Boston - Region I
John F. Kennedy Federal Building
Room 2375
Boston, MA 02203
Beneficiary Services Branch: (617) 565-1232
States in Region I: Connecticut, Maine, Massachusetts, New Hampshire,
Rhode
Island, Vermont
Firm Name:
HMO
Blue
Medicare Name: Senior Plan
Address: c/o BC/BS
of Mass
100
Summer Street
Boston,
MA 02110
Telephone: 1-800-325-2583
or (617) 832-5000
Counties: Hartford,
Tolland
Key: CTH (H2251)
Firm Name: Kaiser
Foundation
Health Plan of CT - Hartford
Medicare Name: Medicare Plus
Address: 76
Batterson Park
Road
P.O.
Box
4011
Farmington,
CT 06034-4011
Telephone: 1-800-305-1992
Counties: Fairfield, Hartford,
Middlesex,
Tolland
Key: CTH (H0704)
Firm Name: Oxford
Health
Plans, Inc.
Medicare Name: Medicare Advantage
Address: 800
Connecticut
Avenue
Norwalk,
CT 06854
Telephone: 1-800-234-1228
Counties: Statewide
Key: CTR (H0752)
Firm
Name: Physicians Health
Service of
CT, Inc.
Medicare Name: Carefree
Address: 120 Hawley
Lane
Trumbull,
CT 06611-5313
Telephone: 1-800-547-8734
or (203) 381-6600
Counties: Statewide
Key: CTR (H0755)
Firm Name: U.S.
HealthCare,
Inc. - Fairfield, CT
Medicare Name: U.S. Healthcare Medicare
Plan
Address: 980 Jolly
Road
P.O.
Box
1109
Blue
Bell, PA 19422
Telephone: 1-800-282-5366
Counties: Statewide
Key: CTR (H0751)
Firm Name: Capital Area
Community
Health Plan - Central, MA
Medicare Name: CHP Medicare Plus
Address: One CHP
Plaza
Latham,
NY 12110-1080
Telephone: 1-800-344-5682
or (518) 783-1864
Counties: Berkshire, Franklin,
Hampden,
Hampshire, Worcester
Key: MAH
(H6221)
Firm Name: Fallon
Community Health
Plan, Inc.
Medicare Name: Senior Plan
Address: 100
Hartwell
Street
West
Boylston, MA 01583-2499
Telephone: 1-800-283-2556
or (508) 799-2100
Counties: Essex, Franklin,
Hampden,
Hampshire, Middlesex,
Norfolk,
Worcester
Key: MAR (H9001)
Firm Name: Harvard
Community
Health Plan - Urban
Medicare Name: First Seniority
Address: 10
Brookline
Place West
Brookline,
MA 02146
Telephone: 1-800-338-4247
Counties: Bristol, Essex,
Middlesex,
Norfolk,
Plymouth,
Suffolk, Worcester
Key: MAR
(H2206)
Firm Name: Harvard
Community
Health Plan of New England
Medicare Name: Care Plus
Address: 1
Hoppin
Street
Providence,
RI 02903
Telephone: 1-800-444-1210
or (401) 331-3000
Counties: Bristol,
Middlesex, Norfolk, Plymouth,Worcester
Key: MAC
(H4101)
Firm Name: HMO
Blue
Medicare Name: Senior Plan
Address: c/o
BC/BS of
Mass
100
Summer Street
Boston,
MA 02100
Telephone: 1-800-325-2583
or (617) 832-5000
Counties: Statewide
Key: MAH (H2251) (CLOSED)
Firm Name: HMO
Blue
Medicare Name: Blue Care 65
Address: c/o
BC/BS of
Mass
100
Summer Street
Boston,
MA 02100
Telephone: 1-800-325-2583
Counties: Barnstable, Berkshire,
Bristol,
Essex, Franklin, Hampden,
Hampshire,
Middlesex, Norfolk, Plymouth, Suffolk, Worcester
Key: MAR (H2261)
Firm
Name: Kaiser
Foundation Health Plan of MA, Inc.
Medicare Name: Medicare Plus
Address: 76
Batterson Park
Road
P.O.
Box
4011
Farmington,
CT 06032
Telephone: 1-800-305-1990
or (413) 256-0151
Counties: Franklin, Hampden,
Hampshire
Key: MAH
(H2254)
Firm
Name: Neighborhood
Health
Plan
Medicare Name: Senior Health Plus
Address: 253
Summer
Street
Boston,
MA 02210
Telephone: (617)
772-5500
(ask for member services)
Counties: Middlesex,
Norfolk,
Suffolk, Worcester
Key: MAH
(H2253)
Firm Name:
Pilgrim
Health Care, Inc.
Medicare Name: Pilgrim Prime 65
Address: 10
Accord
Executive Drive
P.O.
Box
9102
Norwell,
MA 02061
Telephone: 1-800-269-9302
or (617) 871-3950
Counties: Barnstable,
Bristol, Essex, Middlesex,
Norfolk,
Plymouth, Suffolk, Worcester
Key: MAR (H2258)
Firm Name: Tufts
Associated Health
Plan, Inc.
Medicare Name: Secure Horizons/Tufts Health
Plan for
Seniors
Address: 333
Wyman
Street
Waltham,
MA 02254
Telephone: (617)
466-9400
Counties: Essex,
Middlesex,
Norfolk, Plymouth, Suffolk, Worcester
Key: MAR
(H2256)
Firm Name: United
Health Plans
of New England, Inc.
Medicare Name: Senior Care
Address: 475
Kilvert
Street, Suite 310
Warwick,
RI 02886-1392
Telephone: 1-800-448-4481
or (401) 737-6900
Counties: Bristol,
Norfolk, Worcester
Key: MAR
(H4102)
Firm Name: U.S.
HealthCare, Inc. -
Mass
Medicare Name: U.S. HealthCare
Medicare
Address: 3
Burlington
Woods Drive
Burlington,
MA 01803
Telephone: 1-800-282-5366
Counties: Barnstable,
Bristol, Essex, Hampden,
Middlesex,
Norfolk,
Plymouth, Suffolk, Worcester
Key: MAR (H2255)
Firm Name: Harvard
Community
Health Plan of NE, I - Wellesley
Medicare Name: SeniorCare
Address: 10
Brookline
Place West
Brookline,
MA 02146
Telephone: 1-800-421-3550
Counties: Hillsborough,
Rockingham
Key: NHR
(H2204)
Firm Name: HMO Blue
Medicare Name: Senior Plan
Address: c/o
BC/BS of
Mass
100
Summer Street
Boston,
MA 02110
Telephone: 1-800-325-2583
or (617) 832-5000
Counties: Hillsborough,
Rockingham
Key:
NHH (H2251)
Firm Name: U.S.
HealthCare of
New Hampshire, Inc.
Medicare Name: U.S. HealthCare
Medicare
Address: 3
Burlington
Woods Drive
Burlington,
MA 01803
Telephone: 1-800-282-5366
Counties: Cheshire,
Hillsborough, Merrimac, Rockingham
Key: NHR (H3049)
Firm Name: Coordinated
Health
Partners
Medicare Name: Grand Plan
Address: 30
Chestnut
Street
Providence,
RI 02903
Telephone: 1-800-528-4141
Counties: Statewide
Key: RIR (H4152)
Firm
Name: Harvard Community
Health
Plan of NE
Medicare Name: CarePlus
Address: 1
Hoppin
Street
Providence,
RI 02903
Telephone: 1-800-444-1210
or (401) 331-3000
Counties: Bristol, Kent,
Newport,
Providence, Washington
Key: RIC (H4101)
Firm Name: Harvard
Community
Health Plan of NE
Medicare Name: First Seniority
Address: 1
Hoppin
Street
Providence,
RI 02903
Telephone: 1-800-338-4247
Counties: Kent, Providence
Key: RIR (H4149)
Firm Name: United Health
Plans of
New England, Inc.
Medicare Name: Senior Care
Address: MetroCenter
475
Kilvert Street
Warwick,
RI 02886
Telephone: 1-800-448-4481
or (401) 737-6900
Counties: Bristol, Kent,
Newport,
Providence, Washington
Key: RIR (H4102)
Firm Name: United
Health Plans
of New England, Inc.
