Information Book
- 2025 Information Book – HealthTeam Advantage Plan I (PPO)
- 2025 Information Book – HealthTeam Advantage Plan II (PPO)
- 2025 Information Book – HealthTeam Advantage Eagle Plan (PPO)
- 2025 Information Book – HealthTeam Advantage Vitality Plan (PPO)
- 2025 Information Book – HealthTeam Advantage Diabetes & Heart Care (HMO C-SNP)
- 2025 Information Book – HealthTeam Advantage Cardinal Plan (HMO)
Annual Notice of Change
- 2025 Annual Notice of Change – HealthTeam Advantage Plan I (PPO)
- 2025 Annual Notice of Change – HealthTeam Advantage Plan II (PPO)
- 2025 Annual Notice of Change – HealthTeam Advantage Eagle Plan (PPO)
- 2025 Annual Notice of Change – HealthTeam Advantage Diabetes & Heart Care (HMO C-SNP)
- 2025 Annual Notice of Change – HealthTeam Advantage Cardinal Plan (HMO)
Evidence of Coverage
- 2025 Evidence of Coverage – HealthTeam Advantage Plan I (PPO)
- 2025 Evidence of Coverage – HealthTeam Advantage Plan II (PPO)
- 2025 Evidence of Coverage – HealthTeam Advantage Eagle Plan (PPO)
- 2025 Evidence of Coverage – HealthTeam Advantage Vitality Plan (PPO)
- 2025 Evidence of Coverage – HealthTeam Advantage Diabetes & Heart Care (HMO C-SNP)
- 2025 Evidence of Coverage – HealthTeam Advantage Cardinal Plan (HMO)
Summary of Benefits
- 2025 Summary of Benefits – HealthTeam Advantage Plan I (PPO)
- 2025 Summary of Benefits – HealthTeam Advantage Plan II (PPO)
- 2025 Summary of Benefits – HealthTeam Advantage Eagle Plan (PPO)
- 2025 Summary of Benefits – HealthTeam Advantage Vitality Plan (PPO)
- 2025 Summary of Benefits – HealthTeam Advantage Diabetes & Heart Care (HMO C-SNP)
- 2025 Summary of Benefits – HealthTeam Advantage Cardinal Plan (HMO)
Provider and Pharmacy Information
- Find A Provider – Online Lookup
- 2025 Find A Pharmacy – Online Lookup
- 2025 Provider and Pharmacy Directory
- Understanding Medicare Drug Payment Stages – Plan I (PPO), Plan II (PPO), and Cardinal Plan (HMO)
- Understanding Medicare Drug Payment Stages – Vitality Plan (PPO)
- Understanding Medicare Drug Payment Stages – Diabetes & Heart Care (HMO C-SNP)
Part D: Pharmacy Utilization Criteria
- 2025 Prior Authorization Criteria – HealthTeam Advantage Plans
- 2025 Prior Authorization Forms – HealthTeam Advantage Plan I (PPO), Plan II (PPO), Vitality Plan (PPO), & Cardinal Plan (HMO) (Coming Soon)
- 2025 Prior Authorization Forms – HealthTeam Advantage Diabetes & Heart Care Plan (HMO C-SNP) (Coming Soon)
- 2025 Step Therapy Criteria – HealthTeam Advantage Plans
Low Income Subsidy
- 2025 Low Income Subsidy – HealthTeam Advantage Plan I (PPO) (Coming Soon)
- 2025 Low Income Subsidy – HealthTeam Advantage Plan II (PPO) (Coming Soon)
- 2025 Low Income Subsidy – HealthTeam Advantage Eagle Plan (PPO) (Coming Soon)
- 2025 Low Income Subsidy – HealthTeam Advantage Vitality Plan (PPO) (Coming Soon)
- 2025 Low Income Subsidy – HealthTeam Advantage Diabetes & Heart Care (HMO C-SNP) (Coming Soon)
- 2025 Low Income Subsidy – HealthTeam Advantage Cardinal Plan (HMO) (Coming Soon)
Comprehensive Formulary
- 2025 Comprehensive Formulary – HealthTeam Advantage Plan I (PPO), Plan II (PPO), Vitality Plan (PPO), and Cardinal Plan (HMO)
- 2025 Comprehensive Formulary – HealthTeam Advantage Diabetes & Heart Care Plan (HMO C-SNP)
- 2025 Comprehensive Formulary Addendum – HealthTeam Advantage Plan I (PPO), Plan II (PPO), Vitality Plan (PPO), and Cardinal Plan (HMO)
- 2025 Comprehensive Formulary Addendum – HealthTeam Advantage Diabetes & Heart Care Plan (HMO C-SNP)
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