Humana Inc.
Plan ID: H8145-6-0
2025 Humana Gold Choice H8145-006 (PFFS) H8145 — 006 — 0 is a Medicare Advantage plan with drug coverage. It has received a 4-out-of-5 star rating from CMS for 2025.
Learn more about Humana Gold Choice H8145-006 (PFFS) H8145 - 006 - 0, including the health and drug services it covers, by reading our easy-to-use guide. Or contact a licensed insurance agent for help now.
4 / 5 stars for 2025
$38.00 /mo
Monthly premium
$590.00
Drug deductible
$7000.00
Out-of-pocket maximum (Combined)
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2025 Humana Gold Choice H8145-006 (PFFS) H8145 — 006 — 0 is a PFFS offered in Multi-State by Humana Inc.. It has a monthly premium of $38.00.
Standard Part B Premium
$185.00
Part B premium reduction
- $0
Monthly Plan Premium
$38.00
Total Premium:
$223.00
Note:
The standard Medicare Part B premium for 2025 is $185.00. Your premium may differ based on factors like late enrollment, income (IRMAA), or disability status. Most people enrolled in Medicare Part B are required to pay this premium.
Special needs plan type
No
Out-of-pocket maximum (In-Network)
N/A
Out-of-pocket maximum (Out-of-Network)
N/A
Out-of-pocket maximum (Combined)
$7000.00
Plan Organization:
Humana Inc.
Plan Type:
PFFS
Location:
Multi-State
Drugs Covered:
Yes
Drug Formulary:
Pharmacies:
Doctors Link:
Not yet released
The amount you must pay each year before your plan starts to pay for covered services or drugs.
Drug deductible
$590
Note:
This plan does not charge an annual deductible for all drugs. The $590.00 annual deductible only applies to drugs in certain tiers.
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Humana Gold Choice H8145-006 (PFFS) provides the following cost-sharing on drugs. Please check the plan’s formulary for specific drugs covered.
Drug Benefit Type
Enhanced Alternative
Prescription drug deductible
$590.00
This plan's premium may be reduced for you if you qualify for the low-income subsidy (also known as LIS or "Extra help"). The following is what you'll pay for with LIS.
Part D | LIS Full |
---|---|
$26.90 | $26.90 |
After you pay your $590.00 drug deductible, you will pay the following costs for drugs in each tier until your total drug costs (including what this plan has paid and what you have paid) reach $2000.00. Once you reach that amount, you will enter the next coverage phase.
Tier | Preferred Pharmacy | Standard Pharmacy | Preferred Mail | Standard Mail |
---|---|---|---|---|
1. Preferred Generic | - | $15.00 copay | $15.00 copay | $20.00 copay |
2. Standard Generic | - | $47.00 copay | $47.00 copay | $47.00 copay |
3. Preferred Brand | - | 50% coinsurance | 50% coinsurance | 50% coinsurance |
4. Non-Preferred Drug | - | 25% coinsurance | 25% coinsurance | 25% coinsurance |
5. Specialty Tier | - | - | - | - |
After your yearly out-of-pocket drug costs (including drugs purchased through your retail pharmacy and through mail order) reach $2000.00, you pay nothing for Medicare Part D covered drugs. However, you may still pay a share of the costs for excluded drugs covered under any enhanced benefit.
Humana Gold Choice H8145-006 (PFFS) also provides the following benefits.
Hearing Services benefits are covered.
Hearing Exams benefits are covered – including services not usually covered by Medicare plans.
Cost Sharing:
More Details:
Which Hearing Exam Benefits have a Copayment
Medicare-covered Benefits, Routine Hearing Exams, Fitting/Evaluation for Hearing Aid
Is there a deductible?
No
Is there a deductible?
No
Is there a maximum plan benefit coverage?
No
Routine Hearing Exams benefits are covered.
More Details:
Is this benefit unlimited?
No, indicate number
Number of visits
1
Periodicity
Every year
Minimum copayment
0.00
Maximum copayment
0.00
Fitting/Evaluation for Hearing Aid benefits are covered.
More Details:
Is this benefit unlimited?
Yes
Minimum copayment
0.00
Maximum copayment
0.00
Prescription Hearing Aids benefits are covered – including services not usually covered by Medicare plans.
