DR. CHELSEA DIAMOND DMD
Accepted Insurance Health Plans for NPI 1336700327
Dentist - General Practice in Huntington Station, NY
NPI Status: Active since June 21, 2019
Contact Information
135 W JERICHO TPKE
HUNTINGTON STATION, NY
ZIP 11746
Phone: (631) 424-5900
- Ambetter from Arizona Complete Health
- Ambetter from Arkansas Health & Wellness
- Ambetter from Louisiana Healthcare Connections
- Ambetter from Superior HealthPlan
- Ambetter of Oklahoma
- Anthem Blue Cross and Blue Shield
- Antidote Health Plan of Arizona, Inc.
- Antidote Health Plan of Ohio, Inc.
- BEST Life
- Blue Cross and Blue Shield of Illinois
- Blue Cross and Blue Shield of Montana
- Blue Cross and Blue Shield of Oklahoma
- Blue Cross and Blue Shield of Texas
- Guardian
- Humana
- Paramount
- Paramount Dental
- Renaissance Dental
Accepted Health Plans and Insurance Coverage
List of insurance companies accepted by DR. CHELSEA DIAMOND DMD. Use our filterable tables to quickly find the details of your health plan, including: Plan Name, Plan Type and Plan ID. Search this page to find if your specific insurance is accepted. Please verify directly with the provider to make sure your healthplan is currently accepted.
| Plan Name | Plan Type | Plan ID | Dental Only Plan? |
|---|---|---|---|
| Choice Bronze HSA | HMO | 91450AZ0080037 | No |
| Choice Bronze HSA + Vision + Adult Dental | HMO | 91450AZ0180037 | No |
| Clear Silver | HMO | 91450AZ0080097 | No |
| Complete Gold | HMO | 91450AZ0080059 | No |
| Complete Gold + Vision + Adult Dental | HMO | 91450AZ0180059 | No |
| Complete Silver | HMO | 91450AZ0080044 | No |
| Complete Silver + Vision + Adult Dental | HMO | 91450AZ0180044 | No |
| Elite Gold | HMO | 91450AZ0080113 | No |
| Elite Gold + Vision + Adult Dental | HMO | 91450AZ0180113 | No |
| Everyday Bronze | HMO | 91450AZ0080119 | No |
| Everyday Bronze + Vision + Adult Dental | HMO | 91450AZ0180119 | No |
| Standard Expanded Bronze | HMO | 91450AZ0080122 | No |
| Standard Expanded Bronze + Vision + Adult Dental | HMO | 91450AZ0180104 | No |
| Standard Gold | HMO | 91450AZ0080124 | No |
| Standard Gold + Vision + Adult Dental | HMO | 91450AZ0180106 | No |
| Standard Silver | HMO | 91450AZ0080123 | No |
| Standard Silver + Vision + Adult Dental | HMO | 91450AZ0180105 | No |
| Plan Name | Plan Type | Plan ID | Dental Only Plan? |
|---|---|---|---|
| Choice Bronze HSA (QualChoice) | POS | 70525AR0070285 | No |
| Complete Gold | PPO | 62141AR0080014 | No |
| Complete Gold + Vision + Adult Dental | PPO | 62141AR0100014 | No |
| Complete Silver (QualChoice) | POS | 70525AR0070001 | No |
| Connected Silver | PPO | 62141AR0080007 | No |
| Connected Silver (QualChoice) | POS | 70525AR0070261 | No |
| Connected Silver (QualChoiceLife) | PPO | 37903AR0070025 | No |
| Connected Silver + Vision + Adult Dental | PPO | 62141AR0100007 | No |
| Elite Bronze | PPO | 62141AR0080026 | No |
| Elite Bronze + Vision + Adult Dental | PPO | 62141AR0100026 | No |
| Elite Gold (QualChoice) | POS | 70525AR0070268 | No |
| Elite Gold (QualChoiceLife) | PPO | 37903AR0070031 | No |
| Everyday Bronze | PPO | 62141AR0080017 | No |
| Everyday Bronze + Vision + Adult Dental | PPO | 62141AR0100017 | No |
| Everyday Gold | PPO | 62141AR0080030 | No |
| Everyday Gold + Vision + Adult Dental | PPO | 62141AR0100030 | No |
| Everyday Silver (QualChoiceLife) | PPO | 37903AR0070001 | No |
| Focused Silver | PPO | 62141AR0080029 | No |
| Focused Silver + Vision + Adult Dental | PPO | 62141AR0100032 | No |
| Standard Expanded Bronze | PPO | 62141AR0080032 | No |
| Standard Expanded Bronze (QualChoice) | POS | 70525AR0070287 | No |
| Standard Expanded Bronze + Vision + Adult Dental | PPO | 62141AR0100033 | No |
| Standard Gold | PPO | 62141AR0080034 | No |
| Standard Gold (QualChoice) | POS | 70525AR0070289 | No |
| Standard Gold (QualChoiceLife) | PPO | 37903AR0070034 | No |
| Standard Gold + Vision + Adult Dental | PPO | 62141AR0100035 | No |
| Standard Silver | PPO | 62141AR0080033 | No |
| Standard Silver (QualChoice) | POS | 70525AR0070288 | No |
| Standard Silver (QualChoiceLife) | PPO | 37903AR0070033 | No |
| Standard Silver + Vision + Adult Dental | PPO | 62141AR0100034 | No |
| Plan Name | Plan Type | Plan ID | Dental Only Plan? |
|---|---|---|---|
| Complete Gold | EPO | 90787LA0010006 | No |
| Complete Gold + Vision + Adult Dental | EPO | 90787LA0020005 | No |
| Elite Bronze | EPO | 90787LA0010002 | No |
| Elite Bronze + Vision + Adult Dental | EPO | 90787LA0020002 | No |
| Elite Gold | EPO | 90787LA0010008 | No |
| Elite Gold + Vision + Adult Dental | EPO | 90787LA0020008 | No |
| Elite Silver | EPO | 90787LA0010012 | No |
