Find a Provider
This directory provides a list of HealthTeam Advantage’s network providers. To get detailed information about your healthcare coverage, please see your Evidence of Coverage (EOC).
Please Note: This directory is updated monthly. If you’re a member and need help finding a provider call your Healthcare Concierge. PPO members call 888-965-1965, and HMO CSNP members call 888-965-1965
As a HealthTeam Advantage PPO Plan member, you can receive care from any provider or hospital you choose. You do not need a referral to any doctor or hospital. We encourage you to select an in-network provider to act as your Primary Care Provider (PCP). The term PCP will be used throughout this directory. When you select a HealthTeam Advantage in-network PCP, you’ll have a dedicated physician 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.
The network providers listed in this directory have agreed to provide you with your health care coverage. You may go to any of our network providers listed in this directory. If you have been going to one network provider, you are not required to continue going to that same provider. In some cases, you may get covered services from non-network providers.
Out-of-network/non-contracted providers are under no obligation to treat HealthTeam Advantage members, except in emergencies. For a decision about whether we will cover an out-of-network service, we encourage you or your provider to ask us for a pre-service organization determination before you receive the service. Please call your healthcare concierge or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.
If you select an out-of-network provider, please make sure the provider accepts Medicare; otherwise, you may have to pay more for their services. If an out-of-network provider submits a bill directly to you, do not pay the bill. Instead, submit it to HealthTeam Advantage for processing and determination of enrollee liability, if any. Except for emergencies or urgent care, it may cost more to get care from out-of- network providers.
You do not need to get a referral or approval in advance when you get care from out- of-network providers. However, it is strongly recommended that you provide notification to HealthTeam Advantage before you get some services from non-plan providers. If you do not provide this notification, you may be responsible for the providers’ charges if HealthTeam Advantage determines the services are not covered benefits or are not medically necessary. If you provide notification before obtaining services, you will not run the risk of HealthTeam Advantage determining that the services are not covered.
You will have to choose one of our network providers listed in this directory to be your Primary Care Provider (PCP). Generally, you must get your healthcare services from your PCP. There are several types of providers that may serve as your PCP, and these include: Family Practice, General Practice, and Internal Medicine.
The network providers listed in this directory have agreed to provide you with your healthcare coverage. You may go to any of our network providers listed in this directory. If you have been going to one network provider, you are not required to continue going to that same provider. In some cases, you may get covered services from non-network providers.
You must use network providers except in emergency or urgent care situations or for out-of-area renal dialysis or other services. If you obtain routine care from out-of-network providers, neither Medicare nor HealthTeam Advantage will be responsible for the costs.
You may get emergency medical care whenever you need it, anywhere in the United States or its territories. Our plan covers ambulance services in situations where getting to the emergency room in any other way could endanger your health. Please refer to your Evidence of Coverage for details. You may also get covered emergency medical care whenever you need it, anywhere in the world. If you have an emergency, we will talk with the doctors who are giving you emergency care to help manage and follow up on your care. The doctors who are giving you emergency care will decide when your condition is stable, and the medical emergency is over.
After the emergency is over you are entitled to follow-up care to be sure your condition continues to be stable. Your follow-up care will be covered by our plan. If your emergency care is provided by out- of-network providers, we will try to arrange for network providers to take over your care as soon as your medical condition and the circumstances allow. If you obtain routine care from out-of-network providers, you will have to pay the out-of- network cost-sharing except for emergency care and out-of-network urgent care. Please refer to your Evidence of Coverage for more information. HealthTeam Advantage providers follow the CMS standards for appointment wait times.
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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