Shop Plans

Medicare Advantage PPO Plans 2021

As a HealthTeam Advantage PPO health plan member, you can choose to receive care from any provider or hospital in our service area of Anson, Alamance, Burke, Cleveland, Davidson, Davie, Forsyth, Guilford, Lincoln, Randolph, Rockingham, Stanly, and Union 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

$0 Monthly Premium
Options
$0 Deductible for
Medical & Prescription

Out-of-Pocket Maximum

$3,400 In-Network
$5,100 Out-of-Network

Copays

In-Network
Out-Of-Network
Doctor Office Visits
 
 
Primary Care Provider (PCP)

$0

$50

Specialist Visits

$30

$60

Inpatient Hospital Coverage

$295 per day
(Days 1-6)

$0 per day
(Days 7-90)

$500 per day
(Days 1-6)

$0 per day
(Days 7-90)

Skilled Nursintg Facility (SNF)

$0 per day
(Days 1-20)

$178 per day
(Days 21-100)

$50 per day
(Days 1-20)

$178 per day
(Days 21-100)

HealthTeam Advantage PPO Plan II

$60 Monthly Premium
Options
$0 Deductible for
Medical & Prescription

Out-of-Pocket Maximum

$3,100 In-Network
$5,100 Out-of-Network

Copays

In-Network
Out-Of-Network
Doctor Office Visits
 
 
Primary Care Provider (PCP)

$0

$30

Specialist Visits

$20

$50

Inpatient Hospital Coverage

$250 per day
(Day 1)

$125 per day
(Days 2-6)

$500 per day
(Days 1-6)

$0 per day
(Days 7-90)

Skilled Nursintg Facility (SNF)

$0 per day
(Days 1-20)

$160 per day
(Days 21-100)

$50 per day
(Days 1-20)

$178 per day
(Days 21-100)

For additional information please view 2021 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 Anson, Alamance, Burke, Cleveland, Davidson, Davie, Forsyth, Guilford, Lincoln, Randolph, Rockingham, Stanly, or Union county
  • You are a United States Citizen or lawfully present in the United States
About Medicare Eligibility

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.
More About Enrollment Periods

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.