Information Book
-
- 2026 Information Book – HealthTeam Advantage Plan I (PPO)
- 2026 Information Book – HealthTeam Advantage Plan II (PPO)
- 2026 Information Book – HealthTeam Advantage Eagle Plan (PPO)
- 2026 Information Book – HealthTeam Advantage Vitality Plan (PPO)
- 2026 Information Book – HealthTeam Advantage Diabetes & Heart Care (HMO C-SNP)
Annual Notice of Change
-
- 2026 Annual Notice of Change – HealthTeam Advantage Plan I (PPO)
- 2026 Annual Notice of Change – HealthTeam Advantage Plan II (PPO)
- 2026 Annual Notice of Change – HealthTeam Advantage Eagle Plan (PPO)
- 2026 Annual Notice of Change – HealthTeam Advantage Vitality Plan (PPO)
- 2026 Annual Notice of Change – HealthTeam Advantage Diabetes & Heart Care (HMO C-SNP)
Evidence of Coverage
-
- 2026 Evidence of Coverage – HealthTeam Advantage Plan I (PPO) (Coming Soon)
- 2026 Evidence of Coverage – HealthTeam Advantage Plan II (PPO) (Coming Soon)
- 2026 Evidence of Coverage – HealthTeam Advantage Eagle Plan (PPO) (Coming Soon)
- 2026 Evidence of Coverage – HealthTeam Advantage Vitality Plan (PPO) (Coming Soon)
- 2026 Evidence of Coverage – HealthTeam Advantage Diabetes & Heart Care (HMO C-SNP) (Coming Soon)
Summary of Benefits
-
- 2026 Summary of Benefits – HealthTeam Advantage Plan I (PPO)
- 2026 Summary of Benefits – HealthTeam Advantage Plan II (PPO)
- 2026 Summary of Benefits – HealthTeam Advantage Eagle Plan (PPO)
- 2026 Summary of Benefits – HealthTeam Advantage Vitality Plan (PPO)
- 2026 Summary of Benefits – HealthTeam Advantage Diabetes & Heart Care (HMO C-SNP)
Provider and Pharmacy Information
Part D: Pharmacy Utilization Criteria
-
- 2026 Prior Authorization Criteria – HealthTeam Advantage Plans (Coming Soon)
- 2026 Step Therapy Criteria – HealthTeam Advantage Plans (Coming Soon)
Low Income Subsidy
-
- 2026 Low Income Subsidy – HealthTeam Advantage Plan I (PPO) (Coming Soon)
- 2026 Low Income Subsidy – HealthTeam Advantage Plan II (PPO) (Coming Soon)
- 2026 Low Income Subsidy – HealthTeam Advantage Eagle Plan (PPO) (Coming Soon)
- 2026 Low Income Subsidy – HealthTeam Advantage Vitality Plan (PPO) (Coming Soon)
- 2026 Low Income Subsidy – HealthTeam Advantage Diabetes & Heart Care (HMO C-SNP) (Coming Soon)
Comprehensive Formulary
-
- 2026 Comprehensive Formulary – HealthTeam Advantage Plan I (PPO), Plan II (PPO), and Vitality Plan (PPO) (Coming Soon)
- 2026 Comprehensive Formulary – HealthTeam Advantage Diabetes & Heart Care Plan (HMO C-SNP) (Coming Soon)
- 2026 Comprehensive Formulary Addendum – HealthTeam Advantage Plan I (PPO), Plan II (PPO), and Vitality Plan (PPO) (Coming Soon)
- 2026 Comprehensive Formulary Addendum – HealthTeam Advantage Diabetes & Heart Care Plan (HMO C-SNP) (Coming Soon)
Additional Forms
-
- Automatic Bank Draft Authorization
- Authorization for Release of Protected Health Information (PHI)
- Appointment of Representative
- Health Risk Assessment – Online
- Health Risk Assessment – PDF
- Medicare Star Ratings
- HealthTeam Advantage Medical Direct Member Reimbursement Request (PPO or CSNP)
- Dominion Dental Direct Member Reimbursement Form
- VSP Vision Direct Member Reimbursement Form
- Prescription Drug Member Reimbursement Form
- General Request for Medicare Prescription Drug Coverage Determination
Dental Code Quick Reference Guides
-
- HealthTeam Advantage Plan I (PPO) (Coming Soon)
- HealthTeam Advantage Plan II (PPO) (Coming Soon)
- HealthTeam Advantage Eagle Plan (PPO) (Coming Soon)
- HealthTeam Advantage Diabetes & Heart Care (HMO C-SNP) (Coming Soon)