Medicare Name: United SeniorCare
Address: MetroCenter
475
Kilvert Street
Warwick,
RI 02886
Telephone: 1-800-643-4845
Counties: Bristol, Norfolk,
Plymouth,
Worcester
Key: RIR (H4153)
Firm Name: Capital Area
Community
Health Plan - Bennington, VT
Medicare Name: CHP Medicare Plus
Address: One CHP
Plaza
Latham,
NY 12110
Telephone: 1-800-638-0668
or (518) 783-1864
Counties: Addison,
Bennington, Chittenden, Franklin, Rutland, Washington
Key: VTC (H4749)
Firm Name: Capital Area
Community
Health Plan - Central, MA
Medicare Name: CHP Medicare Plus
Address: One CHP
Plaza
Latham,
NY 12110
Telephone: 1-800-638-0668
or (518) 783-1864
Counties: Windham
Key: VTH (H6221)
Firm Name: Aetna Health
Plans of
New Jersey, Inc.
Medicare Name: Senior Choice
Address: 3541
Winchester
Road, Unit 18
Allentown,
PA 18195-0530
Telephone: 1-800-377-6296
(South Jersey) 1-800-624-4478 (North Jersey)
Counties: State-wide
Key: NJR (H3157) NJC (H3104
- CLOSED)
Firm
Name: AmeriHealth HMO,
Inc.
Medicare Name: AmeriHealth 65
Address: 8000
Midlantic
Drive
Suite
333
Mt.
Laurel, NJ 08054-1560
Intermediaries/Carriers
Use:
P.O. Box
41574
Philadelphia,
PA 19101
Telephone: 1-800-645-3965
Counties: Atlantic, Burlington,
Camden,
Cape May,
Cumberland,
Gloucester, Mercer, Ocean, Salem
Key: NJR (H3156)
Firm Name: First
Option Health
Plan of NJ, Inc.
Medicare Name: Senior Options
Address: The
Galleria,
2-40 Bridge Avenue
Building
6, 2nd Floor
Red
Bank,
NJ 07311-3800
Telephone: 1-800-899-0899
Counties: State-wide
Key: NJR (H3155)
Firm Name: HIP of
New Jersey,
Inc. - (d.b.a HIP Health Plan of NJ)
Medicare Name: HIP/VIP
Address: One HIP
Plaza
New
Brunswick, NJ 08902
Telephone: 1-800-794-3442
or 1-800-257-0083
Counties: Atlantic, Bergen,
Burlington,
Camden, Essex, Gloucester,
Hudson,
Hunterdon, Mercer, Middlesex, Monmouth, Morris,
Ocean,
Passaic, Salem, Somerset, Union
Key: NJR
(H3158)
Firm
Name: HIP of New
Jersey, Inc. - (d.b.a HIP Health Plan of NJ)
Medicare Name: HIP/VIP
Address: One HIP
Plaza
New
Brunswick, NJ 08902
Telephone: 1-800-794-3442
or 1-800-257-0083
Counties: Atlantic, Bergen,
Burlington,
Camden, Essex, Gloucester,
Hudson,
Hunterdon, Mercer, Middlesex, Monmouth, Morris,
Ocean,
Passaic, Salem, Somerset, Union
Key: NJC
(H3149) (CLOSED to enrollment of new
individual
medicare
beneficiaries
who were not enrolled prior to
01/01/96
Firm
Name: Medigroup, Inc.
Medicare Name: Medicare Blue
Address: 3 Penn
Plaza
East
MS:
PP16V
Newark,
NJ 07105
Telephone: 1-800-365-2223
Counties: Atlantic, Bergen,
Burlington,
Camden, Cape May,
Cumberland,
Essex, Gloucester, Hudson, Hunterdon,
Mercer,
Middlesex, Monmouth, Morris, Ocean, Passaic,
Salem,
Somerset, Sussex, Union, Warren
Key: NJR (H3154)
Firm Name: Oxford
Health Plan
of New Jersey, Inc.
Medicare Name: Oxford Medicare Advantage
Address: P. O.
Box
5031
Norwalk,
CT 06856
Telephone: 1-800-234-1228
Counties: State-wide
Firm Name: Aetna Health
Plan of
New York
Medicare Name: Senior Choice
Address: 20
Waterview
Boulevard
Parsipany,
NJ 07054
Telephone: 1-800-624-4478
Counties: Bronx, Kings, Nassau,
New York,
Queens,
Richmond,
Rockland, Suffolk, Westchester
Key: NYC (H3353)
Firm Name: Blue Choice
Medicare Name: Blue Choice Senior
Address: Gateway
Center
150
East
Main Street
Rochester,
NY 14647
Telephone: 1-800-462-0108
Counties: Livingston, Monroe,
Ontario,
Seneca, Wayne,Yates
Key: NYC (H3356)
Firm Name: Boro Medical
Center
Medicare Name: Boro Medical Center
Address: 850
Bronx River
Road
Yonkers,
NY 10708
Telephone: (914)
776-2800
Counties: None
Key: NYH (H6331)
Firm Name: Community
Health
Plan - Albany
Medicare Name: Senior Advantage
Address: One CHP
Plaza
Latham,
NY 12110-1080
Telephone: 1-800-638-0668
ext. 42002 or (518) 783-1864
Counties: Albany, Rensselaer,
Saratoga,
Schenectady
Key: NYR (H3368)
Firm Name: Community
Health
Plan - Poughkeepsie
Medicare Name: CHP Medicare Plus
Address: 160
Union
Street
Poughkeepsie,
NY 12601
Intermediaries/Carriers
Use:
One
CHP
Plaza
Latham, NY
12110-1080
Telephone: (914)
471-2368
Counties: Orange, Putnam
Key: NYC (H3308)
Firm Name: Community
Health
Plan - Poughkeepsie
Medicare Name: Senior Advantage
Address: 160
Union
Street
Poughkeepsie,
NY 12601
Intermediaries/Carriers
Use:
One
CHP
Plaza
Latham, NY
12110-1080
Telephone: (914)
471-2368
Counties: Dutchess, Ulster
Key: NYR (H3373)
Firm Name: Community
Health
Plan - United Region
Medicare Name: Senior Advantage
Address: 200
Plaza
Drive
Vestal,
NY 13850
Intermediaries/Carriers
Use:
One
CHP
Plaza
Latham, NY
12110-1080
Telephone: (607)
797-0189
ext. 42010
Counties: Broome, Tioga
Key: NYR (H3371)
Firm Name: Empire
Blue
Cross-Blue Shield
Medicare Name: BlueChoice Senior Plan
Address: 622
Third
Avenue
New
York,
NY 10017
Telephone: 1-800-809-7328
or 1-800-499-9554
Counties: Bronx,
Kings,
Nassau, New York, Queens,
Richmond,
Rockland, Suffolk, Westchester
Key: NYR (H3370)
Firm Name: Health Care
Plan,
Inc.
Medicare Name: SeniorChoice
Address: 900
Guaranty
Building
Buffalo,
NY 14202
Telephone: (716)
847-2051
Counties: Allegany, Cattaraugus,
Chautauqua, Erie,
Genesee,
Niagara, Orleans, Wyoming
Key: NYR (H3351) NYC (H3304
- CLOSED)
Firm Name: HIP of
Greater New
York
Medicare Name: HIP VIP
Address: 7 W.
34th
Street
New
York,
NY 10001
Telephone: 1-800-447-8255
or (212) 630-5000
Counties: Bronx, Kings, Nassau,
New York,
Queens,
Richmond,
Rockland, Suffolk, Westchester
Key: NYR (H3330) (Converted
from H3314/H3315)
Firm
Name: Hlth Svc Med Corp
Cntrl
NY
Medicare Name: PHP Seniority
Address: 8278
Willett
Parkway
Baldwinsville,
NY 13027
Telephone: (315)
638-2133
Counties: Broome, Cayuga,
Cortland,
Herkimer, Madison, Oneida,
Onondago,
Oswego, Tioga, Tompkins
Key: NYR (H3372)
Firm
Name: Independent Health
Association, Inc.