| Elite Silver + Vision + Adult Dental | EPO | 90787LA0020012 | No |
| Everyday Bronze | EPO | 90787LA0010001 | No |
| Everyday Bronze + Vision + Adult Dental | EPO | 90787LA0020001 | No |
| Focused Silver | EPO | 90787LA0010005 | No |
| Focused Silver + Vision + Adult Dental | EPO | 90787LA0020004 | No |
| Standard Expanded Bronze | EPO | 90787LA0010009 | No |
| Standard Expanded Bronze + Vision + Adult Dental | EPO | 90787LA0020009 | No |
| Standard Gold | EPO | 90787LA0010011 | No |
| Standard Gold + Vision + Adult Dental | EPO | 90787LA0020011 | No |
| Standard Silver | EPO | 90787LA0010010 | No |
| Plan Name | Plan Type | Plan ID | Dental Only Plan? |
|---|---|---|---|
| Complete Gold | EPO | 29418TX0140064 | No |
| Complete Gold + Vision + Adult Dental | EPO | 29418TX0160020 | No |
| Complete Silver | EPO | 29418TX0140019 | No |
| Complete Silver + Vision + Adult Dental | EPO | 29418TX0160038 | No |
| Everyday Gold | EPO | 29418TX0140102 | No |
| Everyday Gold + Vision + Adult Dental | EPO | 29418TX0160102 | No |
| Focused Silver | EPO | 29418TX0140100 | No |
| Focused Silver + Vision + Adult Dental | EPO | 29418TX0160100 | No |
| Standard Gold | EPO | 29418TX0140109 | No |
| Standard Gold + Vision + Adult Dental | EPO | 29418TX0160052 | No |
| Standard Silver | EPO | 29418TX0140108 | No |
| Plan Name | Plan Type | Plan ID | Dental Only Plan? |
|---|---|---|---|
| Elite Bronze | PPO | 62505OK0120006 | No |
| Elite Bronze + Vision + Adult Dental | PPO | 62505OK0130006 | No |
| Elite Gold | PPO | 62505OK0120016 | No |
| Elite Gold + Vision + Adult Dental | PPO | 62505OK0130017 | No |
| Everyday Bronze | PPO | 62505OK0120002 | No |
| Everyday Bronze + Vision + Adult Dental | PPO | 62505OK0130002 | No |
| Everyday Gold | PPO | 62505OK0120014 | No |
| Everyday Gold + Vision + Adult Dental | PPO | 62505OK0130014 | No |
| Focused Silver | PPO | 62505OK0120012 | No |
| Focused Silver + Vision + Adult Dental | PPO | 62505OK0130012 | No |
| Standard Expanded Bronze | PPO | 62505OK0120019 | No |
| Standard Expanded Bronze + Vision + Adult Dental | PPO | 62505OK0130019 | No |
| Standard Gold | PPO | 62505OK0120021 | No |
| Standard Gold + Vision + Adult Dental | PPO | 62505OK0130021 | No |
| Standard Silver | PPO | 62505OK0120020 | No |
| Plan Name | Plan Type | Plan ID | Dental Only Plan? |
|---|---|---|---|
| Anthem Bronze Essential 6500 HSA (+ Incentives) | HMO | 17575IN0700058 | No |
| Anthem Bronze Essential 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) | HMO | 17575IN0700065 | No |
| Anthem Bronze Essential 9200 (+ Incentives) | HMO | 17575IN0700045 | No |
| Anthem Bronze Essential 9200 Adult Dental/Vision (+ Incentives) | HMO | 17575IN0700101 | No |
| Anthem Bronze Essential POS 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) | POS | 17575IN0760005 | No |
| Anthem Bronze Essential POS 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) | POS | 17575IN0760007 | No |
| Anthem Bronze Pathway 6900 ($0 Virtual PCP + $0 Select Drugs + Incentives) | EPO | 32753MO0950008 | No |
| Anthem Bronze Pathway 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) | EPO | 32753MO0950021 | No |
| Anthem Bronze Pathway 9200 (+ Incentives) | EPO | 32753MO0950051 | No |
| Anthem Bronze Pathway HMO 7450 for HSA | HMO | 29276OH0920417 | No |
| Anthem Bronze Pathway HMO 7500 Standard ($0 Virtual PCP + $0 Select Drugs) | HMO | 29276OH0920432 | No |
| Anthem Bronze Pathway HMO 9200 ($0 Virtual PCP + $0 Select Drugs) | HMO | 29276OH0920414 | No |
| Anthem Bronze Pathway HMO 9200 Adult Dental & Vision ($0 Virtual PCP + $0 Select Drugs) | HMO | 29276OH0920916 | No |
| Anthem Bronze Pathway/Lean 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) | HMO | 79475WI0340103 | No |
| Anthem Bronze Pathway/Lean 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) | HMO | 79475WI0340141 | No |
| Anthem Bronze Pathway/Lean 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) | HMO | 79475WI0340142 | No |
| Anthem Bronze Pathway/Lean 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) | HMO | 79475WI0340143 | No |
| Anthem Bronze Pathway/Lean HSA (+ Incentives) | HMO | 79475WI0340102 | No |
| Anthem Bronze Pathway/Lean HSA (+ Incentives) | HMO | 79475WI0340132 | No |
| Anthem Bronze Pathway/Lean HSA (+ Incentives) | HMO | 79475WI0340133 | No |
| Anthem Bronze Pathway/Lean HSA (+ Incentives) | HMO | 79475WI0340134 | No |
| Anthem Bronze Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) | HMO | 79475WI0340169 | No |
| Anthem Bronze Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) | HMO | 79475WI0340178 | No |
| Anthem Bronze Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) | HMO | 79475WI0340187 | No |
