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Medical Plans Coverage Codes

For up to date coverage codes, please visit HHIN+.

Quick Links to Coverage Code tables

GRANDFATHERED (GF) COVERAGE CODES

Codes 2022 2023 2024 2025
348 GF GF GF GF
357 GF GF GF GF
420 GF GF GF GF
421 GF GF GF GF
445 GF GF GF GF
446 N/A GF GF GF
448 N/A N/A GF GF
521 GF GF GF GF
522 GF GF GF GF
523 GF GF GF GF
532 GF GF GF GF
558 GF GF GF GF
597 GF GF GF GF
612 GF GF GF GF
613 GF GF GF GF
614 GF GF CLOSED N/A
615 GF GF CLOSED N/A
650 GF GF CLOSED N/A
651 GF GF GF GF
669 GF GF GF GF
673 GF GF GF GF
674 GF GF CLOSED N/A
676 GF GF GF GF
682 GF GF GF GF
683 GF GF GF GF
685 GF GF GF GF
686 GF GF GF GF
687 GF GF GF GF
719 GF GF GF GF
742 GF GF GF GF
760 GF GF GF GF
761 GF GF GF GF
763 GF GF GF GF
764 GF GF CLOSED N/A
767 GF GF GF GF
778 GF GF GF GF
779 GF GF CLOSED N/A
832 GF GF GF GF
E-A GF GF GF GF
E-S GF GF GF GF
E-T GF GF CLOSED N/A
E-X GF GF GF GF
K-A GF GF CLOSED N/A
R-E GF GF CLOSED N/A
R-M GF GF GF GF
X-P GF GF CLOSED N/A
X-Y GF GF GF GF
Y-Q GF GF GF GF
Y-T GF GF GF GF

GRANDMOTHERED (GM) TRANSITIONAL COVERAGE CODES

Codes 2022 2023 2024 2025
474 N/A N/A GM Transitional GM Transitional
477 N/A N/A GM Transitional GM Transitional
503 GM Transitional GM Transitional GM Transitional GM Transitional
505 GM Transitional GM Transitional GM Transitional GM Transitional
736 GM Transitional GM Transitional GM Transitional GM Transitional
749 GM Transitional GM Transitional GM Transitional GM Transitional
756 GM Transitional GM Transitional GM Transitional GM Transitional
766 GM Transitional GM Transitional GM Transitional GM Transitional
854 GM Transitional GM Transitional CLOSED N/A
E-C GM Transitional GM Transitional GM Transitional GM Transitional
E-W GM Transitional GM Transitional GM Transitional GM Transitional
Q-Z N/A N/A GM Transitional GM Transitional
S-X GM Transitional GM Transitional GM Transitional GM Transitional
Z-M GM Transitional GM Transitional GM Transitional GM Transitional