Cost Sharing:
More Details:
Service maximum plan benefit coverage
No
Prescription Hearing Aids (all types) benefits are covered.
More Details:
Is this benefit unlimited?
No, indicate number
Number of visits
2
Periodicity
Every year
Minimum copayment
699.00
Maximum copayment
999.00
Not covered.
Not covered.
Not covered.
Not covered.
Vision Services benefits are covered.
Eye Exams benefits are covered – including services not usually covered by Medicare plans.
Cost Sharing:
More Details:
Which Eye Exams have a Copayment
Routine Eye Exams, Other
Is there a deductible?
No
Is there a deductible?
No
Is there a maximum plan benefit coverage?
Yes
Maximum plan benefit coverage type
Both In-network and Out-of-network services
Maximum amount
75.00
Periodicity
Every year
Routine Eye Exams benefits are covered.
Cost Sharing:
More Details:
Is this benefit unlimited?
No, indicate number
Number of visits
1
Periodicity
Every year
Eyewear benefits are covered – including services not usually covered by Medicare plans.
Cost Sharing:
More Details:
Which Eyewear Benefits have a Copayment
Contact lenses, Eyeglasses (lenses and frames), Eyeglass lenses
Is there a deductible?
No
Is there a deductible?
No
Is there a maximum plan benefit coverage?
Yes
Does the Maximum Plan Benefit Coverage amount apply to In-network services only OR does it apply to both In-network and Out-of-network services?
Both In-network and Out-of-network services
Maximum plan benefit coverage type
Plan-specified amount per period
Do you offer a Combined Max Plan Benefit Coverage Amount for all Eyewear?
Yes
Combined maximum amount
100.00
Periodicity
Every year
Contact Lenses benefits are covered.
Cost Sharing:
More Details:
Is this benefit unlimited?
No, indicate number
Number of pairs
1
Periodicity
Every year
Eyeglasses (lenses and frames) benefits are covered.
Cost Sharing:
More Details:
Is this benefit unlimited?
No, indicate number
Number of pairs
1
Periodicity
Every year
Not covered.
Not covered.
Not covered.
Dental Services benefits are covered.
Medicare Dental Services benefits are covered.
Cost Sharing:
Other Dental Services benefits are covered.
More Details:
Is there a maximum plan benefit coverage?
Yes
Does the maximum plan benefit coverage amount apply to in-network services only or does it apply to both in-network and out-of-network services
Both in-network and out-of-network services
Maximum amount
3000.00
Periodicity
Every year
Oral Exams benefits are covered.
Cost Sharing:
More Details:
Is this benefit unlimited?
No
Number of visits
4
Periodicity
Every year
Dental X-Rays benefits are covered.
Cost Sharing:
More Details:
Is this benefit unlimited?
No
Number of X-Rays
3
Periodicity
Other, Describe
Description
bitewing x-rays, intraoral x-rays 1 set(s)/yr, pano film/diag x-rays 1/5 yrs
Other Diagnostic Dental Services benefits are covered.
Cost Sharing:
More Details:
Is this benefit unlimited?
No
Number of visits
1
Periodicity
Every three years
Prophylaxis (Cleaning) benefits are covered.
Cost Sharing:
More Details:
Is this benefit unlimited?
No
Number of visits
2
Periodicity
Every year
Not covered.
Other Preventive Dental Services benefits are covered.
Cost Sharing:
More Details:
Is this benefit unlimited?
No
Number of visits
4
Periodicity
Every year
Orthodontic Services benefits are covered.
More Details:
Is there a maximum plan benefit coverage?
Yes
Maximum plan benefit coverage type
Covered under Diagnostic and Preventive Dental (16b)
Restorative Services benefits are covered.
Cost Sharing:
More Details:
Is this benefit unlimited?
No
Number of visits
4
Periodicity
Other, Describe
Description
core buildup/prefab post/core 1/tooth/5 yrs, crown recement 1/2 years, crown-1/tooth/5 yrs, filling 1/tooth/2 yrs
Adjunctive General Services benefits are covered.
Cost Sharing:
More Details:
Is this benefit unlimited?