| Anthem Bronze Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) | HMO | 79475WI0340188 | No |
| Anthem Bronze Priority/Lean 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) | HMO | 79475WI0340226 | No |
| Anthem Bronze Priority/Lean 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) | HMO | 79475WI0340227 | No |
| Anthem Bronze Priority/Lean 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) | HMO | 79475WI0340257 | No |
| Anthem Bronze Priority/Lean HSA (+ Incentives) | HMO | 79475WI0340212 | No |
| Anthem Bronze Priority/Lean HSA (+ Incentives) | HMO | 79475WI0340213 | No |
| Anthem Bronze Priority/Lean HSA (+ Incentives) | HMO | 79475WI0340251 | No |
| Anthem Bronze Priority/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) | HMO | 79475WI0340224 | No |
| Anthem Bronze Priority/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) | HMO | 79475WI0340225 | No |
| Anthem Bronze Priority/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) | HMO | 79475WI0340256 | No |
| Anthem Catastrophic Pathway 9200 (+ Incentives) | EPO | 32753MO0950016 | No |
| Anthem Catastrophic Pathway HMO 9200 | HMO | 29276OH0920425 | No |
| Anthem Gold Essential 1500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) | HMO | 17575IN0700067 | No |
| Anthem Gold Essential 2200 ($0 Virtual PCP + $0 Select Drugs + Incentives) | HMO | 17575IN0700056 | No |
| Anthem Gold Pathway 1500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) | EPO | 32753MO0950023 | No |
| Anthem Gold Pathway HMO 1500 Standard ($0 Virtual PCP + $0 Select Drugs) | HMO | 29276OH0920434 | No |
| Anthem Gold Pathway/Lean 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) | HMO | 79475WI0340110 | No |
| Anthem Gold Pathway/Lean 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) | HMO | 79475WI0340159 | No |
| Anthem Gold Pathway/Lean 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) | HMO | 79475WI0340160 | No |
| Anthem Gold Pathway/Lean 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) | HMO | 79475WI0340161 | No |
| Anthem Gold Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) | HMO | 79475WI0340171 | No |
| Anthem Gold Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) | HMO | 79475WI0340179 | No |
| Anthem Gold Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) | HMO | 79475WI0340183 | No |
| Anthem Gold Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) | HMO | 79475WI0340186 | No |
| Anthem Gold Priority/Lean 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) | HMO | 79475WI0340218 | No |
| Anthem Gold Priority/Lean 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) | HMO | 79475WI0340219 | No |
| Anthem Gold Priority/Lean 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) | HMO | 79475WI0340253 | No |
| Anthem Gold Priority/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) | HMO | 79475WI0340230 | No |
| Anthem Gold Priority/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) | HMO | 79475WI0340231 | No |
| Anthem Gold Priority/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) | HMO | 79475WI0340258 | No |
| Anthem Heart Healthy Bronze Pathway HMO 6000 ($0 Virtual PCP + $0 Select Drugs) | HMO | 29276OH0920429 | No |
| Anthem Heart Healthy Bronze Essential 4500 ($0 Virtual PCP + $0 Select Drugs + Incentives) | HMO | 17575IN0700053 | No |
| Anthem Heart Healthy Bronze Pathway 4900 ($0 Virtual PCP + $0 Select Drugs + Incentives) | EPO | 32753MO0950017 | No |
| Anthem Heart Healthy Bronze Pathway/Lean 0 Med Ded ($0 Virtual PCP+$0 Select Drugs+Incentives) | HMO | 79475WI0340111 | No |
| Anthem Heart Healthy Bronze Pathway/Lean 0 Med Ded ($0 Virtual PCP+$0 Select Drugs+Incentives) | HMO | 79475WI0340162 | No |
| Anthem Heart Healthy Bronze Pathway/Lean 0 Med Ded ($0 Virtual PCP+$0 Select Drugs+Incentives) | HMO | 79475WI0340163 | No |
| Anthem Heart Healthy Bronze Pathway/Lean 0 Med Ded ($0 Virtual PCP+$0 Select Drugs+Incentives) | HMO | 79475WI0340164 | No |
| Anthem Heart Healthy Bronze Priority/Lean 0 Med Ded ($0 Virtual PCP+$0 Select Drugs+Incentives) | HMO | 79475WI0340220 | No |
| Anthem Heart Healthy Bronze Priority/Lean 0 Med Ded ($0 Virtual PCP+$0 Select Drugs+Incentives) | HMO | 79475WI0340221 | No |
| Anthem Heart Healthy Bronze Priority/Lean 0 Med Ded ($0 Virtual PCP+$0 Select Drugs+Incentives) | HMO | 79475WI0340254 | No |
| Anthem Heart Healthy Silver Essential 4500 ($0 Virtual PCP + $0 Select Drugs + Incentives) | HMO | 17575IN0700061 | No |
| Anthem Heart Healthy Silver Pathway 2900 ($0 Virtual PCP + $0 Select Drugs + Incentives) | EPO | 32753MO0950002 | No |
