Policies & Procedures
Your Rights
HealthTeam Advantage wants to provide you with thorough coverage and satisfactory service in all aspects of your medical and prescription drug coverage. This page outlines your rights and various procedures to help you make different kinds of requests.
ORGANIZATION DETERMINATIONS, APPEALS AND GRIEVANCES
As a member of HealthTeam Advantage you have the right to submit a Part C organization determination, appeals and grievances as needed. You can learn more about how and why to submit coverage determination, organization determination, appeal or grievance by viewing the HealthTeam Advantage evidence of coverage applicable to your health plan or by viewing the content on the respective pages.
DISENROLLMENTS AND COMPLAINTS
Members who wish to end their enrollment in a HealthTeam Advantage health plan may only end their membership during certain times of the year, known as enrollment periods. All members have the opportunity to leave the plan during the Annual Enrollment Period and during the annual Medicare Advantage Disenrollment Period. In certain situations, you may also be eligible to leave the plan at other times of the year. If you have any questions or would like more information on when you can end your membership, call your Healthcare Concierge toll-free at 1-888-965-1965 (TTY: 711), 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. For more information about 21 disenrolling, view the HealthTeam Advantage evidence of coverage applicable to your health plan. If you have a complaint, you can complain to Medicare.
MATERIAL IN OTHER FORMATS
HealthTeam Advantage materials are available in alternative formats. To request materials in other formats or learn more, please contact customer service toll-free at 1- 888-965-1965 (TTY: 711), 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.
HealthTeam Advantage, a product of Care N’ Care Insurance Company of North Carolina, Inc., is a PPO and HMO Medicare Advantage plan with a Medicare contract. Enrollment in HealthTeam Advantage depends on contract renewal.
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.
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