Each Medicare Advantage and Medicare drug plan has a CMS-assigned ID consisting of a Plan ID, Contract ID, and Segment ID. This unique identifier indicates the network type, provider, plan, and region the plan is offered in.[1][2]

They look like this ContractID-PlanID-SegmentID (ex. H8768-015-000 or H8768-015-0).

1. The first letter of the Contract ID indicates the network type:

  • H or 9: Local Managed Care Organizations other than Regional PPO
  • R: Regional preferred provider organization (PPO)
  • S: Stand-alone prescription drug plan (PDP)
  • E: Employer direct plan
  • F: Employer-Directed PDP
  • X: Limited Income Newly Eligible Transition plan

In most cases, you’ll see H and R on Advantage plans and S on stand-alone drug plans.

With H8768-015-000 we can know is not a regional PPO (it happens to be a local PPO).

2. The next part of the contract ID indicates the organization providing the coverage. With H8768-015-000, 8768 is United HealthCare.

3. Next is the plan ID. Plan ID is a unique identifier of the plan. With H8768-015-000, that is AARP Medicare Advantage Walgreens (PPO).

4. Lastly, the Segment ID indicates the region. With H8768-015-000, the 000 indicates select locations in Ohio. Although it is important to note that 000 does not always mean Ohio, the meaning of a Segment ID is unique to a Plan ID/Contract ID combination. TIP: If you don’t see a segment ID, it probably means the plan is offered across the US or there are no regional options (you are essentially looking at the 000 version of the plan).

Citations

  1. Medicare Part C Contract Number. resdac.org.
  2. Plan Contract ID. resdac.org.