| Anthem Heart Healthy Silver Pathway X HMO 6000 ($0 Virtual PCP + $0 Select Drugs) | HMO | 29276OH0920428 | No |
| Anthem Silver Essential 3500 HSA (+ Incentives) | HMO | 17575IN0700062 | No |
| Anthem Silver Essential 5000 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) | HMO | 17575IN0700066 | No |
| Anthem Silver Essential 7000 ($0 Virtual PCP + $0 Select Drugs + Incentives) | HMO | 17575IN0700055 | No |
| Anthem Silver Essential 7000 Adult Dental/Vision ($0 Virtual PCP + $0 Select Drugs + Incentives) | HMO | 17575IN0700102 | No |
| Anthem Silver Pathway 5000 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) | EPO | 32753MO0950022 | No |
| Anthem Silver Pathway 5350 ($0 Virtual PCP + $0 Select Drugs + Incentives) | EPO | 32753MO0950013 | No |
| Anthem Silver Pathway 7250 ($0 Virtual PCP + $0 Select Drugs + Incentives) | EPO | 32753MO0950015 | No |
| Anthem Silver Pathway HMO 4000 Adult Dental/Vision ($0 Virtual PCP + $0 Select Drugs) | HMO | 29276OH0920917 | No |
| Anthem Silver Pathway HMO 5000 Standard ($0 Virtual PCP + $0 Select Drugs) | HMO | 29276OH0920433 | No |
| Anthem Silver Pathway HMO 5400 for HSA | HMO | 29276OH0920421 | No |
| Anthem Silver Pathway X HMO 4000 ($0 Virtual PCP + $0 Select Drugs) | HMO | 29276OH0920424 | No |
| Anthem Silver Pathway/Lean 4000 (3 Free PCP Visits + $0 Select Drugs + Incentives) | HMO | 79475WI0340106 | No |
| Anthem Silver Pathway/Lean 4000 (3 Free PCP Visits + $0 Select Drugs + Incentives) | HMO | 79475WI0340150 | No |
| Anthem Silver Pathway/Lean 4000 (3 Free PCP Visits + $0 Select Drugs + Incentives) | HMO | 79475WI0340151 | No |
| Anthem Silver Pathway/Lean 4000 (3 Free PCP Visits + $0 Select Drugs + Incentives) | HMO | 79475WI0340152 | No |
| Anthem Silver Pathway/Lean 5300 (3 Free PCP Visits + $0 Select Drugs + Incentives) | HMO | 79475WI0340109 | No |
| Anthem Silver Pathway/Lean 5300 (3 Free PCP Visits + $0 Select Drugs + Incentives) | HMO | 79475WI0340156 | No |
| Anthem Silver Pathway/Lean 5300 (3 Free PCP Visits + $0 Select Drugs + Incentives) | HMO | 79475WI0340157 | No |
| Anthem Silver Pathway/Lean 5300 (3 Free PCP Visits + $0 Select Drugs + Incentives) | HMO | 79475WI0340158 | No |
| Anthem Silver Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) | HMO | 79475WI0340170 | No |
| Anthem Silver Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) | HMO | 79475WI0340180 | No |
| Anthem Silver Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) | HMO | 79475WI0340181 | No |
| Anthem Silver Pathway/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) | HMO | 79475WI0340184 | No |
| Anthem Silver Priority/Lean 4000 (3 Free PCP Visits + $0 Select Drugs + Incentives) | HMO | 79475WI0340214 | No |
| Anthem Silver Priority/Lean 4000 (3 Free PCP Visits + $0 Select Drugs + Incentives) | HMO | 79475WI0340215 | No |
| Anthem Silver Priority/Lean 4000 (3 Free PCP Visits + $0 Select Drugs + Incentives) | HMO | 79475WI0340252 | No |
| Anthem Silver Priority/Lean 5300 (3 Free PCP Visits + $0 Select Drugs + Incentives) | HMO | 79475WI0340222 | No |
| Anthem Silver Priority/Lean 5300 (3 Free PCP Visits + $0 Select Drugs + Incentives) | HMO | 79475WI0340223 | No |
| Anthem Silver Priority/Lean 5300 (3 Free PCP Visits + $0 Select Drugs + Incentives) | HMO | 79475WI0340255 | No |
| Anthem Silver Priority/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) | HMO | 79475WI0340232 | No |
| Anthem Silver Priority/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) | HMO | 79475WI0340233 | No |
| Anthem Silver Priority/Lean Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) | HMO | 79475WI0340259 | No |
| Anthem Dental Family | PPO | 17575IN0860003 | Yes |
| Anthem Dental Family | PPO | 29276OH0830003 | Yes |
| Anthem Dental Family | PPO | 32753MO0860003 | Yes |
| Anthem Dental Family | PPO | 90028WI0420003 | Yes |
| Anthem Dental Family Enhanced | PPO | 17575IN0860004 | Yes |
| Anthem Dental Family Enhanced | PPO | 29276OH0830004 | Yes |
| Anthem Dental Family Enhanced | PPO | 32753MO0860004 | Yes |
| Anthem Dental Family Enhanced | PPO | 90028WI0420004 | Yes |
| Anthem Dental Family Preventive | PPO | 17575IN0860006 | Yes |
| Anthem Dental Family Preventive | PPO | 29276OH0830006 | Yes |
| Anthem Dental Family Preventive | PPO | 32753MO0860006 | Yes |
| Anthem Dental Family Preventive | PPO | 90028WI0420006 | Yes |
| Anthem Dental Family Value | PPO | 17575IN0860005 | Yes |
| Anthem Dental Family Value | PPO | 29276OH0830005 | Yes |
| Anthem Dental Family Value | PPO | 32753MO0860005 | Yes |
| Anthem Dental Family Value | PPO | 90028WI0420005 | Yes |
| Plan Name | Plan Type | Plan ID | Dental Only Plan? |
|---|---|---|---|
