INSURANCE CARD TYPICAL NAME PRODUCT TYPE UCMC WCH TDC UCPC

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1 INSURANCE CARD TYPICAL NAME PRODUCT TYPE UCMC WCH TDC UCPC 3-hab Ohio Worker's Comp ID Card Worker's Comp YES YES YES YES AARP Medicare Complete (underwiritten by United Health Care Medicare Advantage YES YES YES YES AARP (Supplemental underwritten by United Healthcare) Commercial YES YES YES YES My Care Ohio (Aetna logo) Aetna Better Health of Ohio Dual Medicaid portion YES YES YES YES My Care Ohio (Aetna logo) Aetna Better Health of Ohio (Medicare logo on card) Dual Medicare portion YES YES YES YES Aetna Cincinnati Preferred All YES YES YES YES Aetna Medicare SERS Aetna Medicare OPERS Aetna Medicare STRS PPO Aetna Medicare PFFS (no contract so it is our choice to treat) Medicare YES YES YES YES Aetna - Transplant Transplant YES YES YES Transplant Only Aetna Open Access Aetna Select All YES YES YES YES Alliance Behavioral Care Behavioral Amerigroup Amerigroup Cimmunity Care Amerigroup Real Solutions OH Managed Medicaid Anthem BC/BS Blue Cross Blue Shield BC/BS Blue Traditional BC/BS Federal Employee Program Commercial YES YES YES YES BCBS Blue Priority Anthem Blue Priority Blue Priority HMO Transplant only YES Blue Access Value Medicare Anthem Liver Transplant Transplant YES Transplant Only Anthem Medicaid with YRH or YRK prefix on member ID Managed Medicaid PCP only Anthem Medicaid with XTF prefix on member ID Managed Medicaid Anthem Senior Advantage HMO Anthem Medicare Preferred PPO Medicare Select Anthem Pathway X Tiered Pathway Tiered OH Health Exchange Transplant only Anthem BCBS Senior Advantage Senior Advantage and PPO YES Beech Street All YES YES YES YES

2 Bluegrass Family Health KY Exchange Advantage by Buckeye Community Health Plan Managed Medicare YES YES YES YES YES YES YES YES AmBetter Buckeye OH Health Exchange Buckeye MyCare Ohio - Medicaid (back of card says Medicaid Member Only) YES YES YES YES Dual Medicaid portion YES YES YES YES Buckeye MyCare Ohio - Medicare Dual Medicare portion YES YES YES YES Buckeye Community Health Plan OH Managed Medicaid CareSource OH Managed Medicaid YES YES YES YES CareSource Managed Medicare SNP OH Medicare and SNP YES Just 4 Me CareSource OH Health Exchange Center Care All YES YES YES YES Choice Care Humana All YES YES YES YES United States Uniformed Services Tricare Healthnet Prime or Standard Tricare Champus All YES YES YES YES All CIGNA commercial, except Behavioral All YES YES YES YES CIGNA Behavioral Behavioral CIGNA Lifesource Transplant Transplant YES Concert Health Plan All YES YES YES YES Coventry Cares KY Managed Medicaid YES YES YES YES Crossroads Hospice Hospice YES YES YES True Cost Commercial Destiny Hospice Hospice YES YES YES DCA or Direct Care America Chandler Group Interplan Ohio Com Network All YES YES YES YES

3 HealthSmart logo Emerald Health Network logo Indiana State Council of Roofers Health and Welfare All YES YES YES YES Evercare Hospice Hospice YES YES YES First Health All YES YES YES First Health - worker's comp noted Worker's Comp YES YES YES Great West CIGNA One Health All YES YES YES YES HealthSpan PPO HealthSpan Preferred HealthSpan Butler Health Plan HealthSpan All YES YES YES YES HealthSpan Select OH Health Exchange Heartland Hospice Hospice YES YES YES MDwise Hoosier IN Managed Medicaid YES YES YES PBP MDwise Marketplace IN Health Exchange Horizon Behavioral Services Behavioral Hospice of Bluegrass Hospice YES Hospice of Cincinnati Hospice YES YES YES Hospice of Dayton Hospice YES YES YES Hospice of Hope Hospice YES YES YES Hospice of Middletown Hospice YES YES YES Hospice of Soutwest Ohio Hospice YES YES YES Humana All Other Commercial YES YES YES YES ChoiceCare Humana All YES Humana HMOx OH Health Exchange