Medicare Name: Encompass 65
Address: 511
Farber Lakes
Drive
Buffalo,
NY 14221
Telephone: 1-800-247-1466
or (716) 631-9452
Counties: Chautauqua, Erie,
Genessee,
Niagara
Key: NYR (H3362)
Firm Name: Kaiser
Foundation
Health Plan of NY
Medicare Name: Senior Advantage
Address: 210
Westchester
Avenue
White
Plains, NY 10604
Telephone: (914)
682-0700
Counties: Westchester
Key: NYH (H3363) (H3301
- CLOSED)
Firm Name: Managed
Health,
Inc.
Medicare Name: Managed Health 65
Plus
Address: EAB
Plaza
Uniondale,
NY 11556
Telephone: (516)
352-2000
Ext. 6690 or (516) 683-1010
Counties: Nassau,
Queens
Key: NYR (H3359)
Firm
Name: MDLI HealthCare,
Inc.
Medicare Name: MDSelect 65
Address: 275
Broadhollow
Road
Melville,
NY 11747
Telephone: (516)
454-1900
Counties: Nassau, Suffolk
Key: NYR (H3378)
Firm Name: NYLCare
Health Plan of
NY (Formerly, Sanus HP Greater NY)
Medicare Name: NYLCare 65
Address: 75 - 20
Astoria
Blvd.
Jackson
Heights, NY 11370
Telephone: 1-800-231-9555
Counties: Nassau,
Suffolk,
Queens
Key: NYR (H3354)
Firm Name: NYSA-ILA
Coordinating
Committee
Medicare Name: NYSA-ILA
Address: 19th
Floor
2
World
Trade Center
New
York,
NY 10048-0649
Telephone: (212)
323-6009
or (212) 323-6109
Counties: None
Key: NYH (H6333)
Firm Name: NYSA-PPGU
Welfare
Fund
Medicare Name: NYSA-PPGU
Address: 19th
Floor
2
World
Trade Center
New
York,
NY 10048
Telephone: (212)
406-1301
Counties: None
Key: NYH (H6335)
Firm Name: Oxford Health
Plans
Medicare Name: Oxford Medicare Advantage
Address: P.O.
Box 5031
Norwalk,
CT 06856
Telephone: 1-800-234-1228
Counties: Bronx, Kings, Nassau,
New York,
Orange, Putman,
Queens,
Richmond, Rockland, Suffolk, Westchester
Key: NYR (H3307)
Firm
Name: Vytra
HealthCare
Medicare Name: Vytra Medicare
Address: 395
North Service
Road
Melville,
NY 11747
Telephone: (516)
694-4000
Counties: Nassau,
Queens,
Suffolk
Key: NYR (H3360)
Firm Name: WellCare
of New
York, Inc.
Medicare Name: Senior Health Plan
Address: Park
West/Hurley
Avenue Extension
P.O.
Box
4059
Kingston,
NY 12401
Telephone: 1-800-288-5441
or 1-800-439-9355
Counties: Albany, Broome,
Columbia,
Delaware, Dutchess, Greene, Orange,
Otsego,
Rensselaer, Rockland, Sullivan, Ulster
Key: NYR (H3361)
Firm Name: Aetna
Health Plans
of New Jersey, Inc.
Medicare Name: Senior Choice
Address: 3541
Winchester Road,
Unit 18
Allentown,
PA 18195-0530
Telephone: 1-800-624-4478
(North Jersey) 1-800-377-6296 (South Jersey)
Counties: New
Castle
Key: DER (H3157) DEC (H3104
- CLOSED)
Firm Name: Amerihealth
HMO, Inc.
Medicare Name: Amerihealth 65
Address: 1901 Market
Street
28th
Floor
Philadelphia,
PA 19101
Telephone: 1-800-898-3492
Counties: Statewide
Key: DER (H0851)
Firm Name: Optimum
Choice,
Inc.
Medicare Name: Optimum Choice
Advantage
Address: 2301
Research
Boulevard
P.O.
Box
7000
Rockville,
MD 20850-7000
Telephone: 1-800-388-2070
Counties: Statewide
Key: DER (H2153)
Firm Name: U.S.
HealthCare
Delaware
Medicare Name: U.S. Healthcare
Medicare
Address: 980 Jolly
Road
P.O.
Box
1109
Blue
Bell, PA 19422
Telephone: 1-800-282-5366
or (215) 628-4800
Counties: Statewide
Key: DER (H0850)
Firm Name: NYLCare
Health
Plans, Inc. (Formerly, Health Plus, Inc.)
Medicare Name: NYLCare 65
Address: 7601 Ora
Glen
Drive
Greenbelt,
MD 20770
Telephone: 1-800-606-4765
or 1-800-635-3121
Counties: Districtwide
Key: DCR (H2152)
Firm
Name: Prudential Health
Care Plan,
Inc.
Medicare Name: Prudential HealthCare
SeniorCare
Address: 2800 N.
Charles
Street
Baltimore,
MD 21218
Telephone: 1-800-983-0088
Counties: Districtwide
Key: DCR (H2158)
Firm Name: Optimum
Choice,
Inc.
Medicare Name: Optimum Choice
Advantage
Address: 2301
Research
Boulevard
P.O.
Box
7000
Rockville,
MD 20850-7000
Telephone: 1-800-510-9009
Counties: Districtwide
Key: DCR (H2153)
Firm Name: United
Mine Workers
of America
Medicare Name: United Mine Workers
Address: 4455
Connecticut
Ave., NW
Washington,
DC 20008
Telephone: (202)
895-3700
Counties: None
Key: DCH (H90091)
Firm Name: U.S.
HealthCare,
Inc. - DE / U.S. HealthCare - DC
Medicare Name: U.S. Healthcare Medicare
Address: 980 Jolly
Road
P.O.
Box
1109
Blue
Bell, PA 19422
Telephone: 1-800-282-5366
Counties: Districtwide
Key: DCR (H0953)
Firm
Name: HealthCare
Corporation of the Mid-Atlantic
Medicare Name: Care First
Address: 100
South
Charles, Tower II
Baltimore,
MD 21201
Telephone: 1-800-828-3197
or (410) 666-3302
Counties: Statewide
Key: MDR (H2101)
Firm Name: Humana Group
Health
Plan, Inc.
Medicare Name: Humana Gold Plus Plan
Address: 4301
Connecticut
Ave., NW
Washington,
DC 20008
Telephone: 1-800-833-6510
or (202) 364-2000
Counties: Charles,
Howard,
Montgomery, Prince Georges
Key: MDR (H0951) MDH (H6091)
Firm Name: Kaiser
Foundation
of the Mid-Atlantic States
Medicare Name: Medicare Plus
Address: 2101 E.
Jefferson
Street
P.O.
Box
6611
Rockville,
MD 20849
Telephone: 1-800-777-7902 or (301) 468-6000
Counties: Anne
Arundel,
Baltimore, Baltimore City, Carroll,
Harford,
Howard
Key: MDH (H2150)
Firm Name: NYLCare
Health
Plans, Inc. (Formerly, Health Plus,
Inc.)
Medicare Name: NYLCare 65
Address: 7601
Ora Glen
Drive
Greenbelt,
MD 20770
Telephone: 1-800-606-4765
or 1-800-635-3121
Counties: Anne
Arundel,
Baltimore, Baltimore City, Calvert,
Carroll,
Charles, Frederick, Harford, Howard,
Montgomery,
Prince Georges, St. Mary's
Key: MDR (H2152)
Firm Name: Optimum
Choice,
Inc.
Medicare Name: Optimum Choice Advantage
Address: 2301
Research
Boulevard
P.O.
Box
7000
Rockville,
MD 20849
Telephone: 1-800-510-9009
Counties: Allegany,
Anne
Arundel, Baltimore, Baltimore City, Calvert,
Caroline,
Carroll,Charles, Frederick, Howard, Kent, Montgomery,
Prince
Georges, Washington, Wicomico
Key: MDR (H2153)
Firm
Name: Prudential Health
Care Plan,
Inc.
Medicare Name: Prudential HealthCare
SeniorCare
Address: 2800 N.
Charles
Street
Baltimore,
MD 21218
Telephone: 1-800-983-0088
Counties: Anne
Arundel,
Baltimore, Baltimore City, Harford, Howard,
Montgomery,
Prince Georges
Key: MDR (H2158)
Firm Name: U.S.