| Bronze Complete $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx | HMO | 68445AZ0600010 | No |
| Bronze Complete+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx | HMO | 68445AZ0600011 | No |
| Bronze Elite $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx | HMO | 68445AZ0610010 | No |
| Bronze Elite+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx | HMO | 68445AZ0610011 | No |
| Bronze Standard | HMO | 68445AZ0590010 | No |
| Catastrophic Standard | HMO | 68445AZ0590050 | No |
| Gold Complete $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx | HMO | 68445AZ0600030 | No |
| Gold Complete+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx | HMO | 68445AZ0600031 | No |
| Gold Elite $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx | HMO | 68445AZ0610030 | No |
| Gold Elite+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx | HMO | 68445AZ0610031 | No |
| Gold Standard | HMO | 68445AZ0590030 | No |
| Silver Complete $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx | HMO | 68445AZ0600020 | No |
| Silver Complete+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx | HMO | 68445AZ0600021 | No |
| Silver Elite $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx | HMO | 68445AZ0610020 | No |
| Silver Elite+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx | HMO | 68445AZ0610021 | No |
| Silver Standard | HMO | 68445AZ0590020 | No |
| Plan Name | Plan Type | Plan ID | Dental Only Plan? |
|---|---|---|---|
| Bronze Complete $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx | HMO | 31981OH0020010 | No |
| Bronze Complete+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx | HMO | 31981OH0020011 | No |
| Bronze Elite $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx | HMO | 31981OH0030010 | No |
| Bronze Elite+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx | HMO | 31981OH0030011 | No |
| Bronze Standard | HMO | 31981OH0010010 | No |
| Catastrophic Standard | HMO | 31981OH0010050 | No |
| Gold Complete $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx | HMO | 31981OH0020030 | No |
| Gold Complete+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx | HMO | 31981OH0020031 | No |
| Gold Elite $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx | HMO | 31981OH0030030 | No |
| Gold Elite+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx | HMO | 31981OH0030031 | No |
| Gold Standard | HMO | 31981OH0010030 | No |
| Silver Complete $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx | HMO | 31981OH0020020 | No |
| Silver Complete+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care, $0 Core Rx | HMO | 31981OH0020021 | No |
| Silver Elite $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx | HMO | 31981OH0030020 | No |
| Silver Elite+Dental $0 Tier-1 PCP, $0 Antidote 24/7 Virtual PCP/Urg/Chronic Care/Referred Labs, $0 Advanced Rx | HMO | 31981OH0030021 | No |
| Silver Standard | HMO | 31981OH0010020 | No |
| Plan Name | Plan Type | Plan ID | Dental Only Plan? |
|---|---|---|---|
| BEST Life Superior Dental Plan | PPO | 94482NC0020003 | Yes |
| BEST Essential Basic Dental Plan | PPO | 29416MO0020008 | Yes |
| BEST Life Essentail Basic Dental Plan | PPO | 42757UT0020008 | Yes |
| BEST Life Essentail Value Dental Plan | PPO | 42757UT0020006 | Yes |
| BEST Life Essental Value Dental Plan | PPO | 89281SC0020006 | Yes |
| BEST Life Essential Basic Dental | PPO | 94482NC0020008 | Yes |
| BEST Life Essential Basic Dental Plan | PPO | 17121FL0020008 | Yes |
| BEST Life Essential Basic Dental Plan | PPO | 74819AK0020012 | Yes |
| BEST Life Essential Basic Dental Plan | PPO | 75329ND0020008 | Yes |
| BEST Life Essential Basic Dental | PPO | 78461LA0020008 | Yes |
| BEST Life Essential Basic Dental Plan | PPO | 10046HI0020008 | Yes |
| BEST Life Essential Basic Dental Plan | PPO | 11324MS0020008 | Yes |
| BEST Life Essential Basic Dental Plan | PPO | 12538AL0020008 | Yes |
| BEST Life Essential Basic Dental Plan | PPO | 24601TN0020008 | Yes |
| BEST Life Essential Basic Dental Plan | PPO | 26904AR0020008 | Yes |
| BEST Life Essential Basic Dental Plan | PPO | 35700MI0020008 | Yes |
| BEST Life Essential Basic Dental Plan | PPO | 40254OK0020008 | Yes |
| BEST Life Essential Basic Dental Plan | PPO | 47509OH0020008 | Yes |
| BEST Life Essential Basic Dental Plan | PPO | 47665TX0020008 | Yes |
| BEST Life Essential Basic Dental Plan | PPO | 50022NE0020008 | Yes |
| BEST Life Essential Basic Dental Plan | PPO | 61214SD0020008 | Yes |
| BEST Life Essential Basic Dental Plan | PPO | 63790KS0020008 | Yes |
| BEST Life Essential Basic Dental Plan | PPO | 71051IA0020008 | Yes |