NON-GRANDFATHERED (NGF) COVERAGE CODES

Codes 2022 2023 2024 2025
340 NGF NGF NGF NGF
342 NGF NGF NGF NGF
343 NGF NGF NGF NGF
346 NGF NGF NGF NGF
349 NGF NGF NGF NGF
351 NGF NGF NGF NGF
354 NGF NGF NGF NGF
355 NGF NGF NGF NGF
356 NGF NGF NGF NGF
359 NGF NGF NGF NGF
419 NGF NGF NGF NGF
422 NGF NGF NGF NGF
423 NGF NGF NGF NGF
424 NGF NGF NGF NGF
425 NGF NGF NGF NGF
427 NGF NGF NGF NGF
428 NGF NGF CLOSED N/A
431 NGF NGF NGF NGF
432 NGF NGF NGF NGF
434 NGF NGF NGF NGF
435 NGF NGF NGF NGF
437 N/A NGF NGF NGF
438 NGF NGF NGF NGF
441 N/A NGF NGF NGF
442 NGF NGF NGF NGF
443 NGF NGF NGF NGF
450 NGF NGF NGF NGF
451 N/A N/A NGF NGF
452 N/A N/A N/A NGF
454 N/A N/A N/A NGF
457 NGF NGF NGF NGF
468 NGF NGF NGF NGF
471 N/A N/A NGF NGF
475 NGF NGF NGF NGF
478 NGF NGF NGF NGF
479 N/A N/A N/A NGF
481 N/A N/A N/A NGF
491 NGF NGF NGF NGF
500 NGF NGF NGF NGF
501 NGF NGF NGF NGF
502 NGF NGF NGF NGF
506 NGF NGF NGF NGF
507 NGF NGF NGF NGF
508 NGF NGF NGF NGF
510 NGF NGF NGF NGF
511 NGF NGF NGF NGF
517 NGF NGF NGF NGF
518 NGF NGF NGF NGF
519 NGF NGF NGF NGF
524 NGF NGF NGF NGF
525 NGF NGF NGF NGF
536 NGF NGF NGF NGF
551 NGF NGF NGF NGF
556 CLOSED N/A N/A N/A
562 NGF NGF NGF NGF
574 NGF NGF NGF NGF
577 NGF NGF NGF NGF
579 NGF NGF NGF NGF
583 NGF NGF NGF NGF
588 NGF NGF NGF NGF
590 NGF NGF NGF NGF
593 NGF NGF NGF NGF
600 NGF NGF NGF NGF
603 NGF NGF NGF NGF
607 CLOSED N/A N/A N/A
610 NGF NGF NGF NGF
619 NGF NGF CLOSED N/A
629 NGF NGF NGF NGF
632 NGF NGF NGF NGF
638 NGF NGF NGF NGF
662 NGF NGF NGF NGF
663 NGF NGF NGF CLOSED
664 NGF NGF NGF NGF
665 NGF NGF NGF NGF
672 NGF NGF NGF NGF
681 NGF CLOSED N/A N/A
688 NGF NGF NGF NGF
689 NGF NGF NGF NGF
690 NGF NGF NGF NGF
693 NGF NGF NGF NGF
712 NGF NGF NGF NGF
713 NGF NGF NGF NGF
714 NGF NGF NGF NGF
715 NGF NGF NGF NGF
716 NGF NGF NGF NGF
717 NGF NGF NGF NGF
723 NGF NGF NGF NGF
724 NGF NGF NGF NGF
728 NGF NGF NGF NGF
730 NGF NGF NGF NGF
731 NGF NGF NGF NGF
733 NGF NGF NGF NGF
734 NGF NGF NGF NGF
735 NGF NGF NGF NGF
737 NGF NGF NGF NGF
739 NGF NGF NGF NGF
744 NGF NGF CLOSED N/A
745 NGF NGF NGF NGF
746 NGF NGF NGF NGF
747 NGF NGF NGF NGF
748 NGF NGF NGF NGF
750 NGF NGF NGF NGF
751 NGF NGF NGF NGF
752 NGF NGF NGF NGF
753 NGF NGF NGF NGF
754 NGF NGF NGF NGF
757 NGF NGF NGF NGF
758 NGF NGF NGF NGF
759 NGF NGF NGF NGF
762 NGF NGF NGF NGF
765 NGF NGF NGF NGF
768 NGF NGF NGF NGF
773 NGF NGF NGF NGF
775 NGF NGF NGF NGF
776 NGF NGF NGF NGF
777 NGF NGF NGF NGF
780 NGF NGF NGF NGF
781 NGF NGF NGF NGF
782 NGF NGF NGF NGF
783 NGF NGF NGF NGF
784 NGF NGF NGF NGF
785 NGF NGF NGF NGF
786 NGF NGF NGF NGF
788 NGF NGF NGF NGF
789 NGF NGF NGF NGF