HealthCare, Inc. -
Delaware/ U.S. HealthCare - MD
Medicare Name: U.S. Healthcare Medicare
Address: 980
Jolly
Road
P.O.
Box
1109
Blue
Bell, PA 19422
Telephone: 1-800-323-9930
Counties: Anne
Arundel,
Baltimore, Baltimore City
, Carroll,
Cecil,
Frederick,
Howard, Montgomery, Prince Georges
Key: MDR (H2154)
Firm Name: Aetna
Health Plans
of Western PA, Inc.
Medicare Name: Aetna Medicare Program
Address: 5700
Corporate
Drive, Suite 300
Pittsburgh,
PA 15237
Telephone: (412)
366-9000
Counties: Allegheny,
Beaver,
Butler, Washington, Westmoreland
Key: PAC (H3955)
Firm
Name: HealthAmerica -
Pittsburgh
Medicare Name: Advantra
Address: Five
Gateway
Center
Pittsburgh,
PA 15222
Telephone: 1-800-355-9196
Counties: Allegheny, Armstrong,
Beaver,
Butler, Fayette, Greene,
Lawrence,
Washington, Westmoreland
Key: PAR (H3959)
Firm
Name: HealthAmerica of
Central PA
Medicare Name: Advantra
Address: 2601
Market
Place
Harrisburg,
PA 17110
Telephone: 1-800-290-0191
or (717) 671-5220
Counties: Berks, Columbia,
Cumberland,
Dauphin, Lancaster,
Lebanon,
Luzerne, Schuylkill
Key: PAR (H3960)
Firm Name: HealthAmerica
of
Central PA
Medicare Name: Advantra
Address: 2601
Market
Place
Harrisburg,
PA 17110
Telephone: 1-800-290-0191
or (717) 671-5220
Counties: Centre
Key: PAR (H3961)
Firm Name: HMO of
Northeastern
Pennsylvania, Inc.
Medicare Name: First Priority 65
Address: 70 N.
Main
Street
Wilkes-Barre,
PA 18711
Telephone: 1-800-315-2225
or (717) 829-1082
Counties: Bradford,
Clinton, Lackawanna, Luzerne, Lycoming,
Monroe,
Pike, Sullivan, Susquehanna, Wayne, Wyoming
Key: PAR (H3953)
Firm
Name: Keystone Health
Plan East,
Inc.
Medicare Name: Keystone
65
Address: 1901
Market
Street
P.O.
Box
41462
Philadelphia,
PA 19101-41462
Intermediaries/Carriers
Use:
P.O. Box
898815
Camp
Hill, PA 17089-8815
Telephone: 1-800-645-3965
Counties: Bucks,
Chester,
Delaware, Montgomery, Philadelphia
Key: PAR (H3952)
Firm Name: Keystone
Health
Plan West, Inc.
Medicare Name: Security Blue
Address: 120
Fifth Avenue,
Suite 31512
Pittsburgh,
PA 15222
Intermediaries/Carriers
Use:
P.O.
Box
8819
Camp Hill, PA
17089-8819
Telephone: 1-800-935-2583
Counties: Allegheny,
Armstrong, Beaver, Blair, Bradford, Butler,
Cambria,
Crawford, Erie, Fayette, Greene, Indiana,
Lawrence,
Mercer, Somerset, Washington, Westmoreland
Key: PAR (H3957)
Firm Name: Keystone
Health
Plan Central, Inc.
Medicare
Name: SeniorBlue
Address: P.O.
Box 898812
Camp
Hill, PA 17089-8812
Intermediaries/Carriers
Use:
Gov.
Programs-Provider
Corres.
P.O.
Box
890136
Camp Hill, PA
17089-0136
Telephone: 1-800-779-6962
Counties: Berks,
Cumberland, Dauphin, Lebanon,
Lehigh,
North Hampton, Schuylkill, York
Key: PAR (H3962)
Firm Name: Phila
AFL-CIO
Hospital Association
Medicare Name: Union Medicare
Address: Langdon
Street
& Cheltenham Avenue
Philadelphia,
PA 19124
Telephone: (215)
831-7000
or (215) 831-7001
Counties: None
Key: PAH (H6390)
Firm Name: U.S.
Health Care
Systems of PA - Pittsburgh
Medicare Name: U.S. Health Care
Address: 980
Jolly
Road
P.O.
Box
1109
Blue
Bell, PA 19422
Telephone: (215)
628-4800
Counties: Allegheny, Armstrong,
Beaver,
Butler, Fayette, Lawrence,
Washington,
Westmoreland
Key: PAR (H3951)
Firm Name: U.S. Health
Care
Systems of PA - Blue Bell
Medicare Name: U.S. Healthcare Medicare
Address: 980
Jolly
Road
P.O.
Box
1109
Blue
Bell, PA 19422
Telephone: (215)
628-4800
Counties: Berks, Bucks, Chester,
Cumberland, Dauphin, Delaware,
Lancaster,
Lehigh, Montgomery, Northampton, Perry,
Philadelphia,
Schulkill, York
Key: PAR (H3931)
Intermediaries/Carriers Use:
P.O.
Box 31738
Richmond,
VA 23294
Telephone: 1-800-762-3808
or (804) 560-3970
Counties: Chesterfield,
Hanover, Henrico, Richmond City
Key: VAR
Firm Name: Humana Group
Health
Plan, Inc.
Medicare Name: Humana Gold Plus Plan
Address: 4301
Connecticut
Ave., NW
Washington,
DC 20008
Telephone: 1-800-833-6510
or (202) 364-2000
Counties: Alexandria
City,
Arlington, Fairfax, Fairfax City, Falls Church,
Loudon,
Manassas, Manassas Park, Prince William
Key: VAR (H0951) VAH (H6091)
Firm Name: NYLCare
Health Plans,
Inc. (Formerly, Health Plus,
Inc.)
Medicare Name: NYLCare 65
Address: 7601
Ora Glen
Drive
Greenbelt,
MD 20770
Telephone: 1-800-606-4765
or 1-800-635-3121
Counties: Alexandria
City,
Arlington, Caroline, Charles City, Chesterfield, Colonial
Heights,
Dinwiddie, Facquier, Fairfax, Fairfax City, Falls Church City,
Fredericksburg
City, Goochland, Hopewell City, Hanover, Henrico, King
George, King William, Loudon, Louisa,Manassas City, Manassas Park
City, New Kent, Petersburg City, Prince George, Prince William,
Richmond, Richmond City, Stafford, Spotsylvania, Wesmoreland, Fairfax
Key: VAR (H2152)
Firm Name: Optimum
Choice,
Inc.
Medicare Name: Optimum Choice
Advantage
Address: 2301
Research
Boulevard
P.O.
Box
7000
Rockville,
MD 20850-7000
Telephone: 1-800-510-9009
Counties: Alexandria
City,
Arlington, Fairfax, Fairfax City, Falls Church City
Key: VAR (H2153)
Firm
Name: QualChoice of
Virginia
Health Plan, Inc.
Medicare Name: MediChoice
Address: 1807
Seminole
Trail
Charlottesville,
VA 22901
Telephone: 1-888-975-8989
Or (804) 975-8989
Counties: Albemarle,
Buckingham, Charlottesville City, Fluvanna,
Greene,
Louisa, Madison, Nelson, Orange
Key: VAR (H4954)
Firm Name: Sentara
Health
Plans
Medicare Name: Sentara Medicare Choice
Address: 4417
Corporation
Lane,
Virginia
Beach, VA 23462
Telephone: 1-800-969-9775
or (804) 552-7135
Counties:
Chesapeake
City, Gloucester, Hampton City, Isle of Wight,
James
City, Newport News City, Norfolk City, Poquoson City,
Virginia
Beach City, Williamsburg City,York
Key: VAR (H4949)
Firm Name: Advantage
Health
(Formerly Health Guard)
Medicare Name: Health Management Systems
Address: 3000
Guernsey
Street
Bellaire,
OH 43906
Telephone: 1-800-333-3930
or (614) 676-4623
Counties: Marshall,
Ohio,
Wetzel
Key: WVC (H3602)
Firm Name: United
HealthCare of
Alabama, Inc. (Formerly, Complete Health)
Medicare Name: Medicare Complete
Address: 2160
Highland Avenue,
Suite 100
Birmingham,
AL 35205
Telephone: 1-800-239-3215
or
(205) 933-7661
Counties: Mobile
Key:
ALR (H0152)
Firm Name: Health
Partners of
Alabama, Inc.
