Advantage Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Mitchell | H4439_004_0 | Provider Partners Health Plans | Provider Partners North Carolina Community Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $0.00 | $700.00 | $3,750.00 |
| Mitchell | H4439_005_0 | Provider Partners Health Plans | Provider Partners North Carolina Essential Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Mitchell | H4676_002_0 | Troy Medicare | Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Mitchell | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Mitchell | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Mitchell | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Mitchell | H5253_186_0 | UnitedHealthcare | UHC Complete Care NC-25 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $685.00 | $6,400.00 |
| Mitchell | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Mitchell | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Mitchell | H1914_008_0 | Wellcare | Wellcare Carolina Complete Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Mitchell | H4073_003_0 | Wellcare | Wellcare Carolina Complete Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,250.00 |
| Mitchell | H4073_004_0 | Wellcare | Wellcare Carolina Complete Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Montgomery | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Montgomery | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Montgomery | H5299_006_0 | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Montgomery | H5299_009_0 | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $6,750.00 |
| Montgomery | H5299_013_0 | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Montgomery | H5299_015_0 | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $9,850.00 |
| Montgomery | H5299_016_0 | Devoted Health | DEVOTED C-SNP ENHANCED 016 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $5,400.00 |
| Montgomery | H5299_031_0 | Devoted Health | DEVOTED C-SNP GIVEBACK EXTRAS 031 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $700.00 | $7,050.00 |
| Montgomery | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Montgomery | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Montgomery | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Montgomery | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Montgomery | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Montgomery | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Montgomery | H5374_001_0 | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Montgomery | H4676_002_0 | Troy Medicare | Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Montgomery | H0710_034_0 | UnitedHealthcare | UHC Nursing Home Plan NC-F001 (PPO I-SNP) | PPO I-SNP | Institutional | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Montgomery | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Montgomery | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Montgomery | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Montgomery | H5253_189_0 | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $595.00 | $4,450.00 |
| Montgomery | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Montgomery | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Montgomery | H1914_008_0 | Wellcare | Wellcare Carolina Complete Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Montgomery | H4073_003_0 | Wellcare | Wellcare Carolina Complete Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,250.00 |
| Montgomery | H4073_004_0 | Wellcare | Wellcare Carolina Complete Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Moore | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Moore | H3146_022_0 | Aetna Medicare | Aetna Medicare Full Dual Care (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Moore | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Moore | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Moore | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Moore | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Moore | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Moore | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Moore | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Moore | H6351_001_0 | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $6,800.00 |
| Moore | H6351_004_0 | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $0.00 | $3,800.00 |
| Moore | H6351_005_0 | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Basic | $17.50 | $700.00 | $7,550.00 |
| Moore | H5374_001_0 | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Moore | H4676_002_0 | Troy Medicare | Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Moore | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Moore | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Moore | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Moore | H5253_189_0 | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $595.00 | $4,450.00 |
| Moore | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Moore | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Moore | H1914_008_0 | Wellcare | Wellcare Carolina Complete Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Moore | H4073_003_0 | Wellcare | Wellcare Carolina Complete Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,250.00 |
| Moore | H4073_004_0 | Wellcare | Wellcare Carolina Complete Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Nash | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Nash | H3146_022_0 | Aetna Medicare | Aetna Medicare Full Dual Care (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Nash | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Nash | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Nash | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Nash | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Nash | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Nash | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Nash | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Nash | H5374_001_0 | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Nash | H0710_034_0 | UnitedHealthcare | UHC Nursing Home Plan NC-F001 (PPO I-SNP) | PPO I-SNP | Institutional | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Nash | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Nash | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Nash | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Nash | H5253_189_0 | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $595.00 | $4,450.00 |
| Nash | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Nash | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Nash | H4073_003_0 | Wellcare | Wellcare Carolina Complete Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,250.00 |
| Nash | H4073_004_0 | Wellcare | Wellcare Carolina Complete Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| New Hanover | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| New Hanover | H3146_022_0 | Aetna Medicare | Aetna Medicare Full Dual Care (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| New Hanover | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| New Hanover | H5299_006_0 | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| New Hanover | H5299_009_0 | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $6,750.00 |
| New Hanover | H5299_013_0 | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| New Hanover | H5299_014_0 | Devoted Health | DEVOTED C-SNP ENHANCED 014 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $6,200.00 |
| New Hanover | H5299_015_0 | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $9,850.00 |
| New Hanover | H5299_033_0 | Devoted Health | DEVOTED C-SNP GIVEBACK EXTRAS 033 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $700.00 | $7,100.00 |
| New Hanover | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| New Hanover | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| New Hanover | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| New Hanover | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| New Hanover | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| New Hanover | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| New Hanover | H6351_001_0 | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $6,800.00 |
| New Hanover | H6351_004_0 | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $0.00 | $3,800.00 |
| New Hanover | H6351_005_0 | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Basic | $17.50 | $700.00 | $7,550.00 |
| New Hanover | H5374_001_0 | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| New Hanover | H4439_001_0 | Provider Partners Health Plans | Provider Partners North Carolina Advantage Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| New Hanover | H4439_004_0 | Provider Partners Health Plans | Provider Partners North Carolina Community Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $0.00 | $700.00 | $3,750.00 |
| New Hanover | H4439_005_0 | Provider Partners Health Plans | Provider Partners North Carolina Essential Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| New Hanover | H0710_034_0 | UnitedHealthcare | UHC Nursing Home Plan NC-F001 (PPO I-SNP) | PPO I-SNP | Institutional | Enhanced | $0.00 | $700.00 | $9,850.00 |
| New Hanover | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| New Hanover | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| New Hanover | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| New Hanover | H5253_188_0 | UnitedHealthcare | UHC Complete Care NC-27 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $685.00 | $5,900.00 |
| New Hanover | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| New Hanover | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Northampton | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Northampton | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Northampton | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Northampton | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Northampton | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Northampton | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Northampton | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Northampton | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Northampton | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Northampton | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Northampton | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Northampton | H5253_188_0 | UnitedHealthcare | UHC Complete Care NC-27 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $685.00 | $5,900.00 |