4 Humana Gold Plus HMO OH Managed Medicare Humana Gold Choice PFFS Medicare YES YES YES YES Humana PPO Medicare YES YES YES YES Humana National Transplant Transplant Transplant only Transplant Only Humana Preferred POS or PPO Commercial Humana TriHealth Commercial CareSource Humana KY Managed Medicaid Interlink - Transplant Transplant Transplant only Transplant Only Kentucky Health Cooperative KY Exchange YES YES YES Kentucky Spirit KY Managed Medicaid Klais Health Network All Workers Comp Ky Worker's Comp Humana Life Synch Behavioral YES YES Maple Knoll All YES YES YES YES Medical Mutual Market OH Health Exchange YES YES YES YES Medical Mutual PFFS Medicare Medical Mutual Medical Mutual Supermed PPO Medical Mutual Access Mail Handlers Benefits Plan for Hospital/not Behavioral All YES YES YES YES Careworks BWC Bureau of Workers Comp Ohio Worker's Comp YES YES YES YES MetraComp Worker's Comp Molina MyCare Molina Dual Medicaid portion YES YES YES YES Molina MyCare Molina Dual Medicare portion YES YES YES YES Molina Medicaid Managed Medicaid YES YES YES YES

5 Molina Medicare Managed Medicare YES YES YES YES Molina Marketplace Molina Healthcare OH Health Exchange YES YES YES YES MultiPlan - Transplant Transplant Transplant only Transplant only BCE Emergis UP & UP Foremost Pro-America Health Network BPS Wellmark Ohio Health Med Network All YES YES YES YES Mutual of Omaha Commercial Plan Care America or NPPN All YES YES YES YES Ohio Employee Health Partnership Worker's Comp Ohio Health Choice Access Ohio Health Choice Preferred Ohio Health Choice Select All YES YES YES YES Paramount Advantage OH Managed Medicaid YES YES YES YES Paramount HMO Network Group number begins with "IX" OH Health Exchange Physicians Mutual Commercial Cofinity PPOM All YES YES YES YES CareWorks BWC Worker's Comp PHCS Private Healthcare Systems All Protocol Tertiary Network - Transplant Transplant Transplant only YES Transplant only Provider Select All YES YES YES YES Sagamore Health All YES YES YES YES Summit Behavioral on back of card Behavioral Three Rivers District All TRPN Three Rivers Three Rivers Provider Network All YES YES YES YES UMR UC Health All YES YES YES YES

6 United Healthcare with Mental Health notation Optum Behavioral YES YES UHC Select Medicare UHC Secure Horizons UHC Medicare PPO Comp UHC Medicare UHC Medicare PFFS AARP Medicare Advantage Medicare Advantage YES YES YES YES United Healthcare Other United Hlthcare Choice United Hlthcare Select United Hlthcare PPO UHC United Medical Resource United Hlthcare Indemnity United Hlthcare River Valley United Hlthcare Student Resource (UC Students) Commercial YES YES YES YES UHC Community Care OH Medicaid United Resource Networks (URN) Optum - Transplant Transplant Transplant only YES Transplant only USA Commercial USA Medicare USA Work Comp All YES YES YES YES Value Options Behavioral Vista Care USA Hospice Vitas Hospice Hospice YES YES YES WellCare Medicaid KY Managed Medicaid YES YES YES YES WellCare Medicare OH Managed Medicare YES YES YES YES Western Southern Financial Group All YES YES YES YES