Medicare Name: Seniors First
Address: 600 Beacon
Parkway
West, Suite 500
Birmingham,
AL 35209
Telephone: 1-800-947-5093
or
(205) 942-5787
Counties: Jefferson,
Shelby,
Walker
Key: ALR (H0150)
Firm Name: AV-Med
Health Plan,
Inc. - Jacksonville
Medicare Name: AV-Med Medicare Plan
Address: 9424
Baymeadows Road,
Suite 200
Jacksonville,
FL 32256
Telephone: 1-800-535-9355
Counties: Baker,
Clay,
Duval, Nassau, Saint Johns
Key: FLR (H1059)
Firm Name: AV-Med Health
Plan,
Inc. - Miami
Medicare Name: AV-Med Medicare Plan
Address: 9400 South
Dadeland
Boulevard, Suite 200
Miami,
FL
33156
Telephone: 1-800-535-9355
Counties: Broward, Dade, Palm
Beach
Key: FLR (H1016)
Firm Name: AV-Med
Health Plan,
Inc. - Orlando
Medicare Name: AV-Med Medicare Plan
Address: 851
Trafalgar
Court, Suite 225
Maitland,
FL 32751
Telephone: 1-800-535-9355
Counties: Orange,
Osceola,
Seminole, Volusia
Key: FLR (H1061)
Firm Name: AV-Med
Health Plan,
Inc. - Tampa
Medicare Name: AV-Med Medicare Plan
Address: 2701
Rockypoint
Drive, Suite 1050
Tampa,
FL
33607
Telephone: 1-800-535-9355
Counties: Citrus,
Hernando,
Hillsborough, Pasco, Pinellas
Key: FLR (H1062)
Firm
Name: CAC-United
HealthCare Plans of Florida, Inc.
Medicare Name: Medicare Plus
Address: P.O. Box
144240
75
Valencia Ave.
Coral
Gables, FL 33134
Telephone: 1-800-422-4787
Counties: Broward, Dade, Palm
Beach
Key: FLR (H9011)
Firm
Name: CAC-United
HealthCare Plans of Florida, Inc.
Medicare Name: Medicare Plus
Address: 3507
Frontage Road,
Suite 180
Tampa,
FL
33607
Telephone: 1-800-595-0440
Counties: Hillsborough,
Pinellas
Key: FLR (H1080)
Firm Name: Capital
Group
Health Plan Service of Florida
Medicare Name: Capital Health Plan
Address: 2140
Centerville
Place
P.O.
Box
15349
Tallahassee,
FL 32317-5349
Telephone: (904)
386-3161
Counties: Gadsden,
Jefferson, Leon, Wakulla
Key: FLC (H1010)
Firm Name: Cigna
HealthCare of
Florida, Inc. - Tampa
Medicare Name: Cigna HealthCare for
Seniors
Address: 5404
Cypress Center
Drive, Suite 365
Tampa,
FL
33609
Telephone: 1-800-942-2471
or (813) 282-8172
Counties: Hillsborough,
Pinellas
Key: FLR (H1087)
Firm Name: Cigna
HealthCare of
Florida, Inc. - Orlando
Medicare Name: Cigna HealthCare for
Seniors
Address: 900 Cottage
Grove
Road
Mail
Stop
C-38
Bloomfield,
CT 06002
Telephone: 1-800-537-3334
Counties: Orange,
Osceola,
Seminole
Key: FLR (H1098)
Firm Name: Florida
Health Care
Plan, Inc.
Medicare Name: Florida Health Care
Plan
Address: 1340
Ridgewood
Avenue
Holly
Hill, FL 32117
Telephone: 1-800-352-9824
Counties: Flagler,
Volusia
Key: FLR (H1035)
Firm
Name: Foundation Health,
A Florida
Health Plan
Medicare Name: Care Free Medicare
Plan
Address: 7950 NW
53rd Street,
Suite 300
Miami,
FL
33166
Telephone: (305)
591-3311
Counties: Broward, Dade, Palm
Beach
Key:
FLR (H1013)
Firm Name:
Health Options,
Inc. - South Florida
Medicare Name: Medicare and More
Address: 3750 NW
87th Avenue
Suite
300
Miami,
FL
33178
Intermediaries/Carriers
Use:
P.O. Box
45021
Jacksonville,
FL
32232
Telephone: 1-800-633-6808
Counties: Broward, Dade, Palm
Beach
Key:
FLR (H1026)
Firm Name: HIP Health
Plan of
Florida
Medicare Name: HIP Medicare
Advantage
Address: 200 S.
Park
Road
Hollywood,
FL 33021
Telephone: 1-800-385-4447
or 1-800-826-1013
Counties: Broward, Dade, Palm
Beach
Key: FLR (H1076)
(Converted from H6336)
Firm Name: HIP Health
Plan of
Florida, Inc.
Medicare Name: HIP Medicare
Advantage
Address: 200 S.
Park
Road
Hollywood,
FL 33021
Telephone: 1-800-385-4447
or 1-800-826-1013
Counties: Hernando,
Hillsborough, Pasco,
Pinellas
Key: FLR (H1084)
(Converted from H6336)
Firm Name: Humana
Medical
Plan, Inc. - Dade
Medicare Name: Humana Gold Plus Plan
Address: 3400
Lakeside
Drive
Miramar,
FL 33027
Telephone: 1-800-521-4882
Counties: Brevard, Broward,
Charlotte,
Clay, Collier, Dade, Duval,
Flagler,
Glades, Hendry, Hernando, Hillsborough, Indian River,
Lee,
Manatee, Martin, Okeechobee, Orange, Osceola, Palm Beach,
Pasco,
Pinellas, St. Johns, St. Lucie, Sarasota, Seminole, Volusia
Key: FLR (H1036)
Firm
Name: Neighborhood
Health
Partnership, Inc.
Medicare Name: Senior Health Choice
Address: 7600
Corporate Center
Drive
Third
Floor
Miami,
FL
33126
Intermediaries/Carriers Use:
P.O. Box
025680
Miami, FL
33102
Telephone: 1-800-354-0222
Ext. 2347
Counties: Broward, Dade, Palm
Beach
Key: FLR (H1078)
Firm Name: PCA
Health Plans of
Florida, Inc.
Medicare Name: PCA QualiCare
Address: 6101 Blue
Lagoon
Drive, Suite 210
Miami,
FL
33126
Telephone: 1-800-562-9262
Counties: Broward, Dade, Palm
Beach
Key: FLR (H1056)
Firm Name: PCA
Health Plans of
Florida, Inc. - Orlando
Medicare Name: PCA QualiCare
Address: 988
Woodcock Road,
Suite 200
Orlando,
FL 32803
Telephone: 1-800-925-3705
Counties: Orange,
Osceola,
Seminole
Key: FLR (H1067)
Firm Name: PCA Health
Plans of
Florida, Inc. - Tampa
Medicare Name: PCA QualiCare
Address: 2002 North
Lois
Avenue, Suite 300
Tampa,
FL
33607
Telephone: 1-800-685-2279
Counties: Charlotte,
Highlands, Hillsborough, Lee, Manatee,
Pasco,
Pinellas, Polk, Sarasota
Key: FLR (H1068)
Firm Name: PCA Health
Plans of
Florida, Inc. - Jacksonville
Medicare Name: PCA QualiCare
Address: 4160
Woodcock
Drive
Jacksonville,
FL 33207
Telephone: 1-800-234-1552
Counties: Baker,
Clay,
Duval, Nassau
Key: FLR (H1069)
Firm Name: Principal
Health
Care of Florida, Inc.
Medicare Name: Principal Health Care
65
Address: 1200
Riverplace
Boulevard
Suite
500
Jacksonville,
FL 33207
Telephone: 1-800-250-9011
Counties: Duval,
Nassau
Key: FLR (H1088)
Firm Name: Prudential
Health Care
Plan, Inc.