| Northampton | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Northampton | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Onslow | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Onslow | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Onslow | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Onslow | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Onslow | H5253_188_0 | UnitedHealthcare | UHC Complete Care NC-27 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $685.00 | $5,900.00 |
| Onslow | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Onslow | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Orange | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Orange | H3146_022_0 | Aetna Medicare | Aetna Medicare Full Dual Care (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Orange | H5296_004_0 | Alignment Health Plan | Alignment Health Duals+ 004 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Orange | H5296_009_0 | Alignment Health Plan | Alignment Health Heart & Diabetes Plus 009 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $4.80 | $700.00 | $9,850.00 |
| Orange | H5296_011_0 | Alignment Health Plan | Alignment Health Heart & Diabetes 011 (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $250.00 | $3,400.00 |
| Orange | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Orange | H9725_003_0 | HealthSpring | HealthSpring TotalCare (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Orange | H9725_013_0 | HealthSpring | HealthSpring TotalCare Plus (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Orange | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Orange | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Orange | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Orange | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Orange | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Orange | H6351_001_0 | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $6,800.00 |
| Orange | H6351_004_0 | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $0.00 | $3,800.00 |
| Orange | H6351_005_0 | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Basic | $17.50 | $700.00 | $7,550.00 |
| Orange | H4676_002_0 | Troy Medicare | Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Orange | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Orange | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Orange | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Orange | H5253_189_0 | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $595.00 | $4,450.00 |
| Orange | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Orange | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Orange | H1914_008_0 | Wellcare | Wellcare Carolina Complete Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Orange | H4073_003_0 | Wellcare | Wellcare Carolina Complete Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,250.00 |
| Orange | H4073_004_0 | Wellcare | Wellcare Carolina Complete Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Pamlico | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Pamlico | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Pamlico | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Pamlico | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Pamlico | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Pamlico | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Pamlico | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Pamlico | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Pamlico | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Pamlico | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Pamlico | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Pamlico | H5253_188_0 | UnitedHealthcare | UHC Complete Care NC-27 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $685.00 | $5,900.00 |
| Pamlico | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Pamlico | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Pasquotank | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Pasquotank | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Pasquotank | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Pasquotank | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Pasquotank | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Pasquotank | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Pasquotank | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Pasquotank | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Pasquotank | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Pasquotank | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Pasquotank | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Pasquotank | H5253_188_0 | UnitedHealthcare | UHC Complete Care NC-27 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $685.00 | $5,900.00 |
| Pasquotank | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Pasquotank | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Pender | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Pender | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Pender | H5299_006_0 | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Pender | H5299_009_0 | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $6,750.00 |
| Pender | H5299_013_0 | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Pender | H5299_014_0 | Devoted Health | DEVOTED C-SNP ENHANCED 014 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $6,200.00 |
| Pender | H5299_015_0 | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $9,850.00 |
| Pender | H5299_033_0 | Devoted Health | DEVOTED C-SNP GIVEBACK EXTRAS 033 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $700.00 | $7,100.00 |
| Pender | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Pender | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Pender | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Pender | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Pender | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Pender | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Pender | H6351_001_0 | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $6,800.00 |
| Pender | H6351_004_0 | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $0.00 | $3,800.00 |
| Pender | H6351_005_0 | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Basic | $17.50 | $700.00 | $7,550.00 |
| Pender | H4439_001_0 | Provider Partners Health Plans | Provider Partners North Carolina Advantage Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Pender | H4439_004_0 | Provider Partners Health Plans | Provider Partners North Carolina Community Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $0.00 | $700.00 | $3,750.00 |
| Pender | H4439_005_0 | Provider Partners Health Plans | Provider Partners North Carolina Essential Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Pender | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Pender | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Pender | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Pender | H5253_188_0 | UnitedHealthcare | UHC Complete Care NC-27 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $685.00 | $5,900.00 |
| Pender | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Pender | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Perquimans | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Perquimans | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Perquimans | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Perquimans | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Perquimans | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Perquimans | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Perquimans | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Perquimans | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Perquimans | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Perquimans | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Perquimans | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Perquimans | H5253_188_0 | UnitedHealthcare | UHC Complete Care NC-27 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $685.00 | $5,900.00 |
| Perquimans | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Perquimans | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Person | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Person | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Person | H5299_006_0 | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Person | H5299_009_0 | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $6,750.00 |
| Person | H5299_013_0 | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Person | H5299_015_0 | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $9,850.00 |
| Person | H5299_017_0 | Devoted Health | DEVOTED C-SNP ENHANCED 017 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $4,800.00 |
| Person | H5299_032_0 | Devoted Health | DEVOTED C-SNP GIVEBACK EXTRAS 032 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $700.00 | $5,700.00 |
| Person | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Person | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Person | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Person | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Person | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Person | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Person | H6351_001_0 | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $6,800.00 |
| Person | H6351_004_0 | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $0.00 | $3,800.00 |
| Person | H6351_005_0 | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Basic | $17.50 | $700.00 | $7,550.00 |
| Person | H4676_002_0 | Troy Medicare | Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Person | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Person | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Person | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Person | H5253_189_0 | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $595.00 | $4,450.00 |
| Person | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Person | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Person | H1914_008_0 | Wellcare | Wellcare Carolina Complete Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Person | H4073_003_0 | Wellcare | Wellcare Carolina Complete Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,250.00 |