No
Number of visits
5
Periodicity
Other, Describe
Description
emerg treatment for pain, necessary anesthesia with covered service 2/yr, occlusal adj 1/lifetime
Endodontics benefits are covered.
Cost Sharing:
More Details:
Is this benefit unlimited?
No
Number of visits
2
Periodicity
Other, Describe
Description
root canal, root canal retreat 1/tooth/lifetime
Periodontics benefits are covered.
Cost Sharing:
More Details:
Is this benefit unlimited?
No
Number of visits
2
Periodicity
Other, Describe
Description
scaling for mod inflammation 1/yr, scaling/root planing 1 per quadrant/3 yrs
Prosthodontics, removable benefits are covered.
Cost Sharing:
More Details:
Is this benefit unlimited?
No
Number of visits
8
Periodicity
Other, Describe
Description
comp dentures, part dentures 1/5 yrs, denture adj 2/yr, rebase, reline, repair, tissue cond 1/yr
Coinsurance percentage
30
Not covered.
Not covered.
Prosthodontics, fixed benefits are covered.
Cost Sharing:
More Details:
Is this benefit unlimited?
No
Number of visits
4
Periodicity
Other, Describe
Description
bridge recement 1/yr, bridges-pontic 1/5 yrs, bridges-crown 2/5 yrs
Oral and Maxillofacial Surgery benefits are covered.
Cost Sharing:
More Details:
Is this benefit unlimited?
No
Number of visits
3
Periodicity
Other, Describe
Description
extractions 1/tooth/lifetime, oral surg 2/yr
Not covered.
Home Infusion bundled Services benefits are covered.
Cost Sharing:
More Details:
Which Medicare Part B Rx Drugs have a Coinsurance
Medicare Part B Chemotherapy/Radiation Drugs, Other Medicare Part B Drugs
Does this plan have a service specific maximum enrollee out-of-pocket cost (MOOP)?
No
Does the plan offer step therapy?
Yes
Does the benefit step from?
Part B to Part D
Insulin benefits are covered.
Medicare Part B Insulin Drugs benefits are covered.
Cost Sharing:
More Details:
Minimum coinsurance
0
Maximum coinsurance
20
Does the Part B drugs - Insulin cost sharing count towards any plan-level deductible?
No
Medicare Part B Chemotherapy/Radiation Drugs benefits are covered.
More Details:
Minimum coinsurance
0
Maximum coinsurance
20
Other Medicare Part B Drugs benefits are covered.
More Details:
Minimum coinsurance
0
Maximum coinsurance
20
Preventive Services benefits are covered.
Not covered.
Annual Physical Exam benefits are covered – including services not usually covered by Medicare plans.
Cost Sharing:
More Details:
Is there a maximum plan benefit coverage amount?
No
Additional Preventive Services benefits are covered – including services not usually covered by Medicare plans.
Cost Sharing:
More Details:
Which Other Defined Supplemental Benefits have a Copayment
14c4: Fitness Benefit*
Is there a service-specific Maximum Plan Benefit Coverage amount for Other Defined Supplemental Benefits?
No
Not covered.
Not covered.
Not covered.
Not covered.
Not covered.
Not covered.
Not covered.
Not covered.
Not covered.
Not covered.
Not covered.
Not covered.
Not covered.
Not covered.
Not covered.
Not covered.
Fitness Benefit benefits are covered.
More Details:
Type of Fitness Benefit offered
Memory Fitness
Minimum copayment
0.00
Maximum copayment
0.00
Not covered.
Not covered.
Not covered.
Not covered.
Not covered.
Kidney Disease Education Services benefits are covered.
Cost Sharing:
More Details:
Minimum copayment
0.00
Maximum copayment
0.00
Other Preventive Services benefits are covered.
Cost Sharing:
More Details:
Which Services have a Copayment
Medicare-covered Glaucoma Screening, Medicare-covered Diabetes Self-Management Training, Medicare-covered Barium Enemas, Medicare-covered Digital Rectal Exams, Medicare-covered EKG following Welcome Visit
Glaucoma Screening benefits are covered.
More Details:
Minimum copayment
0.00
Maximum copayment
0.00
Diabetes Self-Management Training benefits are covered.