Medicare Name: Prudential SeniorCare
Address: 1200
RiverPlace
Boulevard, Suite 701
Jacksonville,
FL 32207
Telephone: (904)
346-5800
Counties: Baker,
Clay,
Duval, Nassau, Saint Johns
Key: FLR (H1070)
Firm
Name: Prudential Health
Care Plan, Inc.
Medicare Name: Prudential SeniorCare
Address: 5900 North
Andrews
Ave., Suite 1000
Ft.
Lauderdale, FL 33309
Telephone: 1-800-778-9115
Counties: Dade,
Broward,
Palm Beach
Key: FLR (H1073)
Firm
Name: Prudential Health
Care Plan, Inc.
Medicare Name: Prudential SeniorCare
Address: 6200
Courtney
Campbell Causeway, Suite 350
Tampa,
FL 33607
Telephone: 1-800-284-4302
or
(813) 288-6206
Counties: Hillsborough,
Pasco,
Pinellas
Key: FLR (H1074)
Firm
Name: Prudential Health
Care Plan, Inc.
Medicare Name: Prudential SeniorCare
Address: 2301 Lucien
Way,
Suite 230
Maitland,
FL 32751-7086
Telephone: 1-800-217-9911
Counties: Orange,
Osceola,
Seminole
Key: FLR (H1081)
Firm
Name: HMO Georgia,
Inc.
Medicare Name: BlueChoice Platinum
Address: 3350
Peachtree
Road, NE
Atlanta,
GA 30326
Telephone: 1-800-441-2273
or 1-800-914-9271
Counties: Clayton, Cobb, De
Kalb, Douglas,
Fayette, Fulton, Gwinnett,
Gwinnett, Henry, Rockdale
Key: GAR (H1168)
Firm Name: Kaiser
Foundation
Health Plan of GA, Inc.
Medicare Name: Senior Secure
Address: 3495
Piedmont
Road, Bldg. 9
Atlanta,
GA 30305
Telephone: (404)
261-2590
Counties: Cherokee, Clayton,
Cobb, Coweta,
De Kalb, Douglas, Fayette,
Forsyth, Fulton, Gwinnett, Henry, Newton, Paulding,
Rockdale
Key: GAH (H1149)
Firm
Name: Kaiser Foundation
Health
Plan of GA, Inc.
Medicare Name: Kaiser Foundation Health
Plan
Address: 3495
Piedmont
Road, Bldg. 9
Atlanta,
GA 30305
Telephone: 1-888-468-0100
(Toll Free)
Counties: Butts, Cherokee,
Clayton, Cobb,
Coweta, De Kalb, Douglas, Fayette,
Forsyth, Fulton, Gwinnett, Henry, Newton, Paulding, Rockdale,
Spalding
Key: GAR (H1170)
Firm Name: United
HealthCare of
Georgia, Inc.
Medicare Name: United for Seniors
Address: 2970
Clairmont
Road, Suite 300
Atlanta,
GA 30329-1634
Telephone: 1-800-825-0552
Counties: Bartow, Cherokee,
Clayton, Cobb,
DeKalb, Fayette, Forsyth,
Fulton,
Gwinnett, Henry, Newton, Rockdale,
Spalding
Key: GAR (H1155)
Firm
Name: U.S. HealthCare of
Georgia,
Inc.
Medicare Name: US HealthCare Medicare
Plan
Address: 980
Jolly
Road
Blue
Bell, PA 19422
Telephone: 1-800-282-5366
Counties: Clayton, Cobb, DeKalb,
Fulton,
Gwinnett
Key: GAR (H1156)
Firm
Name: Humana Health
Plan,
Inc.
Medicare Name: Humana Gold Plus Plan
Address: 101 E.
Main St.,
12th Floor
Louisville,
KY 40202
Telephone: (502)
580-5050
Counties: Jefferson
Key: KYR (H1890)
Firm
Name: Humana Health Plan
of Ohio,
Inc.
Medicare Name: Humana Gold Plus Plan
Address: 101 E.
Main St. -
Member Services
Louisville,
KY 40201
Intermediaries/Carriers Use:
Billing
Department
PO
Box
98007
Louisville,
KY 40298-8007
Telephone: 1-800-833-6563
Or 1-800-992-2551
Counties: Boone, Campbell,
Kenton
Key: KYR (H3666)
Firm Name: Kaiser
Foundation
Health Plan of NC - Raliegh
Medicare Name: The Kaiser Permanente
Medicare Plan
Address: 3120
Highwoods
Boulevard
Raleigh,
NC 27604
Telephone: 1-800-755-1925
or (919) 319-3070
Counties: Alamance, Caswell,
Chatham,
Durham, Franklin, Granville,
Harnett,
Johnston, Nash, Orange, Person, Wake
Key: NCC (H3454) (Converted
from H3452)
Firm Name: Kaiser
Foundation
Health Plan of NC - Charlotte
Medicare Name: The Kaiser Permanente
Medicare Plan
Address: 3120
Highwoods
Boulevard
Raleigh,
NC 27604
Telephone: 1-800-755-1925
or (919) 319-3070
Counties: Cabarrus, Catawba,
Gaston,
Iredell, Lincoln,
Mecklenburg, Rowan, Stanly, Union
Key: NCC (H3453) (Converted
from H3451)
Firm Name: Partners
National
Health Plans of NC, Inc.
Medicare Name: Partners Prime
Address: 2085
Frontis
Plaza Boulevard
Winston-Salem,
NC 27103
Telephone: 1-800-942-5695
or (910) 760-4822
Counties: Alamance, Davidson,
Davie,
Forsyth, Guilford, Iredell,
Orange,
Rockingham, Stokes, Surry, Yadkin
Key: NCR (H3449)
Firm
Name: QualChoice of
North
Carolina, Inc.
Medicare Name: QualChoice Plus
Address: 2000
West First
Street, Suite 210
Winston
Salem, NC 27104
Telephone: 1-800-816-8117
or (910) 716-0900
Counties: Davidson, Forsyth,
Stokes,
Surry, Wilkes, Yadkin
Key: NCR (H3455)
Firm Name: Companion
HealthCare -
Columbia
Medicare Name: Prime Companion
Address: I-20 At
Alpine
Road
Columbia,
SC 29219-2401
Telephone: 1-800-618-8497
Counties: Berkeley, Charleston,
Darlington, Dorchester, Florence,
Kershaw,
Lee, Lexington, Newberry, Orangeburg, Richland
Key: SCR (H4249)
Firm Name: Companion
HealthCare -
Greenville
Medicare Name: Prime Companion
Address: I-20 At
Alpine
Road
Columbia,
SC 29219-2401
Telephone: 1-800-618-8497
Counties: Greenville,
Spartanburg
Key: SCR (H4250)
Firm
Name: Health Net HMO,
Inc.
Medicare Name: Health Net 65
Address: 44
Vantage Way,
Suite 300
Nashville,
TN 37228
Telephone: 1-888-501-3965
or 1-888-583-3346
Counties: Davidson, DeKalb,
Sumner,
Williamson, Wilson
Key: TNR (H4454)
Firm Name: Deere
Family
Healthplan, Inc.
Medicare Name: Deere Family Healthplan
Medicare
Program
Address: 1515
5th Avenue,
Suite 600
Moline,
IL 61265-1368
Telephone: (309)
765-1600
Counties: Caroll,
Henry,
Mercer, Rock Island, Whiteside
Key: ILH
(H1454)
Firm Name: Dreyer
HMO
Medicare Name: Dreyer HMO
Address: 1877
Downer
Place
Aurora,
IL 60506
Telephone: (708)
859-0400
Counties: Kane, Kendall,
DuPage
Key: ILH (H6144)
Firm Name: FHP of
Illinois,
Inc.
Medicare Name: FHP Senior Plan
Address: One
Lincoln
Centre, Suite 700
Oakbrook
Terrace, IL 60181
Telephone: (708)
916-8400
Counties: Cook
Key: ILR (H1460)
Firm Name: Group Health
Plan,
Inc.
Medicare Name: GHP Senior Plan
Address: 940
West Port
Plaza, Suite 300
St.