| Person | H4073_004_0 | Wellcare | Wellcare Carolina Complete Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Pitt | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Pitt | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Pitt | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Pitt | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Pitt | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Pitt | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Pitt | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Pitt | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Pitt | H6351_001_0 | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $6,800.00 |
| Pitt | H6351_004_0 | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $0.00 | $3,800.00 |
| Pitt | H6351_005_0 | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Basic | $17.50 | $700.00 | $7,550.00 |
| Pitt | H5374_001_0 | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Pitt | H6345_001_0 | PruittHealth Premier | PruittHealth Premier (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Pitt | H6345_003_0 | PruittHealth Premier | PruittHealth Premier (HMO I-SNP) | HMO I-SNP | Institutional | Enhanced | $0.00 | $350.00 | $5,900.00 |
| Pitt | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Pitt | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Pitt | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Pitt | H5253_188_0 | UnitedHealthcare | UHC Complete Care NC-27 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $685.00 | $5,900.00 |
| Pitt | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Pitt | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Polk | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Polk | H8212_001_0 | AmeriHealth Caritas VIP Care | AmeriHealth Caritas VIP Care (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $1.90 | $450.00 | $9,850.00 |
| Polk | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Polk | H5299_006_0 | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Polk | H5299_009_0 | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $6,750.00 |
| Polk | H5299_013_0 | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Polk | H5299_015_0 | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $9,850.00 |
| Polk | H5299_018_0 | Devoted Health | DEVOTED C-SNP ENHANCED 018 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $5,600.00 |
| Polk | H5299_034_0 | Devoted Health | DEVOTED C-SNP GIVEBACK EXTRAS 034 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $700.00 | $7,150.00 |
| Polk | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Polk | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Polk | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Polk | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Polk | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Polk | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Polk | H6351_001_0 | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $6,800.00 |
| Polk | H6351_004_0 | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $0.00 | $3,800.00 |
| Polk | H6351_005_0 | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Basic | $17.50 | $700.00 | $7,550.00 |
| Polk | H5374_001_0 | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Polk | H4172_001_0 | NHC Advantage | NHC Advantage (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $12.20 | $700.00 | $9,850.00 |
| Polk | H4172_003_0 | NHC Advantage | Senior Care (HMO I-SNP) | HMO I-SNP | Institutional | Enhanced | $0.00 | $500.00 | $5,000.00 |
| Polk | H4676_002_0 | Troy Medicare | Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Polk | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Polk | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Polk | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Polk | H5253_186_0 | UnitedHealthcare | UHC Complete Care NC-25 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $685.00 | $6,400.00 |
| Polk | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Polk | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Polk | H1914_008_0 | Wellcare | Wellcare Carolina Complete Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Polk | H4073_003_0 | Wellcare | Wellcare Carolina Complete Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,250.00 |
| Polk | H4073_004_0 | Wellcare | Wellcare Carolina Complete Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Randolph | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Randolph | H3146_022_0 | Aetna Medicare | Aetna Medicare Full Dual Care (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Randolph | H3146_053_0 | Aetna Medicare | Aetna Medicare Chronic Care (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $700.00 | $6,750.00 |
| Randolph | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Randolph | H5299_006_0 | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Randolph | H5299_009_0 | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $6,750.00 |
| Randolph | H5299_013_0 | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Randolph | H5299_015_0 | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $9,850.00 |
| Randolph | H5299_017_0 | Devoted Health | DEVOTED C-SNP ENHANCED 017 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $4,800.00 |
| Randolph | H5299_032_0 | Devoted Health | DEVOTED C-SNP GIVEBACK EXTRAS 032 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $700.00 | $5,700.00 |
| Randolph | H9725_003_0 | HealthSpring | HealthSpring TotalCare (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Randolph | H9725_013_0 | HealthSpring | HealthSpring TotalCare Plus (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Randolph | H9725_020_0 | HealthSpring | HealthSpring Achieve (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $500.00 | $4,450.00 |
| Randolph | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Randolph | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Randolph | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Randolph | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Randolph | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Randolph | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Randolph | H6351_001_0 | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $6,800.00 |
| Randolph | H6351_004_0 | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $0.00 | $3,800.00 |
| Randolph | H6351_005_0 | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Basic | $17.50 | $700.00 | $7,550.00 |
| Randolph | H5374_001_0 | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Randolph | H0710_034_0 | UnitedHealthcare | UHC Nursing Home Plan NC-F001 (PPO I-SNP) | PPO I-SNP | Institutional | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Randolph | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Randolph | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Randolph | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Randolph | H5253_189_0 | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $595.00 | $4,450.00 |
| Randolph | H5253_216_2 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Randolph | H5253_217_2 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Randolph | H1914_008_0 | Wellcare | Wellcare Carolina Complete Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Randolph | H4073_003_0 | Wellcare | Wellcare Carolina Complete Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,250.00 |
| Randolph | H4073_004_0 | Wellcare | Wellcare Carolina Complete Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Richmond | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Richmond | H3146_022_0 | Aetna Medicare | Aetna Medicare Full Dual Care (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Richmond | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Richmond | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Richmond | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Richmond | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Richmond | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Richmond | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Richmond | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Richmond | H6351_001_0 | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $6,800.00 |
| Richmond | H6351_004_0 | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $0.00 | $3,800.00 |
| Richmond | H6351_005_0 | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Basic | $17.50 | $700.00 | $7,550.00 |
| Richmond | H6345_001_0 | PruittHealth Premier | PruittHealth Premier (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Richmond | H6345_003_0 | PruittHealth Premier | PruittHealth Premier (HMO I-SNP) | HMO I-SNP | Institutional | Enhanced | $0.00 | $350.00 | $5,900.00 |
| Richmond | H4676_002_0 | Troy Medicare | Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Richmond | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Richmond | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Richmond | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Richmond | H5253_189_0 | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $595.00 | $4,450.00 |
| Richmond | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Richmond | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Richmond | H1914_008_0 | Wellcare | Wellcare Carolina Complete Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Richmond | H4073_003_0 | Wellcare | Wellcare Carolina Complete Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,250.00 |
| Richmond | H4073_004_0 | Wellcare | Wellcare Carolina Complete Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Robeson | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Robeson | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Robeson | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Robeson | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Robeson | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Robeson | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Robeson | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Robeson | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Robeson | H6351_001_0 | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $6,800.00 |
| Robeson | H6351_004_0 | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $0.00 | $3,800.00 |
| Robeson | H6351_005_0 | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Basic | $17.50 | $700.00 | $7,550.00 |