More Details:
Minimum copayment
0.00
Maximum copayment
0.00
Barium Enemas benefits are covered.
More Details:
Minimum copayment
0.00
Maximum copayment
0.00
Digital Rectal Exams benefits are covered.
More Details:
Minimum copayment
0.00
Maximum copayment
0.00
EKG following Welcome Visit benefits are covered.
More Details:
Minimum copayment
0.00
Maximum copayment
0.00
Other Services benefits are covered.
Acupuncture benefits are covered – including services not usually covered by Medicare plans.
Cost Sharing:
More Details:
Is this benefit unlimited for Number of Treatments?
No
Limit for Number of Treatments
20
Periodicity
Every year
Is there a maximum plan benefit coverage amount?
No
Not covered.
Meal Benefit benefits are covered.
Cost Sharing:
More Details:
Does the plan provide a limited duration Meal Benefit as a supplemental benefit under Part C? Note: Only primarily health-related meals offered in accordance with Chapter 4 of the MMCM should be entered in this section.
Yes
Type of primarily health related meals benefit offered
For a chronic illness
Is there a maximum plan benefit coverage amount?
No
Not covered.
Dialysis Services benefits are covered.
Cost Sharing:
More Details:
Minimum coinsurance
20
Maximum coinsurance
20
Medical Equipment benefits are covered.
Durable Medical Equipment (DME) benefits are covered.
More Details:
Is there a coinsurance?
Yes
Minimum coinsurance
20
Maximum coinsurance
20
Is there a copayment ?
No
Are there preferred vendors/manufacturers for Durable Medical Equipment (DME)?
No
Not covered.
Prosthetics/Medical Supplies - Non-Medicare benefit benefits are covered.
More Details:
Is there a coinsurance?
Yes
Which Prosthetics/Medical Supplies have a Coinsurance
Medicare-covered Prosthetic Devices, Medicare-covered Medical Supplies
Is there a copayment ?
No
Prosthetic Devices benefits are covered.
More Details:
Minimum coinsurance
20
Maximum coinsurance
20
Medical Supplies benefits are covered.
Cost Sharing:
Diabetic Equipment benefits are covered.
Cost Sharing:
More Details:
Which Diabetic Supplies and Services have a Coinsurance
Medicare-covered Diabetic Therapeutic Shoes or Inserts
Which Diabetic Supplies and Services have a Copayment
Medicare-covered Diabetes Supplies, Medicare-covered Diabetic Therapeutic Shoes or Inserts
Do you limit Diabetic supplies and services to those from specified manufacturers
Yes
Diabetic Supplies benefits are covered.
More Details:
Minimum coinsurance
10
Maximum coinsurance
10
Minimum copayment
0.00
Maximum copayment
0.00
Diabetic Therapeutic Shoes/Inserts benefits are covered.
More Details:
Minimum copayment
0.00
Maximum copayment
0.00
Ambulance and Transportation Services benefits are covered.
All Ambulance Services benefits are covered.
More Details:
Is there a coinsurance?
Yes
Which Services have a Coinsurance
Medicare-covered Ground Ambulance Services
Is this Coinsurance waived if admitted to hospital?
No
Is there a copayment ?
Yes
Which Services have a Copayment
Medicare-covered Air Ambulance Services
Is this Copayment waived if admitted to hospital?
No
Ground Ambulance Services benefits are covered.
Cost Sharing:
Air Ambulance Services benefits are covered.
Cost Sharing:
Transportation Services benefits are covered.
Not covered.
Not covered.
Outpatient Services benefits are covered.
All Outpatient Hospital Services benefits are covered.
Cost Sharing:
More Details:
Which Services have a Copayment
Medicare-covered Outpatient Hospital Services, Medicare-covered Observation Services
Outpatient Hospital Services benefits are covered.
Cost Sharing:
Observation Services benefits are covered.
Cost Sharing:
More Details:
Periodicity
Per stay
Ambulatory Surgical Center (ASC) Services benefits are covered.
Cost Sharing:
Outpatient Substance Abuse Services benefits are covered.
Cost Sharing:
More Details:
Which Outpatient Substance Abuse services have a Copayment
Medicare-covered Individual Sessions, Medicare-covered Group Sessions
Individual Sessions for Outpatient Substance Abuse benefits are covered.
