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Medicare Advantage PPO Plans 2023
As a HealthTeam Advantage PPO health plan member, you can choose to receive care from any provider or hospital in our Service area includes the following counties in North Carolina: Alamance, Caswell, Davidson, Davie, Forsyth, Guilford, Montgomery, Randolph, Rockingham, Stokes, and Yadkin counties. And, since HealthTeam Advantage is a Preferred Provider Organization (PPO) plan, you don’t need a referral for any specialists, hospitals, or providers.
Are you eligible?
Compare PPO I and PPO II
HealthTeam Advantage PPO Plan I
Medical & Prescription
Featured Benefits
Out-of-Pocket Maximum
Copays
In-Network
Out-Of-Network
Doctor Office Visits
$0
$50
$25
$75
Inpatient Hospital Coverage
$295 per day
(Days 1-6)
$0 per day
(Days 7-90)
$0 per day
(Days 91 Beyond)
$650 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)
$184 per day
(Days 21-100)
$50 per day
(Days 1-20)
$184 per day
(Days 21-100)
HealthTeam Advantage PPO Plan II
Medical & Prescription
Featured Benefits
Out-of-Pocket Maximum
Copays
In-Network
Out-Of-Network
Doctor Office Visits
$0
$30
$15
$50
Inpatient Hospital Coverage
$200 per day
(Day 1-5)
$0 per day
(Days 6-90)
$0 per day
(Days 91 Beyond)
$500 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)
$184 per day
(Days 21-100)
$50 per day
(Days 1-20)
$184 per day
(Days 21-100)
For additional information please view 2023 HTA PPO Benefits at a Glance PDF
Are You Eligible?
You’re eligible for HealthTeam Advantage PPO plans if:
- You’re entitled to Medicare Part A and are enrolled in Medicare Part B
- You live in Alamance, Caswell, Davidson, Davie, Forsyth, Guilford, Montgomery, Randolph, Rockingham, Stokes, or Yadkin county
- You are a United States Citizen or lawfully present in the United States
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.
Detailed and Additional Information
Our Provider Network
We do encourage you to choose an in-network provider as your primary care provider (PCP) because you’ll have a dedicated doctor who will focus on your individual healthcare needs and coordinate your care with other in-network providers if needed. This allows you to keep your out-of-pocket costs lower and more predictable.
If you do select an out-of-network provider, please make sure the provider accepts Medicare; otherwise, you will be responsible for the full cost of services. Except for emergencies or urgent care, it may cost more to get care from out-of-network providers.