| Robeson | H5374_001_0 | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Robeson | H4676_002_0 | Troy Medicare | Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Robeson | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Robeson | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Robeson | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Robeson | H5253_188_0 | UnitedHealthcare | UHC Complete Care NC-27 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $685.00 | $5,900.00 |
| Robeson | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Robeson | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Robeson | H1914_008_0 | Wellcare | Wellcare Carolina Complete Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Robeson | H4073_003_0 | Wellcare | Wellcare Carolina Complete Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,250.00 |
| Robeson | H4073_004_0 | Wellcare | Wellcare Carolina Complete Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Rockingham | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Rockingham | H3146_022_0 | Aetna Medicare | Aetna Medicare Full Dual Care (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Rockingham | H3146_053_0 | Aetna Medicare | Aetna Medicare Chronic Care (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $700.00 | $6,750.00 |
| Rockingham | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Rockingham | H5299_006_0 | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Rockingham | H5299_009_0 | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $6,750.00 |
| Rockingham | H5299_013_0 | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Rockingham | H5299_015_0 | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $9,850.00 |
| Rockingham | H5299_017_0 | Devoted Health | DEVOTED C-SNP ENHANCED 017 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $4,800.00 |
| Rockingham | H5299_032_0 | Devoted Health | DEVOTED C-SNP GIVEBACK EXTRAS 032 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $700.00 | $5,700.00 |
| Rockingham | H9725_003_0 | HealthSpring | HealthSpring TotalCare (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Rockingham | H9725_013_0 | HealthSpring | HealthSpring TotalCare Plus (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Rockingham | H9725_020_0 | HealthSpring | HealthSpring Achieve (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $500.00 | $4,450.00 |
| Rockingham | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Rockingham | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Rockingham | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Rockingham | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Rockingham | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Rockingham | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Rockingham | H6351_001_0 | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $6,800.00 |
| Rockingham | H6351_004_0 | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $0.00 | $3,800.00 |
| Rockingham | H6351_005_0 | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Basic | $17.50 | $700.00 | $7,550.00 |
| Rockingham | H5374_001_0 | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Rockingham | H6345_001_0 | PruittHealth Premier | PruittHealth Premier (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Rockingham | H6345_003_0 | PruittHealth Premier | PruittHealth Premier (HMO I-SNP) | HMO I-SNP | Institutional | Enhanced | $0.00 | $350.00 | $5,900.00 |
| Rockingham | H0710_034_0 | UnitedHealthcare | UHC Nursing Home Plan NC-F001 (PPO I-SNP) | PPO I-SNP | Institutional | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Rockingham | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Rockingham | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Rockingham | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Rockingham | H5253_189_0 | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $595.00 | $4,450.00 |
| Rockingham | H5253_216_2 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Rockingham | H5253_217_2 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Rockingham | H1914_008_0 | Wellcare | Wellcare Carolina Complete Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Rockingham | H4073_003_0 | Wellcare | Wellcare Carolina Complete Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,250.00 |
| Rockingham | H4073_004_0 | Wellcare | Wellcare Carolina Complete Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Rowan | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Rowan | H5296_004_0 | Alignment Health Plan | Alignment Health Duals+ 004 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Rowan | H5296_009_0 | Alignment Health Plan | Alignment Health Heart & Diabetes Plus 009 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $4.80 | $700.00 | $9,850.00 |
| Rowan | H5296_011_0 | Alignment Health Plan | Alignment Health Heart & Diabetes 011 (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $250.00 | $3,400.00 |
| Rowan | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Rowan | H5299_006_0 | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Rowan | H5299_009_0 | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $6,750.00 |
| Rowan | H5299_013_0 | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Rowan | H5299_015_0 | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $9,850.00 |
| Rowan | H5299_016_0 | Devoted Health | DEVOTED C-SNP ENHANCED 016 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $5,400.00 |
| Rowan | H5299_031_0 | Devoted Health | DEVOTED C-SNP GIVEBACK EXTRAS 031 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $700.00 | $7,050.00 |
| Rowan | H9725_003_0 | HealthSpring | HealthSpring TotalCare (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Rowan | H9725_013_0 | HealthSpring | HealthSpring TotalCare Plus (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Rowan | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Rowan | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Rowan | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Rowan | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Rowan | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Rowan | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Rowan | H6351_001_0 | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $6,800.00 |
| Rowan | H6351_004_0 | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $0.00 | $3,800.00 |
| Rowan | H6351_005_0 | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Basic | $17.50 | $700.00 | $7,550.00 |
| Rowan | H5374_001_0 | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Rowan | H6345_001_0 | PruittHealth Premier | PruittHealth Premier (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Rowan | H6345_003_0 | PruittHealth Premier | PruittHealth Premier (HMO I-SNP) | HMO I-SNP | Institutional | Enhanced | $0.00 | $350.00 | $5,900.00 |
| Rowan | H0710_034_0 | UnitedHealthcare | UHC Nursing Home Plan NC-F001 (PPO I-SNP) | PPO I-SNP | Institutional | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Rowan | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Rowan | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Rowan | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Rowan | H5253_189_0 | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $595.00 | $4,450.00 |
| Rowan | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Rowan | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Rowan | H1914_008_0 | Wellcare | Wellcare Carolina Complete Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Rowan | H4073_003_0 | Wellcare | Wellcare Carolina Complete Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,250.00 |
| Rowan | H4073_004_0 | Wellcare | Wellcare Carolina Complete Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Rutherford | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Rutherford | H5299_006_0 | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Rutherford | H5299_009_0 | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $6,750.00 |
| Rutherford | H5299_013_0 | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Rutherford | H5299_015_0 | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $9,850.00 |
| Rutherford | H5299_018_0 | Devoted Health | DEVOTED C-SNP ENHANCED 018 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $5,600.00 |
| Rutherford | H5299_034_0 | Devoted Health | DEVOTED C-SNP GIVEBACK EXTRAS 034 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $700.00 | $7,150.00 |
| Rutherford | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Rutherford | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Rutherford | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Rutherford | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Rutherford | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Rutherford | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Rutherford | H6622_027_0 | Humana | Humana Dual Select H6622-027 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $4.10 | $700.00 | $9,850.00 |
| Rutherford | H5374_001_0 | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Rutherford | H0710_034_0 | UnitedHealthcare | UHC Nursing Home Plan NC-F001 (PPO I-SNP) | PPO I-SNP | Institutional | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Rutherford | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Rutherford | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Rutherford | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Rutherford | H5253_186_0 | UnitedHealthcare | UHC Complete Care NC-25 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $685.00 | $6,400.00 |
| Rutherford | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Rutherford | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Rutherford | H1914_008_0 | Wellcare | Wellcare Carolina Complete Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Rutherford | H4073_003_0 | Wellcare | Wellcare Carolina Complete Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,250.00 |
| Rutherford | H4073_004_0 | Wellcare | Wellcare Carolina Complete Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Sampson | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Sampson | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Sampson | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Sampson | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Sampson | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Sampson | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Sampson | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Sampson | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Sampson | H6351_001_0 | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $6,800.00 |