| BEST Life Essential Basic Dental Plan | PPO | 77352AZ0020008 | Yes |
| BEST Life Essential Basic Dental Plan | PPO | 83557IN0020008 | Yes |
| BEST Life Essential Basic Dental Plan | PPO | 89281SC0020008 | Yes |
| BEST Life Essential Basic Dental Plan | PPO | 93895MT0020008 | Yes |
| BEST Life Essential Vakue Dental Plan | PPO | 17121FL0020006 | Yes |
| BEST Life Essential Value Dental Plan | PPO | 29416MO0020006 | Yes |
| BEST Life Essential Value Dental | PPO | 94482NC0020006 | Yes |
| BEST Life Essential Value Dental Plan | PPO | 10046HI0020006 | Yes |
| BEST Life Essential Value Dental Plan | PPO | 11324MS0020006 | Yes |
| BEST Life Essential Value Dental Plan | PPO | 12538AL0020006 | Yes |
| BEST Life Essential Value Dental Plan | PPO | 24601TN0020006 | Yes |
| BEST Life Essential Value Dental Plan | PPO | 26904AR0020006 | Yes |
| BEST Life Essential Value Dental Plan | PPO | 35700MI0020006 | Yes |
| BEST Life Essential Value Dental Plan | PPO | 40254OK0020006 | Yes |
| BEST Life Essential Value Dental Plan | PPO | 47509OH0020006 | Yes |
| BEST Life Essential Value Dental Plan | PPO | 47665TX0020006 | Yes |
| BEST Life Essential Value Dental Plan | PPO | 50022NE0020006 | Yes |
| BEST Life Essential Value Dental Plan | PPO | 61214SD0020006 | Yes |
| BEST Life Essential Value Dental Plan | PPO | 63790KS0020006 | Yes |
| BEST Life Essential Value Dental Plan | PPO | 71051IA0020006 | Yes |
| BEST Life Essential Value Dental Plan | PPO | 74819AK0020010 | Yes |
| BEST Life Essential Value Dental Plan | PPO | 75329ND0020006 | Yes |
| BEST Life Essential Value Dental Plan | PPO | 77352AZ0020006 | Yes |
| BEST Life Essential Value Dental Plan | PPO | 78461LA0020006 | Yes |
| BEST Life Essential Value Dental Plan | PPO | 83557IN0020006 | Yes |
| BEST Life Essential Value Dental Plan | PPO | 93895MT0020006 | Yes |
| BEST Life Preferred Dental Plan | PPO | 47665TX0020007 | Yes |
| BEST Life Preferred Dental Plan | PPO | 74819AK0020011 | Yes |
| BEST Life Preferred Dental | PPO | 17121FL0020007 | Yes |
| BEST Life Preferred Dental Plan | PPO | 10046HI0020007 | Yes |
| BEST Life Preferred Dental plan | PPO | 11324MS0020007 | Yes |
| BEST Life Preferred Dental Plan | PPO | 12538AL0020007 | Yes |
| BEST Life Preferred Dental Plan | PPO | 24601TN0020007 | Yes |
| BEST Life Preferred Dental Plan | PPO | 26904AR0020007 | Yes |
| BEST Life Preferred Dental Plan | PPO | 29416MO0020007 | Yes |
| BEST Life Preferred Dental Plan | PPO | 35700MI0020007 | Yes |
| BEST Life Preferred Dental Plan | PPO | 40254OK0020007 | Yes |
| BEST Life Preferred Dental Plan | PPO | 42757UT0020007 | Yes |
| BEST Life Preferred Dental Plan | PPO | 47509OH0020007 | Yes |
| BEST Life Preferred Dental Plan | PPO | 50022NE0020007 | Yes |
| BEST Life Preferred Dental Plan | PPO | 61214SD0020007 | Yes |
| BEST Life Preferred Dental Plan | PPO | 63790KS0020007 | Yes |
| BEST Life Preferred Dental Plan | PPO | 71051IA0020007 | Yes |
| BEST Life Preferred Dental Plan | PPO | 75329ND0020007 | Yes |
| BEST Life Preferred Dental Plan | PPO | 77352AZ0020007 | Yes |
| BEST Life Preferred Dental Plan | PPO | 78461LA0020007 | Yes |
| BEST Life Preferred Dental Plan | PPO | 83557IN0020007 | Yes |
| BEST Life Preferred Dental Plan | PPO | 89281SC0020007 | Yes |
| BEST Life Preferred Dental Plan | PPO | 93895MT0020007 | Yes |
| BEST Life Preferred Dental Plan | PPO | 94482NC0020007 | Yes |
| BEST Life Superior Dental | PPO | 17121FL0020003 | Yes |
| BEST Life Superior Dental Plan | PPO | 89281SC0020003 | Yes |
| BEST Life Superior Dental Plan | PPO | 10046HI0020003 | Yes |
| BEST Life Superior Dental Plan | PPO | 11324MS0020003 | Yes |
| BEST Life Superior Dental Plan | PPO | 12538AL0020003 | Yes |
| BEST Life Superior Dental Plan | PPO | 24601TN0020003 | Yes |
| BEST Life Superior Dental Plan | PPO | 26904AR0020003 | Yes |
| BEST Life Superior Dental Plan | PPO | 29416MO0020003 | Yes |
| BEST Life Superior Dental Plan | PPO | 35700MI0020003 | Yes |
| BEST Life Superior Dental Plan | PPO | 40254OK0020003 | Yes |
| BEST Life Superior Dental Plan | PPO | 42757UT0020003 | Yes |
| BEST Life Superior Dental Plan | PPO | 47509OH0020003 | Yes |
| BEST Life Superior Dental Plan | PPO | 47665TX0020003 | Yes |
| BEST Life Superior Dental Plan | PPO | 50022NE0020003 | Yes |
| BEST Life Superior Dental Plan | PPO | 61214SD0020003 | Yes |
| BEST Life Superior Dental Plan | PPO | 63790KS0020003 | Yes |
| BEST Life Superior Dental Plan | PPO | 71051IA0020003 | Yes |
| BEST Life Superior Dental Plan | PPO | 74819AK0020007 | Yes |
| BEST Life Superior Dental Plan | PPO | 75329ND0020003 | Yes |
| BEST Life Superior Dental Plan | PPO | 77352AZ0020003 | Yes |