791 NGF NGF NGF NGF
792 NGF NGF NGF NGF
794 NGF NGF NGF NGF
795 NGF NGF NGF NGF
796 NGF NGF NGF NGF
797 NGF NGF NGF NGF
804 NGF NGF NGF NGF
807 NGF NGF NGF NGF
809 NGF NGF NGF NGF
811 NGF NGF NGF NGF
812 NGF NGF NGF NGF
813 NGF NGF NGF NGF
817 NGF NGF NGF NGF
819 NGF NGF NGF NGF
820 NGF NGF NGF NGF
821 NGF NGF NGF NGF
822 NGF NGF NGF NGF
823 NGF NGF NGF NGF
824 NGF NGF NGF NGF
825 NGF NGF NGF NGF
826 NGF NGF NGF NGF
827 NGF NGF NGF NGF
828 NGF NGF NGF NGF
830 NGF NGF NGF NGF
833 NGF NGF NGF NGF
836 NGF NGF NGF NGF
837 NGF NGF NGF NGF
838 NGF NGF NGF NGF
842 NGF NGF NGF NGF
845 NGF NGF NGF NGF
852 NGF NGF NGF NGF
853 NGF NGF NGF NGF
855 NGF NGF NGF NGF
858 NGF NGF NGF NGF
859 NGF NGF NGF CLOSED
863 NGF NGF NGF NGF
869 NGF NGF NGF NGF
870 NGF NGF NGF NGF
872 NGF NGF NGF NGF
873 NGF NGF NGF NGF
886 NGF NGF CLOSED N/A
895 NGF NGF NGF NGF
896 NGF NGF NGF NGF
898 NGF NGF NGF NGF
899 NGF NGF NGF NGF
900 NGF NGF NGF NGF
901 NGF NGF NGF NGF
902 NGF NGF NGF NGF
903 NGF NGF NGF CLOSED
904 NGF NGF NGF NGF
905 NGF NGF NGF NGF
906 NGF NGF NGF NGF
907 NGF NGF NGF CLOSED
908 NGF NGF NGF NGF
909 NGF NGF NGF NGF
910 NGF NGF NGF NGF
911 NGF NGF NGF CLOSED
912 NGF NGF NGF NGF
913 NGF NGF NGF NGF
914 NGF NGF NGF NGF
915 NGF NGF NGF CLOSED
916 NGF NGF NGF NGF
917 NGF NGF NGF NGF
918 NGF NGF NGF NGF
919 NGF NGF NGF CLOSED
920 NGF NGF NGF NGF
921 NGF NGF NGF NGF
922 NGF NGF NGF NGF
923 NGF NGF NGF CLOSED
924 NGF NGF NGF NGF
925 NGF NGF NGF NGF
926 NGF NGF NGF NGF
927 NGF NGF NGF NGF
928 NGF NGF NGF NGF
929 NGF NGF NGF NGF
930 NGF NGF NGF NGF
931 NGF NGF NGF CLOSED
932 NGF NGF NGF NGF
933 NGF NGF NGF NGF
934 NGF NGF NGF NGF
935 NGF NGF NGF CLOSED
936 NGF NGF NGF NGF
939 N/A NGF NGF NGF
940 N/A NGF NGF NGF
941 N/A NGF NGF NGF
942 N/A NGF NGF NGF
943 N/A NGF NGF NGF
944 N/A NGF NGF NGF
954 NGF NGF NGF NGF
959 NGF NGF NGF NGF
960 NGF NGF NGF NGF
961 NGF NGF NGF NGF
962 NGF NGF NGF NGF
963 NGF NGF NGF NGF
964 NGF NGF NGF NGF
965 NGF NGF NGF NGF
966 NGF NGF NGF NGF
967 NGF NGF NGF NGF
968 NGF NGF NGF NGF
969 NGF NGF NGF NGF
970 NGF NGF NGF NGF
971 NGF NGF NGF NGF
972 NGF NGF NGF NGF
973 NGF NGF NGF NGF
974 NGF NGF NGF NGF
976 NGF NGF NGF NGF
977 NGF NGF NGF NGF
978 NGF NGF NGF NGF
991 NGF NGF NGF CLOSED
992 NGF NGF NGF NGF
993 NGF NGF NGF NGF
994 NGF NGF NGF NGF
995 NGF NGF NGF CLOSED
996 NGF NGF NGF NGF
997 NGF NGF NGF NGF
E-D NGF NGF NGF NGF
E-E NGF NGF NGF NGF
E-F NGF NGF NGF NGF
E-G NGF NGF NGF NGF
E-H NGF NGF NGF NGF
E-I NGF NGF NGF NGF
E-J NGF NGF NGF NGF
E-K NGF NGF NGF NGF
E-L NGF NGF NGF NGF
E-M NGF NGF NGF NGF
E-N NGF NGF NGF NGF
E-O NGF NGF NGF NGF