| Sampson | H6351_004_0 | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $0.00 | $3,800.00 |
| Sampson | H6351_005_0 | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Basic | $17.50 | $700.00 | $7,550.00 |
| Sampson | H4676_002_0 | Troy Medicare | Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Sampson | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Sampson | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Sampson | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Sampson | H5253_189_0 | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $595.00 | $4,450.00 |
| Sampson | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Sampson | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Sampson | H1914_008_0 | Wellcare | Wellcare Carolina Complete Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Sampson | H4073_003_0 | Wellcare | Wellcare Carolina Complete Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,250.00 |
| Sampson | H4073_004_0 | Wellcare | Wellcare Carolina Complete Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Scotland | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Scotland | H3146_022_0 | Aetna Medicare | Aetna Medicare Full Dual Care (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Scotland | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Scotland | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Scotland | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Scotland | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Scotland | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Scotland | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Scotland | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Scotland | H6351_001_0 | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $6,800.00 |
| Scotland | H6351_004_0 | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $0.00 | $3,800.00 |
| Scotland | H6351_005_0 | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Basic | $17.50 | $700.00 | $7,550.00 |
| Scotland | H5374_001_0 | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Scotland | H4676_002_0 | Troy Medicare | Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Scotland | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Scotland | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Scotland | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Scotland | H5253_189_0 | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $595.00 | $4,450.00 |
| Scotland | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Scotland | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Scotland | H1914_008_0 | Wellcare | Wellcare Carolina Complete Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Scotland | H4073_003_0 | Wellcare | Wellcare Carolina Complete Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,250.00 |
| Scotland | H4073_004_0 | Wellcare | Wellcare Carolina Complete Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Stanly | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Stanly | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Stanly | H5299_006_0 | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Stanly | H5299_009_0 | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $6,750.00 |
| Stanly | H5299_013_0 | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Stanly | H5299_015_0 | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $9,850.00 |
| Stanly | H5299_016_0 | Devoted Health | DEVOTED C-SNP ENHANCED 016 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $5,400.00 |
| Stanly | H5299_031_0 | Devoted Health | DEVOTED C-SNP GIVEBACK EXTRAS 031 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $700.00 | $7,050.00 |
| Stanly | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Stanly | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Stanly | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Stanly | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Stanly | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Stanly | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Stanly | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Stanly | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Stanly | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Stanly | H5253_189_0 | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $595.00 | $4,450.00 |
| Stanly | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Stanly | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Stanly | H1914_008_0 | Wellcare | Wellcare Carolina Complete Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Stanly | H4073_003_0 | Wellcare | Wellcare Carolina Complete Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,250.00 |
| Stanly | H4073_004_0 | Wellcare | Wellcare Carolina Complete Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Stokes | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Stokes | H3146_053_0 | Aetna Medicare | Aetna Medicare Chronic Care (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $700.00 | $6,750.00 |
| Stokes | H8212_001_0 | AmeriHealth Caritas VIP Care | AmeriHealth Caritas VIP Care (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $1.90 | $450.00 | $9,850.00 |
| Stokes | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Stokes | H5299_006_0 | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Stokes | H5299_009_0 | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $6,750.00 |
| Stokes | H5299_013_0 | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Stokes | H5299_015_0 | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $9,850.00 |
| Stokes | H5299_017_0 | Devoted Health | DEVOTED C-SNP ENHANCED 017 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $4,800.00 |
| Stokes | H5299_032_0 | Devoted Health | DEVOTED C-SNP GIVEBACK EXTRAS 032 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $700.00 | $5,700.00 |
| Stokes | H9725_003_0 | HealthSpring | HealthSpring TotalCare (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Stokes | H9725_013_0 | HealthSpring | HealthSpring TotalCare Plus (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Stokes | H9725_020_0 | HealthSpring | HealthSpring Achieve (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $500.00 | $4,450.00 |
| Stokes | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Stokes | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Stokes | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Stokes | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Stokes | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Stokes | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Stokes | H6351_001_0 | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $6,800.00 |
| Stokes | H6351_004_0 | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $0.00 | $3,800.00 |
| Stokes | H6351_005_0 | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Basic | $17.50 | $700.00 | $7,550.00 |
| Stokes | H5374_001_0 | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Stokes | H0710_034_0 | UnitedHealthcare | UHC Nursing Home Plan NC-F001 (PPO I-SNP) | PPO I-SNP | Institutional | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Stokes | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Stokes | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Stokes | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Stokes | H5253_189_0 | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $595.00 | $4,450.00 |
| Stokes | H5253_216_2 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Stokes | H5253_217_2 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Stokes | H1914_008_0 | Wellcare | Wellcare Carolina Complete Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Stokes | H4073_003_0 | Wellcare | Wellcare Carolina Complete Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,250.00 |
| Stokes | H4073_004_0 | Wellcare | Wellcare Carolina Complete Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Surry | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Surry | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Surry | H5299_006_0 | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Surry | H5299_009_0 | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $6,750.00 |
| Surry | H5299_013_0 | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Surry | H5299_014_0 | Devoted Health | DEVOTED C-SNP ENHANCED 014 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $6,200.00 |
| Surry | H5299_015_0 | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $9,850.00 |
| Surry | H5299_045_0 | Devoted Health | DEVOTED C-SNP GIVEBACK EXTRAS 045 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $700.00 | $6,750.00 |
| Surry | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Surry | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Surry | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Surry | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Surry | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Surry | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Surry | H5374_001_0 | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Surry | H6345_001_0 | PruittHealth Premier | PruittHealth Premier (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Surry | H6345_003_0 | PruittHealth Premier | PruittHealth Premier (HMO I-SNP) | HMO I-SNP | Institutional | Enhanced | $0.00 | $350.00 | $5,900.00 |
| Surry | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Surry | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Surry | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Surry | H5253_189_0 | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $595.00 | $4,450.00 |
| Surry | H5253_216_2 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Surry | H5253_217_2 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Surry | H4073_003_0 | Wellcare | Wellcare Carolina Complete Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,250.00 |
| Surry | H4073_004_0 | Wellcare | Wellcare Carolina Complete Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Swain | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Swain | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Swain | H5299_006_0 | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Swain | H5299_009_0 | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $6,750.00 |