| BEST Life Superior Dental Plan | PPO | 78461LA0020003 | Yes |
| BEST Life Superior Dental Plan | PPO | 83557IN0020003 | Yes |
| BEST Life Superior Dental Plan | PPO | 93895MT0020003 | Yes |
| BESTOne Dental Plus Silver | PPO | 84033IL0020001 | Yes |
| Plan Name | Plan Type | Plan ID | Dental Only Plan? |
|---|---|---|---|
| BlueCare Dental 4 Kids? 1A | PPO | 36096IL0830003 | Yes |
| BlueCare Dental 4 Kids? 1B | PPO | 36096IL0830004 | Yes |
| BlueCare Dental? 1A | PPO | 36096IL0830001 | Yes |
| BlueCare Dental? 1B | PPO | 36096IL0830002 | Yes |
| BlueCare Dental? 1C | PPO | 36096IL0830005 | Yes |
| BlueCare Dental? 1D | PPO | 36096IL0830006 | Yes |
| Plan Name | Plan Type | Plan ID | Dental Only Plan? |
|---|---|---|---|
| BlueCare Dental 4 Kids? 1A | PPO | 30751MT0580003 | Yes |
| BlueCare Dental 4 Kids? 1B | PPO | 30751MT0580004 | Yes |
| BlueCare Dental? 1A | PPO | 30751MT0580001 | Yes |
| BlueCare Dental? 1B | PPO | 30751MT0580002 | Yes |
| BlueCare Dental? 1C | PPO | 30751MT0580005 | Yes |
| BlueCare Dental? 1D | PPO | 30751MT0580006 | Yes |
| Plan Name | Plan Type | Plan ID | Dental Only Plan? |
|---|---|---|---|
| BlueCare Dental 4 Kids? 1A | PPO | 87571OK0390003 | Yes |
| BlueCare Dental 4 Kids? 1B | PPO | 87571OK0390004 | Yes |
| BlueCare Dental? 1A | PPO | 87571OK0390001 | Yes |
| BlueCare Dental? 1B | PPO | 87571OK0390002 | Yes |
| BlueCare Dental? 1C | PPO | 87571OK0390005 | Yes |
| BlueCare Dental? 1D | PPO | 87571OK0390006 | Yes |
| Plan Name | Plan Type | Plan ID | Dental Only Plan? |
|---|---|---|---|
| BlueCare Dental 1D | PPO | 33602TX0500007 | Yes |
| BlueCare Dental 4 Kids? 1A | PPO | 33602TX0500003 | Yes |
| BlueCare Dental 4 Kids? 1B | PPO | 33602TX0500004 | Yes |
| BlueCare Dental? 1A | PPO | 33602TX0500001 | Yes |
| BlueCare Dental? 1B | PPO | 33602TX0500002 | Yes |
| BlueCare Dental? 1C | PPO | 33602TX0500006 | Yes |
| Plan Name | Plan Type | Plan ID | Dental Only Plan? |
|---|---|---|---|
| Guardian Basics for Families and Individuals | PPO | 12846TX0280004 | Yes |
| Guardian Basics for Families and Individuals | PPO | 12846TX0280004 | Yes |
| Guardian Choice for Families and Individuals | PPO | 12846TX0290005 | Yes |
| Guardian Choice for Families and Individuals | PPO | 12846TX0290005 | Yes |
| Guardian Essentials for Families and Individuals | PPO | 12846TX0270004 | Yes |
| Guardian Essentials for Families and Individuals | PPO | 12846TX0270004 | Yes |
| Guardian Preventive Plus for Families and Individuals | PPO | 12846TX0300003 | Yes |
| Guardian Preventive Plus for Families and Individuals | PPO | 12846TX0300003 | Yes |
| Plan Name | Plan Type | Plan ID | Dental Only Plan? |
|---|---|---|---|
| Humana Dental Smart Choice | PPO | 44965LA0590001 | Yes |
| Humana Dental Smart Choice | PPO | 62294MI0420001 | Yes |
| Humana Dental Smart Choice | PPO | 91604WI0490002 | Yes |
| Humana Dental Smart Choice | PPO | 97596OH0580003 | Yes |
| Humana Dental Smart Choice - High | PPO | 15980FL0160004 | Yes |
| Humana Dental Smart Choice - High | PPO | 23468OK0200002 | Yes |
| Humana Dental Smart Choice - High | PPO | 31358HI0010002 | Yes |
| Humana Dental Smart Choice - High | PPO | 32237NC0290002 | Yes |
| Humana Dental Smart Choice - High | PPO | 44580AL0380003 | Yes |
| Humana Dental Smart Choice - High | PPO | 48963MS0510003 | Yes |
| Humana Dental Smart Choice - High | PPO | 63141TX0760002 | Yes |
| Humana Dental Smart Choice - High | PPO | 66105AZ0620003 | Yes |
| Humana Dental Smart Choice - High | PPO | 68303IL0700002 | Yes |
| Humana Dental Smart Choice - High | PPO | 82120TN0630005 | Yes |
| Humana Dental Smart Choice - High | PPO | 99791IN0540002 | Yes |
| Humana Dental Smart Choice - Lite | PPO | 15980FL0160005 | Yes |
| Humana Dental Smart Choice - Lite | PPO | 30613MO0560002 | Yes |
| Humana Dental Smart Choice - Lite | PPO | 32237NC0290003 | Yes |
| Humana Dental Smart Choice - Lite | PPO | 44580AL0380004 | Yes |
| Humana Dental Smart Choice - Lite | PPO | 63141TX0760003 | Yes |
| Humana Dental Smart Choice - Lite | PPO | 82120TN0630006 | Yes |
| Humana Dental Smart Choice - Low | PPO | 15980FL0160003 | Yes |
| Humana Dental Smart Choice - Low | PPO | 23468OK0200001 | Yes |
| Humana Dental Smart Choice - Low | PPO | 30613MO0560001 | Yes |
| Humana Dental Smart Choice - Low | PPO | 31358HI0010001 | Yes |
| Humana Dental Smart Choice - Low | PPO | 32237NC0290001 | Yes |
| Humana Dental Smart Choice - Low | PPO | 44580AL0380001 | Yes |
| Humana Dental Smart Choice - Low | PPO | 48963MS0510002 | Yes |
| Humana Dental Smart Choice - Low | PPO | 63141TX0760001 | Yes |
| Humana Dental Smart Choice - Low | PPO | 66105AZ0620002 | Yes |
