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HealthTeam Advantage Diabetes & Heart Care HMO CSNP Plan 2024

As a HealthTeam Advantage HMO health plan member living in Alamance, Davidson, Davie, Forsyth, Guilford, Randolph, or Rockingham County, you can choose to receive care from any provider or hospital in our service area. To join HealthTeam Advantage Diabetes & Heart Care (HMO CSNP) health plan, you must meet the special eligibility requirements of a diagnosis of Diabetes Mellitus and/or Chronic Heart Failure. Our service area includes the North Carolina counties listed above.

HealthTeam Advantage HMO CSNP

$0 Monthly Premium
$0 Deductible for Medical

Out-of-Pocket Maximum

$3,500

Copays

 
Doctor Office Visits
 
Primary Care Provider (PCP)
Cardiologist
Endocrinologist
Podiatrist

$0

Other Specialist Visits

$20

Inpatient Hospital Coverage

$225 per day
(Days 1-6)

$0 per day
(Days 7-90)

$0 per day
(Days 91 Beyond)

Skilled Nursing Facility (SNF)

$0 per day
(Days 1-20)

$203 per day
(Days 21-100)

For additional information please view
2024 HealthTeam Advantage CSNP Benefits at a Glance PDF

Are You Eligible?

You’re eligible to join HealthTeam Advantage Diabetes & Heart Care HMO CSNP if:

  • You’re entitled to Medicare Part A and are enrolled in Medicare Part B
  • You live in Alamance, Davidson, Davie, Forsyth, Guilford, Randolph, or Rockingham Counties.
  • You are a United States Citizen or lawfully present in the United States
  • You have diabetes and/or chronic heart failure (CHF)

Enrollment Dates

Understanding Enrollment Periods

  • Initial Enrollment Period – When you’re first eligible for Medicare (for example, when you turn 65), you have a 7-month window to sign up for Part A and/or Part B or a Medicare Advantage plan. That time period is 3 months before your birthday month, your birthday month, and 3 months after your birthday month.
  • Annual Enrollment Period – is October 15-December 7 every year. During this time, you can switch, drop, or join a Medicare Advantage plan.
  • Open Enrollment Period – is January 1-March 31 every year. This is your only opportunity outside of the Annual Enrollment Period to switch Medicare Advantage plans.

Our Provider Network

As this plan is a HMO (health maintenance organization) it’s important to know which providers are part of our network because, with limited exceptions, while you’re a member of this plan you must use network providers to get your medical care and services. The only exceptions are emergencies, urgently needed services when the network is not available (generally, when you are out of the area), out-of-area dialysis services, and cases in which HealthTeam Advantage Diabetes & Heart Care Plan (HMO CSNP) authorizes use of out-of-network providers.