| Swain | H5299_013_0 | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Swain | H5299_015_0 | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $9,850.00 |
| Swain | H5299_018_0 | Devoted Health | DEVOTED C-SNP ENHANCED 018 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $5,600.00 |
| Swain | H5299_034_0 | Devoted Health | DEVOTED C-SNP GIVEBACK EXTRAS 034 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $700.00 | $7,150.00 |
| Swain | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Swain | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Swain | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Swain | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Swain | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Swain | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Swain | H6622_027_0 | Humana | Humana Dual Select H6622-027 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $4.10 | $700.00 | $9,850.00 |
| Swain | H4676_002_0 | Troy Medicare | Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Swain | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Swain | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Swain | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Swain | H5253_186_0 | UnitedHealthcare | UHC Complete Care NC-25 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $685.00 | $6,400.00 |
| Swain | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Swain | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Swain | H1914_008_0 | Wellcare | Wellcare Carolina Complete Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Swain | H4073_003_0 | Wellcare | Wellcare Carolina Complete Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,250.00 |
| Swain | H4073_004_0 | Wellcare | Wellcare Carolina Complete Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Transylvania | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Transylvania | H5296_004_0 | Alignment Health Plan | Alignment Health Duals+ 004 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Transylvania | H5296_009_0 | Alignment Health Plan | Alignment Health Heart & Diabetes Plus 009 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $4.80 | $700.00 | $9,850.00 |
| Transylvania | H5296_011_0 | Alignment Health Plan | Alignment Health Heart & Diabetes 011 (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $250.00 | $3,400.00 |
| Transylvania | H8212_001_0 | AmeriHealth Caritas VIP Care | AmeriHealth Caritas VIP Care (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $1.90 | $450.00 | $9,850.00 |
| Transylvania | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Transylvania | H5299_006_0 | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Transylvania | H5299_009_0 | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $6,750.00 |
| Transylvania | H5299_013_0 | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Transylvania | H5299_015_0 | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $9,850.00 |
| Transylvania | H5299_018_0 | Devoted Health | DEVOTED C-SNP ENHANCED 018 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $5,600.00 |
| Transylvania | H5299_034_0 | Devoted Health | DEVOTED C-SNP GIVEBACK EXTRAS 034 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $700.00 | $7,150.00 |
| Transylvania | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Transylvania | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Transylvania | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Transylvania | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Transylvania | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Transylvania | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Transylvania | H6622_027_0 | Humana | Humana Dual Select H6622-027 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $4.10 | $700.00 | $9,850.00 |
| Transylvania | H6345_001_0 | PruittHealth Premier | PruittHealth Premier (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Transylvania | H6345_003_0 | PruittHealth Premier | PruittHealth Premier (HMO I-SNP) | HMO I-SNP | Institutional | Enhanced | $0.00 | $350.00 | $5,900.00 |
| Transylvania | H4676_002_0 | Troy Medicare | Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Transylvania | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Transylvania | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Transylvania | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Transylvania | H5253_186_0 | UnitedHealthcare | UHC Complete Care NC-25 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $685.00 | $6,400.00 |
| Transylvania | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Transylvania | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Transylvania | H1914_008_0 | Wellcare | Wellcare Carolina Complete Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Transylvania | H4073_003_0 | Wellcare | Wellcare Carolina Complete Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,250.00 |
| Transylvania | H4073_004_0 | Wellcare | Wellcare Carolina Complete Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Tyrrell | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Tyrrell | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Tyrrell | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Tyrrell | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Tyrrell | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Tyrrell | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Tyrrell | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Tyrrell | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Tyrrell | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Tyrrell | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Tyrrell | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Tyrrell | H5253_188_0 | UnitedHealthcare | UHC Complete Care NC-27 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $685.00 | $5,900.00 |
| Tyrrell | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Tyrrell | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Tyrrell | H1914_008_0 | Wellcare | Wellcare Carolina Complete Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Union | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Union | H3146_022_0 | Aetna Medicare | Aetna Medicare Full Dual Care (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Union | H3146_037_0 | Aetna Medicare | Aetna Medicare Chronic Care (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $700.00 | $6,750.00 |
| Union | H3146_044_0 | Aetna Medicare | Aetna Medicare Chronic Care Value (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $700.00 | $9,250.00 |
| Union | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Union | H5299_006_0 | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Union | H5299_009_0 | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $6,750.00 |
| Union | H5299_013_0 | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Union | H5299_015_0 | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $9,850.00 |
| Union | H5299_016_0 | Devoted Health | DEVOTED C-SNP ENHANCED 016 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $5,400.00 |
| Union | H5299_031_0 | Devoted Health | DEVOTED C-SNP GIVEBACK EXTRAS 031 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $700.00 | $7,050.00 |
| Union | H9725_003_0 | HealthSpring | HealthSpring TotalCare (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Union | H9725_013_0 | HealthSpring | HealthSpring TotalCare Plus (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Union | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Union | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Union | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Union | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Union | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Union | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Union | H6351_001_0 | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $6,800.00 |
| Union | H6351_004_0 | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $0.00 | $3,800.00 |
| Union | H6351_005_0 | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Basic | $17.50 | $700.00 | $7,550.00 |
| Union | H5374_001_0 | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Union | H4439_001_0 | Provider Partners Health Plans | Provider Partners North Carolina Advantage Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Union | H4439_004_0 | Provider Partners Health Plans | Provider Partners North Carolina Community Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $0.00 | $700.00 | $3,750.00 |
| Union | H4439_005_0 | Provider Partners Health Plans | Provider Partners North Carolina Essential Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Union | H6345_001_0 | PruittHealth Premier | PruittHealth Premier (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Union | H6345_003_0 | PruittHealth Premier | PruittHealth Premier (HMO I-SNP) | HMO I-SNP | Institutional | Enhanced | $0.00 | $350.00 | $5,900.00 |
| Union | H0710_034_0 | UnitedHealthcare | UHC Nursing Home Plan NC-F001 (PPO I-SNP) | PPO I-SNP | Institutional | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Union | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Union | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Union | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Union | H5253_189_0 | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $595.00 | $4,450.00 |
| Union | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Union | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Union | H1914_008_0 | Wellcare | Wellcare Carolina Complete Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Union | H4073_003_0 | Wellcare | Wellcare Carolina Complete Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,250.00 |
| Union | H4073_004_0 | Wellcare | Wellcare Carolina Complete Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Vance | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Vance | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Vance | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Vance | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Vance | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Vance | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Vance | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Vance | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Vance | H6351_001_0 | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $6,800.00 |