Louis, MO 63146
Telephone: (314)
453-1700
Counties: Jersey,
Macoupin, Madison, Monroe, Saint Clair
Key: ILH (H2601)
Firm Name: Group Health
Plan,
Inc.
Medicare Name: GHP Senior Plan
Address: 940
West Port
Plaza, Suite 300
St.
Louis, MO 63146
Telephone: (314)
453-1700
Counties: Jersey,
Macoupin, Madison, Monroe, Saint Clair
Key: ILR (H2663)
Firm Name: HEALTH DIRECT
Insurance, Inc.
Medicare Name: HEALTH DIRECT Seniors
Address: 1011 E.
Touhy
Avenue, Suite 500
Des
Plaines, IL 60018-2808
Telephone: (847)
391-9505
Counties: Cook,
DuPage,
Kane, Lake, McHenry, Will
Key: ILR (H1458)
Firm Name: Heritage
National
Health Plan
Medicare Name: Heritage National Health
Plan
Address: 1515
Fifth
Avenue, Suite 600
Moline,
IL 61265
Telephone: (309)
765-1253
or (309) 765-1200
Counties: None
Key: ILH (H1605)
Firm Name: Humana
Health Care
Plan, Inc.
Medicare Name: Gold Plus
Address: 30 S.
Wacker
Drive, Suite 3100
Chicago,
IL 60606
Telephone: (312)
441-1414
Counties: Cook, DuPage, Kane,
Lake, Will
Key: ILR (H1406)
Firm Name: Sidney
Hillman
HC
Medicare Name: Sidney Hillman Health Center
Address: 333
South Ashland
Avenue
Chicago,
IL 60607-2750
Telephone: (312)
738-6175
Counties: None
Key: ILH (H6141)
Firm
Name: Union
Medical Center
Medicare Name: Union Medical Center
Address: 1657
West Adams
Street
Chicago,
IL 60612
Telephone: (312)
829-1134
Counties: None
Key:
ILH (H6143)
Firm
Name: United HealthCare
Illinois,
Inc.
Medicare Name: United for Seniors
Address: 1 South
Wacker
Drive
P.O.
Box
909714
Chicago,
IL 60690-9714
Telephone: 1-800-767-9010
or (312) 424-4460
Counties: Cook, DuPage, Kane,
Kendall,
Lake, McHenry, Will
Key: ILR (H9045)
Firm Name:
Wabash
Memorial Hospital
Medicare Name: Wabash Area Hospital
Association
Address: 1501 N.
Water
Street
P.O.
Box
1340
Decatur,
IL 62525
Telephone: (217)
429-5246
Counties: None
Key: ILH
(H6140)
Firm Name: Anthem Health
Plan of
Indiana, Inc.
Medicare Name: Anthem Advantage of
Indiana,
(Advantage)
Address: 5451
West
Lakeview Parkway South Drive
Indianapolis,
IN 46268
Telephone: (317)
290-5790
Counties:
Boone,
Hamilton, Hancock, Hendricks, Howard,
Johnson,
Marion, Montgomery, Tipton
Key: INR (H1557)
Firm Name: Arnett
HMO
Medicare Name: Arnett HMO
Address: 3768
Rome
Drive
P.O.
Box
6108
Lafayette,
IN 47903
Telephone: (317)
448-8200
or (317) 448-8582
Counties:
None
Key: INH (H6151)
Firm
Name: HealthSource
Indiana Managed Care Plan, Inc.
Medicare Name: Senior Care
Address: 225 S.
East
Street, Suite
240
Indianapolis,
IN 46202
Telephone: (317)
685-8300
or (317) 685-2800
Counties: Greene, Jackson,
Lawrence,
Martin, Monroe, Orange, Washington
Key: INR (H1551)
Firm Name: Humana
Health Care
Plan, Inc.
Medicare Name: Humana Gold Plus Plan
Address: 30 S.
Wacker
Drive, Suite 3100
Chicago,
IL 60606
Telephone: (312)
441-1414
Counties: Lake
Key: INR
(H1406)
Firm Name: Humana
Health Plan,
Inc.
Medicare Name: Humana Gold Plus Plan
Address: 101 E.
Main St.,
12th Floor
Louisville,
KY 40202
Telephone: (502)
580-1000
Counties: Clark,
Floyd
Key: INR (H1890)
Firm Name: Maxicare
Indiana,
Inc.
Medicare Name: Maxicare 65 Plus
Address: 9480
Priority Way
West Drive
Indianapolis,
IN 46240-3899
Telephone: (317)
844-5775
or (317) 843-9989
Counties: Boone, Hamilton,
Hancock,
Hendricks, Johnson,
Marion,
Morgan, Shelby
Key: INR
(H9028)
Firm Name: Rush
Prudential HMO,
Inc.
Medicare Name: Rush-Anchor
Address: 233 S.
Wacker
Drive, Suite 3900
Chicago,
IL 60606-6309
Telephone: (312)
234-7000
Counties: Lake,
Porter
Key: INC (H1449)
Firm Name: The M
Plan,
Inc.
Medicare Name: Senior Securecare
Address: 8802 N.
Meridan
Street, Suite 100
Indianapolis,
IN 46260-5318
Telephone: (317)
571-5300
or (800) 878-8802
Counties: Boone,
Hancock,
Johnson, Morgan, Hamilton,
Hendricks,
Marion, Shelby
Key: INC
(H1553)
Firm Name: Welborn
HMO
Medicare Name: Welborn HMO
Address: 19 NW
4th Street,
Suite 600
Evansville,
IN 47708
Telephone: (812)
425-3939
or (812) 426-6600
Counties: Daviess, DuBois,
Gibson, Knox,
Perry, Pike,
Posey,
Spencer, Vanderburgh, Warrick
Key: INH (H6152)
Firm Name: Blue Care
Network -
Health Central
Medicare Name: Medicare Plus
Address: 1403 S.
Creyts
Road
Lansing,
MI 48917
Telephone: (517)
322-8000
Counties: Clinton, Ingham,
Ionia, Eaton,
Jackson, Shiawassee
Key: MIR
(H9009)
Firm
Name: Comprehensive
Health Services, Inc.
Medicare Name: The Wellness Plan
Address: 2875 W.
Grand
Boulevard
Detroit,
MI 48202
Telephone: (313)
875-4200
Counties: Genesee, Macomb,
Monroe,
Muskegon, Oakland,
Oceana,
Washtenaw, Wayne
Key: MIH
(H2349)
Firm Name: Health
Alliance Plan of
Michigan
Medicare Name: Seniors Plus
Address: 2850
West Grand
Boulevard
Detroit,
MI 48202
Telephone: 1-800-422-4641
or (313) 872-8100
Counties: Macomb,
Oakland,
Wayne
Key: MIR (H2312)
Firm
Name: MCare
Medicare Name: MCare Senior Plan
Address: 2301
Commonwealth
Blvd.
Ann
Arbor, MI 48105-1573
Telephone: 1-800-228-8554
or 1-800-810-1699 (Marketing)
Counties: Genessee,
Macomb, Oakland, Washtenaw, Wayne
Key: MIR (H2353)
Firm
Name: Medica
Medicare Name: PHP + Medicare
Address: 5601
Smetana
Drive
P.O.
Box
9310
Minneapolis,
MN 55440-9310
Telephone: (612)
945-8000
or (612) 992-2900
Counties: Aitkin, Anoka,
Carlton, Carver,
Chisago, Crow Wing,
Dakota,
Dodge, Goodhue, Grant, Isanti, Kanabec,
Kandiyohi,
Lake, McLeod, Meeker, Mille Lacs,
Morrison,
Otter Tail, Pine, Pope, Ramsey,Scott,
Sibley,
Steele, Todd, Washington, Wright
Key: MNH
(H2450 - CLOSED)
Firm
Name: Medica
Medicare Name: SeniorCare Select
Address: 5601
Smetana
Drive
P.
O. Box
9310
Minneapolis,
MN 55440-9310
Telephone: (612)
945-8000
or (612) 992-2900
Counties: Saint
Louis
Key: MNH
(H2451)
FirmName: Medica (Terminated
12/95)
Medicare Name: SeniorCare Chisago
Address: 5601
Smetana
Drive
P.O.