More Details:
Minimum copayment
45.00
Maximum copayment
95.00
Group Sessions for Outpatient Substance Abuse benefits are covered.
More Details:
Minimum copayment
45.00
Maximum copayment
95.00
Outpatient Blood Services benefits are covered – including services not usually covered by Medicare plans.
Cost Sharing:
More Details:
Enhanced benefit
Three (3) Pint Deductible Waived
Diagnostic and Radiological Services benefits are covered.
All Diagnostic services benefits are covered.
More Details:
Is there a copayment?
Yes
Which Outpatient Diagnostic Procedures/Tests/Lab Services have a Copayment
Medicare-covered Diagnostic Procedures/Tests, Medicare-covered Lab Services
If a member receives multiple services at the same location on the same day, does only the maximum copay apply?
Yes
Diagnostic Procedures/Tests benefits are covered.
More Details:
Minimum copayment
0.00
Maximum copayment
95.00
Lab Services benefits are covered.
Cost Sharing:
All Radiological Services benefits are covered.
Cost Sharing:
More Details:
Which Outpatient Diagnostic/Therapeutic Radiological Services have a Coinsurance
Medicare-covered Therapeutic Radiological Services, Medicare-covered X-Ray Services
Is there a copayment?
Yes
Which Outpatient Diagnostic/Therapeutic Radiological Services have a Copayment
Medicare-covered Diagnostic Radiological Services, Medicare-covered Therapeutic Radiological Services
If a member receives multiple services at the same location on the same day, does only the maximum copay apply?
Yes
Diagnostic Radiological Services benefits are covered.
Cost Sharing:
More Details:
Minimum coinsurance
20
Minimum copayment
0.00
Therapeutic Radiological Services benefits are covered.
Cost Sharing:
More Details:
Minimum coinsurance
20
Outpatient X-Ray Services benefits are covered.
Cost Sharing:
Primary Care benefits are covered.
Primary Care Physician Services benefits are covered.
Cost Sharing:
Chiropractic Services benefits are covered.
Cost Sharing:
More Details:
Which Chiropractic Services have a Copayment
Routine Care
Not covered.
Occupational Therapy Services benefits are covered.
More Details:
Is there a coinsurance?
No
Is there a copayment ?
Yes
Minimum copayment
35.00
Maximum copayment
35.00
Physician Specialist Services benefits are covered.
Cost Sharing:
Mental Health Specialty Services benefits are covered.
Cost Sharing:
More Details:
Which Mental Health Specialty Services have a Copayment
Medicare-covered Individual Sessions, Medicare-covered Group Sessions
Individual Sessions for Mental Health Specialty Services benefits are covered.
More Details:
Minimum copayment
45.00
Maximum copayment
45.00
Group Sessions for Mental Health Specialty Services benefits are covered.
More Details:
Minimum copayment
45.00
Maximum copayment
45.00
Not covered.
Other Health Care Professional benefits are covered.
Cost Sharing:
More Details:
Minimum copayment
0.00
Maximum copayment
55.00
Psychiatric Services benefits are covered.
Cost Sharing:
More Details:
Which Psychiatric Services have a Copayment
Medicare-covered Individual Sessions, Medicare-covered Group Sessions
Individual Sessions for Psychiatric Services benefits are covered.
More Details:
Minimum copayment
45.00
Maximum copayment
45.00
Group Sessions for Psychiatric Services benefits are covered.
More Details:
Minimum copayment
45.00
Maximum copayment
45.00
Physical Therapy and Speech-Language Pathology Services benefits are covered.
Cost Sharing:
More Details:
Is there a coinsurance?
No
Is there a copayment ?
Yes
Additional Telehealth Benefits benefits are covered – including services not usually covered by Medicare plans.
Cost Sharing:
More Details:
Medicare-covered benefits that may have Additional Telehealth Benefits available
4b: Urgently Needed Services, 7a: Primary Care Physician Services, 7d: Physician Specialist Services, 7e1: Individual Sessions for Mental Health Specialty Services, 7e2: Group Sessions for Mental Health Specialty Services, 7h1: Individual Sessions for Psychiatric Services, 7h2: Group Sessions for Psychiatric Services, 9c1: Individual Sessions for Outpatient Substance Abuse, 9c2: Group Sessions for Outpatient Substance Abuse
Opioid Treatment Program Services benefits are covered.