| Vance | H6351_004_0 | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $0.00 | $3,800.00 |
| Vance | H6351_005_0 | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Basic | $17.50 | $700.00 | $7,550.00 |
| Vance | H4676_002_0 | Troy Medicare | Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Vance | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Vance | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Vance | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Vance | H5253_189_0 | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $595.00 | $4,450.00 |
| Vance | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Vance | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Vance | H1914_008_0 | Wellcare | Wellcare Carolina Complete Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Vance | H4073_003_0 | Wellcare | Wellcare Carolina Complete Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,250.00 |
| Vance | H4073_004_0 | Wellcare | Wellcare Carolina Complete Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Wake | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Wake | H3146_022_0 | Aetna Medicare | Aetna Medicare Full Dual Care (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Wake | H5296_004_0 | Alignment Health Plan | Alignment Health Duals+ 004 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Wake | H5296_009_0 | Alignment Health Plan | Alignment Health Heart & Diabetes Plus 009 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $4.80 | $700.00 | $9,850.00 |
| Wake | H5296_011_0 | Alignment Health Plan | Alignment Health Heart & Diabetes 011 (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $250.00 | $3,400.00 |
| Wake | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Wake | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Wake | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Wake | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Wake | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Wake | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Wake | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Wake | H6351_001_0 | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $6,800.00 |
| Wake | H6351_004_0 | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $0.00 | $3,800.00 |
| Wake | H6351_005_0 | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Basic | $17.50 | $700.00 | $7,550.00 |
| Wake | H5374_001_0 | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Wake | H6345_001_0 | PruittHealth Premier | PruittHealth Premier (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Wake | H6345_003_0 | PruittHealth Premier | PruittHealth Premier (HMO I-SNP) | HMO I-SNP | Institutional | Enhanced | $0.00 | $350.00 | $5,900.00 |
| Wake | H0710_034_0 | UnitedHealthcare | UHC Nursing Home Plan NC-F001 (PPO I-SNP) | PPO I-SNP | Institutional | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Wake | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Wake | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Wake | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Wake | H5253_189_0 | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $595.00 | $4,450.00 |
| Wake | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Wake | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Wake | H1914_008_0 | Wellcare | Wellcare Carolina Complete Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Wake | H4073_003_0 | Wellcare | Wellcare Carolina Complete Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,250.00 |
| Wake | H4073_004_0 | Wellcare | Wellcare Carolina Complete Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Warren | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Warren | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Warren | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Warren | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Warren | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Warren | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Warren | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Warren | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Warren | H6351_001_0 | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $6,800.00 |
| Warren | H6351_004_0 | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $0.00 | $3,800.00 |
| Warren | H6351_005_0 | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Basic | $17.50 | $700.00 | $7,550.00 |
| Warren | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Warren | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Warren | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Warren | H5253_188_0 | UnitedHealthcare | UHC Complete Care NC-27 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $685.00 | $5,900.00 |
| Warren | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Warren | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Warren | H1914_008_0 | Wellcare | Wellcare Carolina Complete Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Warren | H4073_003_0 | Wellcare | Wellcare Carolina Complete Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,250.00 |
| Warren | H4073_004_0 | Wellcare | Wellcare Carolina Complete Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Washington | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Washington | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Washington | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Washington | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Washington | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Washington | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Washington | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Washington | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Washington | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Washington | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Washington | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Washington | H5253_188_0 | UnitedHealthcare | UHC Complete Care NC-27 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $685.00 | $5,900.00 |
| Washington | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Washington | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Watauga | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Watauga | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Watauga | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Watauga | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Watauga | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Watauga | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Watauga | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Watauga | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Watauga | H6351_001_0 | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $6,800.00 |
| Watauga | H6351_004_0 | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $0.00 | $3,800.00 |
| Watauga | H6351_005_0 | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Basic | $17.50 | $700.00 | $7,550.00 |
| Watauga | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Watauga | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Watauga | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Watauga | H5253_186_0 | UnitedHealthcare | UHC Complete Care NC-25 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $685.00 | $6,400.00 |
| Watauga | H5253_216_2 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Watauga | H5253_217_2 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Watauga | H1914_008_0 | Wellcare | Wellcare Carolina Complete Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Watauga | H4073_003_0 | Wellcare | Wellcare Carolina Complete Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,250.00 |
| Watauga | H4073_004_0 | Wellcare | Wellcare Carolina Complete Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Wayne | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Wayne | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Wayne | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Wayne | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Wayne | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Wayne | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Wayne | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Wayne | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Wayne | H6351_001_0 | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $6,800.00 |
| Wayne | H6351_004_0 | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $0.00 | $3,800.00 |
| Wayne | H6351_005_0 | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Basic | $17.50 | $700.00 | $7,550.00 |
| Wayne | H5374_001_0 | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Wayne | H0710_034_0 | UnitedHealthcare | UHC Nursing Home Plan NC-F001 (PPO I-SNP) | PPO I-SNP | Institutional | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Wayne | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Wayne | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Wayne | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Wayne | H5253_189_0 | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $595.00 | $4,450.00 |
| Wayne | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Wayne | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Wilkes | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Wilkes | H5296_004_0 | Alignment Health Plan | Alignment Health Duals+ 004 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Wilkes | H5296_009_0 | Alignment Health Plan | Alignment Health Heart & Diabetes Plus 009 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $4.80 | $700.00 | $9,850.00 |
| Wilkes | H5296_011_0 | Alignment Health Plan | Alignment Health Heart & Diabetes 011 (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $250.00 | $3,400.00 |
| Wilkes | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Wilkes | H5299_006_0 | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Wilkes | H5299_009_0 | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $6,750.00 |
| Wilkes | H5299_013_0 | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Wilkes | H5299_014_0 | Devoted Health | DEVOTED C-SNP ENHANCED 014 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $6,200.00 |
| Wilkes | H5299_015_0 | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $9,850.00 |
| Wilkes | H5299_045_0 | Devoted Health | DEVOTED C-SNP GIVEBACK EXTRAS 045 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $700.00 | $6,750.00 |