| Humana Dental Smart Choice - Low | PPO | 68303IL0700001 | Yes |
| Humana Dental Smart Choice - Low | PPO | 82120TN0630004 | Yes |
| Humana Dental Smart Choice - Low | PPO | 99791IN0540001 | Yes |
| Humana Dental Smart Choice Basic | PPO | 46958UT0470002 | Yes |
| Humana Dental Smart Choice- Lite | PPO | 68303IL0700003 | Yes |
| Plan Name | Plan Type | Plan ID | Dental Only Plan? |
|---|---|---|---|
| Paramount Dental Essential Plus Plan | EPO | 95233MI0210002 | Yes |
| Paramount Dental Preventive Family Plan | EPO | 95233MI0210001 | Yes |
| Paramount Dental Total Care Plan | EPO | 95233MI0210003 | Yes |
| Plan Name | Plan Type | Plan ID | Dental Only Plan? |
|---|---|---|---|
| HRI Essential Plus Plan | HMO | 33086IN0060002 | Yes |
| HRI Essential Plus Plan | PPO | 25945OH0020002 | Yes |
| HRI Preventive Family Plan | HMO | 33086IN0060001 | Yes |
| HRI Preventive Family Plan | PPO | 25945OH0020001 | Yes |
| HRI Total Care Plan | HMO | 33086IN0060003 | Yes |
| HRI Total Care Plan | PPO | 25945OH0020003 | Yes |
| Plan Name | Plan Type | Plan ID | Dental Only Plan? |
|---|---|---|---|
| Alabama Preferred Plan | PPO | 28725AL0110002 | Yes |
| Alabama Preferred Plan (Pediatric Only) | PPO | 28725AL0130002 | Yes |
| Alabama Preferred Plus Plan | PPO | 28725AL0110001 | Yes |
| Alabama Preferred Plus Plan (Pediatric Only) | PPO | 28725AL0130001 | Yes |
| Alabama Wellness Essentials Plan | PPO | 28725AL0150001 | Yes |
| Florida Preferred Plan | PPO | 48129FL0130004 | Yes |
| Florida Preferred Plan (Pediatric Only) | PPO | 48129FL0150004 | Yes |
| Florida Preferred Plus Plan | PPO | 48129FL0130003 | Yes |
| Florida Preferred Plus Plan (Pediatric Only) | PPO | 48129FL0150003 | Yes |
| Florida Wellness Essentials Plan | PPO | 48129FL0180001 | Yes |
| High PPO Dental Plan | PPO | 28419LA0040001 | Yes |
| High PPO Dental Plan (Pediatric Only) | PPO | 28419LA0050001 | Yes |
| Kansas Preferred Plan | PPO | 95038KS0040003 | Yes |
| Kansas Preferred Plan (Pediatric Only) | PPO | 95038KS0050002 | Yes |
| Kansas Wellness Essentials Plan | PPO | 95038KS0070001 | Yes |
| Low PPO Dental Plan | PPO | 28419LA0040002 | Yes |
| Low PPO Dental Plan (Pediatric Only) | PPO | 28419LA0050002 | Yes |
| Mississippi Preferred Plan | PPO | 84254MS0050003 | Yes |
| Mississippi Preferred Plan (Pediatric Only) | PPO | 84254MS0060002 | Yes |
| Mississippi Wellness Essentials Plan | PPO | 84254MS0090001 | Yes |
| Missouri Preferred Plan | PPO | 35853MO0040004 | Yes |
| Missouri Preferred Plan (Pediatric Only) | PPO | 35853MO0050004 | Yes |
| Missouri Preferred Plus Plan | PPO | 35853MO0040003 | Yes |
| Missouri Preferred Plus Plan (Pediatric Only) | PPO | 35853MO0050003 | Yes |
| Missouri Wellness Essentials Plan | PPO | 35853MO0070001 | Yes |
| New Hampshire Preferred Plan | PPO | 72953NH0040002 | Yes |
| New Hampshire Preferred Plan (Pediatric Only) | PPO | 72953NH0060002 | Yes |
| New Hampshire Preferred Plus Plan | PPO | 72953NH0040001 | Yes |
| New Hampshire Preferred Plus Plan (Pediatric Only) | PPO | 72953NH0060001 | Yes |
| Oklahoma Preferred Plan | PPO | 13711OK0040003 | Yes |
| Oklahoma Preferred Plan (Pediatric Only) | PPO | 13711OK0050002 | Yes |
| Oklahoma Wellness Essentials (On Exchange) | PPO | 13711OK0100001 | Yes |
| South Carolina Preferred Plan | PPO | 97325SC0060004 | Yes |
| South Carolina Preferred Plan (Pediatric Only) | PPO | 97325SC0070004 | Yes |
| South Carolina Preferred Plus Plan | PPO | 97325SC0060003 | Yes |
| South Carolina Preferred Plus Plan (Pediatric Only) | PPO | 97325SC0070003 | Yes |
| South Carolina Wellness Essentials Plan | PPO | 97325SC0090001 | Yes |
| Texas Preferred Plan | PPO | 40540TX0060005 | Yes |
| Texas Preferred Plan (Pediatric Only) | PPO | 40540TX0070004 | Yes |
| Texas Preferred Plus Plan | PPO | 40540TX0060003 | Yes |
| Texas Preferred Plus Plan (Pediatric Only) | PPO | 40540TX0070003 | Yes |
| Texas Wellness Essentials Plan | PPO | 40540TX0100001 | Yes |
| Utah Preferred Plan | PPO | 87169UT0040004 | Yes |
| Utah Preferred Plan (Pediatric Only) | PPO | 87169UT0050004 | Yes |
| Utah Preferred Plus Plan | PPO | 87169UT0040003 | Yes |
| Utah Preferred Plus Plan (Pediatric Only) | PPO | 87169UT0050003 | Yes |
| Wisconsin Preferred Plan | PPO | 34210WI0040003 | Yes |
| Wisconsin Preferred Plan (Pediatric Only) | PPO | 34210WI0050002 | Yes |
| Wisconsin Wellness Essentials | PPO | 34210WI0070001 | Yes |
| Wyoming Preferred Plan | PPO | 80132WY0040004 | Yes |
| Wyoming Preferred Plan (Pediatric Only) | PPO | 80132WY0050004 | Yes |
| Wyoming Preferred Plus Plan | PPO | 80132WY0040003 | Yes |
| Wyoming Preferred Plus Plan (Pediatric Only) | PPO | 80132WY0050003 | Yes |