E-P NGF NGF NGF NGF
E-Q NGF NGF NGF NGF
E-R NGF NGF NGF NGF
E-V NGF NGF NGF NGF
E-Y NGF NGF NGF NGF
E-Z NGF NGF NGF NGF
H-W NGF NGF NGF NGF
I-P N/A NGF NGF NGF
I-Q N/A NGF NGF NGF
I-R N/A NGF NGF NGF
I-S N/A NGF NGF NGF
I-T N/A NGF NGF NGF
I-U N/A NGF NGF NGF
I-V N/A NGF NGF NGF
I-W N/A NGF NGF NGF
I-X N/A NGF NGF NGF
I-Y N/A NGF NGF NGF
I-Z N/A NGF NGF NGF
K-B NGF NGF NGF NGF
K-C NGF NGF NGF NGF
K-D NGF NGF NGF NGF
K-E NGF NGF NGF NGF
K-G NGF NGF NGF NGF
K-H NGF NGF NGF NGF
K-I NGF NGF NGF NGF
K-J NGF NGF NGF NGF
K-K NGF NGF NGF NGF
K-N NGF NGF NGF NGF
K-O N/A NGF CLOSED N/A
N-I NGF NGF NGF NGF
O-A N/A NGF NGF NGF
O-B N/A NGF NGF NGF
O-C N/A NGF NGF NGF
O-D N/A NGF NGF NGF
Q-A NGF NGF NGF NGF
Q-B N/A NGF NGF NGF
Q-C N/A NGF NGF NGF
Q-D N/A NGF NGF NGF
Q-E N/A NGF NGF NGF
Q-F N/A NGF NGF NGF
Q-G N/A NGF NGF NGF
Q-H N/A NGF NGF NGF
Q-I N/A NGF NGF NGF
Q-J N/A NGF NGF NGF
Q-K N/A NGF NGF NGF
Q-L N/A NGF NGF NGF
Q-M N/A NGF NGF NGF
Q-N NGF NGF NGF NGF
Q-O NGF NGF NGF NGF
Q-P NGF NGF NGF NGF
Q-Q NGF NGF NGF NGF
Q-R NGF NGF NGF NGF
Q-S NGF NGF NGF NGF
Q-T NGF NGF NGF NGF
Q-U NGF NGF NGF NGF
Q-V NGF NGF NGF NGF
Q-W NGF NGF NGF NGF
Q-X NGF NGF NGF NGF
Q-Y N/A NGF NGF NGF
R-A NGF NGF NGF NGF
R-B NGF NGF NGF NGF
R-C NGF NGF NGF NGF
R-D NGF NGF NGF NGF
R-F NGF NGF NGF NGF
R-G NGF NGF NGF NGF
R-H NGF NGF NGF NGF
R-I NGF NGF NGF NGF
R-K NGF NGF NGF NGF
R-L NGF NGF NGF NGF
R-N NGF NGF NGF NGF
R-O NGF NGF NGF NGF
R-P NGF NGF NGF NGF
R-Q NGF NGF NGF NGF
R-R NGF NGF NGF NGF
R-S NGF NGF NGF NGF
R-T NGF NGF NGF NGF
R-U NGF NGF NGF NGF
R-V NGF NGF NGF NGF
R-W NGF NGF NGF NGF
R-X NGF NGF NGF NGF
R-Y NGF NGF NGF NGF
R-Z NGF NGF NGF NGF
X-C NGF NGF NGF NGF
X-D NGF NGF NGF NGF
X-E NGF NGF NGF NGF
X-G NGF NGF NGF NGF
X-M NGF NGF NGF NGF
X-S NGF NGF NGF NGF
X-V NGF NGF NGF NGF
X-Z NGF NGF NGF NGF
Y-P NGF CLOSED N/A N/A
Y-R NGF NGF NGF NGF
Y-W NGF NGF NGF NGF
Y-Y NGF NGF NGF NGF
Y-Z NGF NGF NGF NGF
Z-N NGF NGF NGF NGF
Z-X NGF NGF NGF NGF
Z-Y NGF NGF NGF NGF

RETIREE COVERAGE CODES

Codes 2022 2023 2024 2025
345 Retiree Retiree Retiree Retiree
449 Retiree Retiree Retiree Retiree
455 Retiree Retiree Retiree Retiree
463 Retiree Retiree Retiree Retiree
486 Retiree Retiree Retiree CLOSED
533 Retiree Retiree Retiree Retiree
563 Retiree Retiree Retiree Retiree
667 Retiree Retiree Retiree Retiree
668 Retiree Retiree Retiree Retiree
S-S Retiree Retiree Retiree CLOSED

OTHER COVERAGE CODES

Codes 2022 2023 2024 2025
646 None None None None
X-A None None None None
CURRENT AS OF 08/03/2026

Revision History

Date Nature of Revision
08/03/2026 Migrated to new platform.