| Wilkes | H9725_003_0 | HealthSpring | HealthSpring TotalCare (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Wilkes | H9725_013_0 | HealthSpring | HealthSpring TotalCare Plus (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Wilkes | H9725_020_0 | HealthSpring | HealthSpring Achieve (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $500.00 | $4,450.00 |
| Wilkes | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Wilkes | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Wilkes | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Wilkes | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Wilkes | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Wilkes | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Wilkes | H6351_001_0 | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $6,800.00 |
| Wilkes | H6351_004_0 | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $0.00 | $3,800.00 |
| Wilkes | H6351_005_0 | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Basic | $17.50 | $700.00 | $7,550.00 |
| Wilkes | H4439_001_0 | Provider Partners Health Plans | Provider Partners North Carolina Advantage Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Wilkes | H4439_004_0 | Provider Partners Health Plans | Provider Partners North Carolina Community Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $0.00 | $700.00 | $3,750.00 |
| Wilkes | H4439_005_0 | Provider Partners Health Plans | Provider Partners North Carolina Essential Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Wilkes | H0710_034_0 | UnitedHealthcare | UHC Nursing Home Plan NC-F001 (PPO I-SNP) | PPO I-SNP | Institutional | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Wilkes | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Wilkes | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Wilkes | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Wilkes | H5253_186_0 | UnitedHealthcare | UHC Complete Care NC-25 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $685.00 | $6,400.00 |
| Wilkes | H5253_216_2 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Wilkes | H5253_217_2 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Wilkes | H1914_008_0 | Wellcare | Wellcare Carolina Complete Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Wilkes | H4073_003_0 | Wellcare | Wellcare Carolina Complete Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,250.00 |
| Wilkes | H4073_004_0 | Wellcare | Wellcare Carolina Complete Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Wilson | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Wilson | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Wilson | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Wilson | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Wilson | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Wilson | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Wilson | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Wilson | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Wilson | H6351_001_0 | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $6,800.00 |
| Wilson | H6351_004_0 | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $0.00 | $3,800.00 |
| Wilson | H6351_005_0 | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Basic | $17.50 | $700.00 | $7,550.00 |
| Wilson | H5374_001_0 | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Wilson | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Wilson | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Wilson | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Wilson | H5253_189_0 | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $595.00 | $4,450.00 |
| Wilson | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Wilson | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Wilson | H4073_003_0 | Wellcare | Wellcare Carolina Complete Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,250.00 |
| Wilson | H4073_004_0 | Wellcare | Wellcare Carolina Complete Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Yadkin | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Yadkin | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Yadkin | H5299_006_0 | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Yadkin | H5299_009_0 | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $6,750.00 |
| Yadkin | H5299_013_0 | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Yadkin | H5299_015_0 | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $9,850.00 |
| Yadkin | H5299_017_0 | Devoted Health | DEVOTED C-SNP ENHANCED 017 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $4,800.00 |
| Yadkin | H5299_032_0 | Devoted Health | DEVOTED C-SNP GIVEBACK EXTRAS 032 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $700.00 | $5,700.00 |
| Yadkin | H9725_003_0 | HealthSpring | HealthSpring TotalCare (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Yadkin | H9725_013_0 | HealthSpring | HealthSpring TotalCare Plus (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Yadkin | H9725_020_0 | HealthSpring | HealthSpring Achieve (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $500.00 | $4,450.00 |
| Yadkin | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Yadkin | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Yadkin | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Yadkin | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Yadkin | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Yadkin | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Yadkin | H6351_001_0 | Liberty Medicare Advantage | Liberty Medicare Advantage Nursing Home Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $6,800.00 |
| Yadkin | H6351_004_0 | Liberty Medicare Advantage | Liberty Medicare Advantage (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $0.00 | $3,800.00 |
| Yadkin | H6351_005_0 | Liberty Medicare Advantage | Liberty Medicare Dual Plan (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Basic | $17.50 | $700.00 | $7,550.00 |
| Yadkin | H5374_001_0 | Longevity Health Plan | Longevity Health Plan (HMO I-SNP) | HMO I-SNP | Institutional | Basic | $13.30 | $700.00 | $9,850.00 |
| Yadkin | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Yadkin | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Yadkin | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Yadkin | H5253_189_0 | UnitedHealthcare | UHC Complete Care NC-28 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $595.00 | $4,450.00 |
| Yadkin | H5253_216_2 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Yadkin | H5253_217_2 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Yadkin | H1914_008_0 | Wellcare | Wellcare Carolina Complete Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Yadkin | H4073_003_0 | Wellcare | Wellcare Carolina Complete Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,250.00 |
| Yadkin | H4073_004_0 | Wellcare | Wellcare Carolina Complete Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Yancey | H3146_002_0 | Aetna Medicare | Aetna Medicare Full Dual (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Yancey | H9147_001_0 | Blue Cross and Blue Shield of North Carolina | Healthy Blue + Medicare (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.20 | $700.00 | $9,850.00 |
| Yancey | H5299_006_0 | Devoted Health | DEVOTED DUAL PLUS 006 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Yancey | H5299_009_0 | Devoted Health | DEVOTED DUAL 009 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $6,750.00 |
| Yancey | H5299_013_0 | Devoted Health | DEVOTED DUAL FULL 013 NC (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Yancey | H5299_015_0 | Devoted Health | DEVOTED C-SNP PLUS 015 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $9,850.00 |
| Yancey | H5299_018_0 | Devoted Health | DEVOTED C-SNP ENHANCED 018 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $461.00 | $5,600.00 |
| Yancey | H5299_034_0 | Devoted Health | DEVOTED C-SNP GIVEBACK EXTRAS 034 NC (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $700.00 | $7,150.00 |
| Yancey | H1036_167_0 | Humana | Humana Gold Plus SNP-DE H1036-167 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $0.00 | $9,850.00 |
| Yancey | H1036_307_0 | Humana | Humana Dual Select H1036-307 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $200.00 | $9,850.00 |
| Yancey | H1036_308_0 | Humana | Humana Gold Plus - Diabetes and Heart (HMO C-SNP) | HMO C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Yancey | H1036_331_0 | Humana | Humana Gold Plus SNP-DE H1036-331 (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Yancey | H5525_036_0 | Humana | HumanaChoice SNP-DE H5525-036 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $550.00 | $9,850.00 |
| Yancey | H5525_072_0 | Humana | Humana Dual Select H5525-072 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Yancey | H6622_027_0 | Humana | Humana Dual Select H6622-027 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $4.10 | $700.00 | $9,850.00 |
| Yancey | H4676_002_0 | Troy Medicare | Troy Medicare for Dual-eligible Beneficiaries (HMO D-SNP) | HMO D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,850.00 |
| Yancey | H1889_005_0 | UnitedHealthcare | UHC Dual Complete NC-Q1 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Yancey | H1889_034_0 | UnitedHealthcare | UHC Dual Complete NC-S2 (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Yancey | H5253_116_0 | UnitedHealthcare | UHC Dual Advantage NC-V1 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $5,900.00 |
| Yancey | H5253_186_0 | UnitedHealthcare | UHC Complete Care NC-25 (HMO-POS C-SNP) | HMO-POS C-SNP | Chronic or Disabling Condition | Enhanced | $0.00 | $685.00 | $6,400.00 |
| Yancey | H5253_216_1 | UnitedHealthcare | UHC Dual Complete NC-S3 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $3.80 | $700.00 | $9,850.00 |
| Yancey | H5253_217_1 | UnitedHealthcare | UHC Dual Complete NC-Q2 (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Yancey | H1914_008_0 | Wellcare | Wellcare Carolina Complete Dual Liberty Open (PPO D-SNP) | PPO D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
| Yancey | H4073_003_0 | Wellcare | Wellcare Carolina Complete Dual Reserve (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $13.30 | $700.00 | $9,250.00 |
| Yancey | H4073_004_0 | Wellcare | Wellcare Carolina Complete Dual Liberty (HMO-POS D-SNP) | HMO-POS D-SNP | Dual-Eligible | Enhanced | $0.00 | $700.00 | $9,850.00 |
50
true
Full Width