A Comprehensive Formulary is a list of covered drugs selected by HealthTeam Advantage. We generally cover drugs listed in our formulary if it is medically necessary, the prescription is filled at a HealthTeam Advantage network pharmacy, and other plan rules are followed.
You can search for medications on our formulary online, or download the Comprehensive Formulary under the 2020 Plan Documents. If you prefer, we will mail you a copy of the most recent version.
HealthTeam Advantage Plan I and Plan II PPO members call your Healthcare Concierge at 1-888-965-1965 (TTY: 711)
HealthTeam Advantage Diabetes & Heart Care HMO CSNP members call your Healthcare Concierge at 1-833-324-3242 (TTY:711), October 1–March 31, 8 a.m. to 8 p.m. ET, 7 days a week, or April 1–September 30, 8 a.m. to 8 p.m. ET, Monday through Friday. Or send an email to firstname.lastname@example.org
Prospective members please call 1-877-905-9216 (TTY: 711), October 1–March 31, 8 a.m. to 8 p.m. ET, 7days a week, or April 1–September 30, 8 a.m. to 8 p.m. ET, Monday through Friday.
For more information on how to fill your prescriptions, please review your Evidence of Coverage (EOC) document available on the 2020 Plan Documents page.
The Medicare program allows HealthTeam Advantage to make changes in our formulary at any time during the calendar year. A change in our formulary can affect which drugs are covered, the amount of copay, and limits on usage. If the plan makes any negative, non-maintenance formulary change, affected members will receive written notice that explains the change; the formulary on our website will also be updated. For a list of changes made to the formulary, please see the formulary addendum available on the 2020 Plan Documents page.
Some covered drugs may have additional requirements or limits on coverage. These requirements and limits may include prior authorization, step therapy, and quantity limits. For more information on formulary restrictions, see the Formulary Restrictions page or review your Evidence of Coverage (EOC) document or Comprehensive Formulary available on the 2020 Plan Documents.
HealthTeam Advantage, a product of Care N’ Care Insurance Company of North Carolina, Inc., is a Medicare Advantage plan with a Medicare contract. Enrollment in HealthTeam Advantage depends on contract renewal. This information is not a complete description of benefits. Call for more information: prospective members call 877-905-9216 , HTA PPO members call 888-965-1965, and HTA CSNP members call 833-324-3242 (TTY:711) from October 1–March 31, 8 a.m. to 8 p.m. ET, seven days a week, or April 1–September 30, 8 a.m. to 8 p.m. ET, Monday through Friday. Medicare beneficiaries may also enroll in HealthTeam Advantage through the CMS Medicare Online Enrollment Center located at http://medicare.gov. Limitations, copayments, and restrictions may apply. Benefits, premiums and/or copayments/coinsurance may change on January 1 of each year. The formulary, pharmacy network, and/or provider network may change at any time. You will receive notice when necessary.
Every year, Medicare evaluates plans based on a 5-star rating system.