Cost Sharing:
More Details:
Minimum copayment
45.00
Maximum copayment
95.00
Home Health Services benefits are covered.
Cost Sharing:
More Details:
Is there a coinsurance?
No
Is there a copayment ?
Yes
Authorization required for this benefit?
No
Referral required for this benefit?
No
Not covered.
Not covered.
Partial Hospitalization benefits are covered.
Cost Sharing:
Emergency Services benefits are covered.
Emergency Services benefits are covered.
Cost Sharing:
More Details:
Is there a coinsurance?
No
Is there a copayment?
Yes
Is the copayment for Medicare-covered benefits waived if admitted to hospital?
No
Does the cost sharing count towards any plan-level deductible?
No
Urgently Needed Services benefits are covered.
Cost Sharing:
More Details:
Is there a coinsurance?
No
Is there a copayment?
Yes
Is the copayment for Medicare-covered benefits waived if admitted to hospital?
No
Does the cost sharing count towards any plan-level deductible?
No
Worldwide Emergency Services benefits are covered – including services not usually covered by Medicare plans.
Cost Sharing:
More Details:
Which Worldwide Services have a Copayment
Worldwide Emergency Coverage, Worldwide Urgent Coverage, Worldwide Emergency Transportation
Is there a maximum plan benefit coverage?
No
Worldwide Emergency Coverage benefits are covered.
Cost Sharing:
Worldwide Urgent Coverage benefits are covered.
Cost Sharing:
Worldwide Emergency Transportation benefits are covered.
Cost Sharing:
Cardiac Rehabilitation Services benefits are covered.
Cost Sharing:
More Details:
Which Cardiac and Pulmonary Rehabilitation Services have a Copayment
Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, Additional Cardiac Rehabilitation Services
Not covered.
Not covered.
Not covered.
Not covered.
Skilled Nursing Facility (SNF) benefits are covered.
Cost Sharing:
Days 1-20: | Days 21-100: | |
---|---|---|
Copayment | 0.00 | 203.00 |
More Details:
Does the plan provide Skilled Nursing Facility Services as a supplemental benefit under Part C?
No
Do you allow less than 3 day inpatient hospital stay prior to SNF admission?
Yes
Days
Zero
Do you charge the Medicare-defined cost share for tier 1?
No
Periodicity
Original Medicare
Not covered.
Not covered.
Inpatient Hospital benefits are covered.
Inpatient Hospital-Acute benefits are covered – including services not usually covered by Medicare plans.
Cost Sharing:
Days 1-7: | Days 8-90: | |
---|---|---|
Copayment | 230.00 | 0.00 |
More Details:
Enhanced benefits
Non-Medicare-covered Stay
Do you charge the Medicare-defined cost share for tier 1?
No
Copayment for Medicare-covered stay
0.00
Periodicity
Per Admission or Per Stay
Do you charge cost sharing on the day of discharge?
No
Additional Days for Inpatient Hospital-Acute benefits are covered.
Days 91-999: | |
---|---|
Copayment | 0.00 |
More Details:
Is this benefit unlimited?
Yes
Number of day intervals for Additional Days
One
Not covered.
Not covered.
Inpatient Hospital Psychiatric benefits are covered.
Cost Sharing:
Days 1-7: | Days 8-90: | |
---|---|---|
Copayment | 230.00 | 0.00 |
More Details:
Do you charge the Medicare-defined cost share for tier 1?
No
Copayment for Medicare-covered stay
0.00
Periodicity
Per Admission or Per Stay
Do you charge cost sharing on the day of discharge?
No
Not covered.
Not covered.
Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross Blue Shield, Anthem Blue Cross, Aspire Health Plan, Capital Blue Cross, Cigna Healthcare, Dean Health Plan, Devoted Health, Florida Blue Medicare, GlobalHealth, Health Care Service Corporation, Healthy Blue, Humana, Molina Healthcare, Mutual of Omaha, Premera Blue Cross, Medica Central Health Plan, SCAN Health Plan, Baylor Scott & White Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint.
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