Box
9310
Minneapolis,
MN 55440-9310
Telephone: (612)
945-8000
or (612) 992-2900
Counties: Chisago
Key: MNC
(H2452)
Firm Name: Medica
(Formerly, Share
Health Plan)
MedicareName: SeniorCare
Address: 5601
Smetana
Drive
P.O.
Box
9310
Minneapolis,
MN 55440-9310
Telephone: (612)
945-8000
or (612) 992-2900
Counties: Anoka,
Carver,
Dakota, Goodhue, Hennepin,
Ramsey,
Scott, Washington, Pierce, St. Croix
Key: MNR
(H9006)
Firm Name: Advantage
Health
(Formerly, Health Guard)
Medicare Name: Advantage Gold
Address: 121
Seventh
Street
Pittsburg,
PA 15222
Telephone: 1-800-333-3930
or (412) 391-9300
Counties: Belmont, Monroe,
Harrison,
Jefferson, Wetzel
Key: OHC (H3602)
Firm Name: Aetna
Health Plans
of Ohio, Inc.
Medicare Name: Senior Choice
Address: 3690 Orange Place, Suite 200
Cleveland,
OH 44122
Firm Name: Community
Mutual
Insurance Company
Medicare Name: Anthem Senior
Advantage
Address: Governors
Hill
Complex
8845
Governors Hill Drive
Cincinnati,
OH 45249-3302
Telephone: 1-800-467-1199
Counties: Brown,
Butler,
Carroll, Clark, Clermont, Clinton, Columbiana,
Coshocton,
Cuyahoga, Darke, Delaware, Fairfield, Franklin,
Geauga,
Greene, Hamilton, Highland, Holmes, Lake, Licking,
Lorain,
Madison, Mahoning, Medina, Miami, Montgomery,
Pickaway,
Portage, Preble, Shelby, Stark, Summit,
Trumbull,
Tuscarawas,
Union, Warren, Wayne
Key: OHR (H3655)
Firm Name: FHP of
Ohio,
Inc.
Medicare Name: Senior Plan
Address: 11260
Chester
Road, Suite 800
Cincinnati,
OH 45246
Telephone: 1-800-838-6017
Counties: Butler,
Clark,
Clermont, Hamilton, Montgomery, Warren
Key: OHR (H3658)
Firm Name: Health
First
(Formerly, HealthOhio)
Medicare Name: Health First
Address: 372
East Center
Street
Marion,
OH 43302
Telephone: 1-800-858-1472
or (614) 387-6355
Counties: Crawford,
Delaware, Hardin, Logan, Marion,
Morrow,
Richland, Union, Wyandot
Key: OHH (H3601)
Firm Name: Health
Plan of the
Upper Ohio Valley, Inc.
Medicare Name: Health Plan of the Upper
OhioValley
Address: 52160
National
Road East
St.
Clairsville, OH 43950
Telephone: 1-800-624-6961
or (614) 695-3585
Counties: Belmont,
Guernsey, Harrison, Jefferson, Monroe, Noble
Key: OHC (H5102)
Firm
Name: Humana Health Plan
of Ohio,
Inc.
Medicare Name: Humana Gold Plus Plan
Address: 101
East Main
Street - Member Services
Louisville,
KY 40201
Intermediaries/Carriers Use:
Billing
Department
PO
Box
98007
Louisville,
KY 40298-8007
Telephone: 1-800-833-6563
or 1-800-992-2551
Counties: Clermont,
Hamilton, Warren
Key: OHR (H3666)
Firm Name: Kaiser
Foundation
Health Plan of Ohio - Cleveland
Medicare Name: Medicare Plus
Address: North
Point
Tower, Suite 1200
1001
Lakeside Avenue
Cleveland,
OH 44114-1153
Telephone: 1-800-524-7371
or (216) 621-5600
Counties: Cuyahoga, Geauga, Lake,
Lorain,
Medina, Portage,
Stark,
Summit, Wayne
Key: OHR (H3607) (Converted
from H6360)
Firm Name: Kaiser
Foundation
Health Plan of Ohio - Akron
Medicare Name: Medicare Plus
Address: North
Point
Tower, Suite 1200
1001
Lakeside Avenue
Cleveland,
OH 44114-1153
Telephone: 1-800-524-7371
or (216) 621-5600
Counties: Portage, Summit
Key: OHR (H3612)
Firm Name: Paramount
Care,
Inc.
Medicare Name: Paramount Elite
Address: P.O.
Box 928
Toledo,
OH 43697-0928
Telephone: (419)
891-2500
Counties: Fulton,
Henry,
Lucas, Ottawa, Sandusky, Seneca, Wood
Key: OHR (H3653)
Firm
Name: PrimeTime Medical
Insurance
Company
Medicare Name: PrimeTime Health Plan
Address: 2600
Sixth
Street, S.W.
Canton,
OH 44710
Telephone: 1-800-519-4542
Counties: Stark,
Wayne
Key: OHR (H3664)
Firm Name: Prudential
Health Care
Plan of Northern Ohio
Medicare Name: Prudential SeniorCare
Address: The
Galleria
& Tower at Erieview
1301
East
9th Street, 15th Floor
Cleveland,
Ohio 44114
Telephone: 1-800-458-3940
or (216) 241-5623
Counties: Cuyahoga,
Lake
Key: OHR (H3654)
Firm
Name: Summacare,
Inc.
Medicare Name: Summacare Secure
Address: P. O.
Box 3620
400
West
Market Street
Akron,
OH
44309
Telephone: 1-800-996-6250
or (330) 996-8885
Counties: Medina,
Portage,
Stark, Summit
Key: OHR (H3660)
Firm Name: United
HealthCare of
Ohio, Inc.
Medicare Name: Medicare Complete
Address: 3650
Olentangy
River Road
Columbus,
OH 43214
Telephone: 1-800-504-4848
Counties: Ashland,
Butler,
Clark, Cuyahoga, Delaware, Franklin,
Hamilton,
Knox, Lorain, Madison, Mahoning, Marion,
Montgomery,
Stark, Summit, Trumbull
Key: OHR (H3659)
Firm Name: Qual
Choice Health
Plan
Medicare Name: Qual Choice HMO Prime
Address: 6000
Parkland
Boulevard
Cleveland,
Ohio 44124
Telephone: (216)
460-0093
Counties: Cuyahoga,
Lake
Key: OHR (H3657)
Firm Name: Dean Health
Plan,
Inc./Deancare HMO
Medicare Name: Deancare HMO
Address: 2711
Allen
Boulevard
Middleton,
WI 53562-0000
Telephone: 1-800-
279-1301
or (608) 836-1400
Counties: Columbia, Crawford,
Dane, Dodge,
Fond du Lac,
Grant,
Green, Green Lake, Iowa, Jefferson,
Juneau,
LaFayette, Marquette, Richland, Rock,
Sauk,
Walworth
Key: WIH (H6521)
Firm Name: HMO
Midwest
Medicare Name: Medicare and More
Address: 3535
Blue Cross
Road
Box
64179
St.
Paul,
MN 55164
Telephone: 1-800-382-2000
or (612) 456-8000
Counties: Ashland, Barron,
Bayfield,
Burnett, Dunn,
Pierce,
Pepin, Polk, St. Croix, Sawyer,
Washburn,
Douglas
Key: WIH (H5251)
Firm Name: Network
Health Plan
of Wisconsin, Inc.
Medicare Name: Network Senior Plus
Address: 1165
Appleton
Road
P.O.
Box
120
Menasha,
WI 54952-0120
Telephone: 1-800-826-0940
or (414) 727-0100
Counties: Calumet,
Fond du
lac, Manitowoc, Outagamie,
Sheboygan,
Waupaca, Waushara, Winnebago
Key: WIC (H5254)
Firm Name: Network
Health Plan
of Wisconsin, Inc.
Medicare Name: Network Health Plan
Address: 1165
Appleton
Road
P.O.
Box
120
Menasha,
WI 54952-0120
Telephone: 1-800-826-0940
or (414) 727-0100
Counties: Brown,
Calumet, Fond
Du Lac, Manitowoc,
Outagamie,
Waupaca, Waushara, Winnebago
Key: WIH (H5252)