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  3. HealthTeam Advantage Plan II
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HealthTeam Advantage Plan II (PPO) Medicare Advantage Plan H9808-005 • 2027

CMS Rating: ☆☆☆☆☆ (3.5 out of 5 stars*)
Monthly Premium
$34.00Plus Part B premium.
Medical Deductible
$0.00
Maximum Out-of-Pocket
$4700.00In-network
Part B Giveback
Not offered
Prescription Coverage
Enhanced, $550.00 deductible
Additional Benefits
Dental, Vision, Hearing
Service Area
See List
Total Enrollment
706 beneficiaries
Last update: October 3, 2026
  • Benefits & Costs
  • Prescription Drugs
  • CMS Star Ratings
  • Contact HealthTeam Advantage
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  • Plan FAQs

HealthTeam Advantage Plan II (PPO) Introduction

This Medicare Advantage PPO plan, HealthTeam Advantage Plan II, is offered by HealthTeam Advantage and uses a Preferred Provider Organization (PPO) provider network. It comes with prescription drug coverage. For the 2027 plan year, the monthly premium is $34.00, the medical deductible is $0.00, and the in-network maximum out-of-pocket is $4700.00. The plan is identified by CMS Plan ID H9808-005. The 2027 Part D prescription drug deductible is $550.00.

Plan Benefits

HealthTeam Advantage Plan II includes cost-sharing, which refers to out-of-pocket expenses for covered healthcare services. The tables below outline the most common in-network out-of-pocket costs associated with plan H9808-005.

Compare 2027 plan benefits with 2026.

Office Visits

Office visit costs by plan year.
Covered Service 2027 2026
Primary care In-network: $0 copay
Out-of-network: 30% coinsurance
In-network: $0 copay
Out-of-network: $30 copay
Specialist In-network: $35 copay
Out-of-network: 30% coinsurance
In-network: $20 copay
Out-of-network: $60 copay

Preventive and Wellness Services

Preventive and wellness service costs and benefits by plan year.
Covered Service 2027 2026
Annual wellness exam In-network: $0 copay
Out-of-network: 30% coinsurance
In-network: $0 copay
Telehealth benefit In-network: $0-$35 copay In-network: $0-$20 copay
Routine chiropractic Not covered Not covered
Fitness benefits Coming soon In-network: $0 copay
Out-of-network: $0 copay, 0% coinsurance
Health education Not covered Not covered
Counseling services Not covered Not covered
Over-the-counter drug benefits Not covered In-network: $0 copay
Out-of-network: $0 copay, 0% coinsurance
Health transportation (non-emergency) Coming soon Not covered

Diagnostic, Lab, and Imaging Services

Diagnostic, laboratory, and imaging service costs by plan year.
Covered Service 2027 2026
Diagnostic radiology services In-network: $0-$350 copay
Out-of-network: 30% coinsurance
In-network: $0-$275 copay
Out-of-network: 20% coinsurance
Lab services In-network: $5-$15 copay
Out-of-network: 30% coinsurance
In-network: $5-$10 copay
Out-of-network: 20% coinsurance
Outpatient x-rays In-network: $10 copay
Out-of-network: 30% coinsurance
In-network: $10 copay
Out-of-network: 20% coinsurance
Diagnostic tests and procedures In-network: $5-$200 copay
Out-of-network: 30% coinsurance
In-network: $5-$75 copay
Out-of-network: 20% coinsurance

Emergency and Urgent Care Services

Emergency, urgent care, hospital, ambulance, and skilled nursing costs by plan year.
Covered Service 2027 2026
Emergency room care $130 copay $130 copay
Worldwide emergency care Coming soon $0 copay
Urgent care $40 copay $30 copay
Inpatient hospital care In-network:
Tier 1
$300 per day for days 1-5
$0 per day for days 6-90
$0 per stay
Out-of-network:
30% per stay
In-network:
Tier 1
$275 per day for days 1-5
$0 per day for days 6-90
$0 per stay
Out-of-network:
20% per stay
Skilled Nursing Facility In-network:
Tier 1
$0 per day for days 1-20
$221 per day for days 21-100
Out-of-network:
30% per stay
In-network:
Tier 1
$0 per day for days 1-20
$218 per day for days 21-100
Out-of-network:
20% per stay
Ground ambulance In-network: $200 copay
Out-of-network: $200 copay
In-network: $200 copay
Out-of-network: $200 copay

Mental Health Services

Mental health therapy and inpatient psychiatric care costs by plan year.
Covered Service 2027 2026
Outpatient individual therapy In-network: $35 copay
Out-of-network: 30% coinsurance
In-network: $20 copay
Out-of-network: 20% coinsurance
Outpatient group therapy In-network: $15 copay
Out-of-network: 30% coinsurance
In-network: $20 copay
Out-of-network: 20% coinsurance
Inpatient psychiatric hospital care In-network:
Tier 1
$300 per day for days 1-5
$0 per day for days 6-90
$0 per stay
Out-of-network:
30% per stay
In-network:
Tier 1
$275 per day for days 1-5
$0 per day for days 6-90
$0 per stay
Out-of-network:
20% per stay

Rehabilitation Services

Physical, speech, and occupational therapy costs by plan year.
Covered Service 2027 2026
Physical therapy and speech and language therapy In-network: $20-$35 copay
Out-of-network: 30% coinsurance
In-network: $20 copay
Out-of-network: 20% coinsurance
Occupational therapy In-network: $35 copay
Out-of-network: 30% coinsurance
In-network: $20 copay
Out-of-network: 20% coinsurance

Medical Equipment and Supplies

Diabetes supplies, durable medical equipment, and prosthetic costs by plan year.
Covered Service 2027 2026
Diabetes supplies In-network: 0%-25% coinsurance
Out-of-network: 30%-50% coinsurance
In-network: 0%-20% coinsurance
Out-of-network: 20% coinsurance
Durable medical equipment In-network: 20% coinsurance
Out-of-network: 50% coinsurance
In-network: 20% coinsurance
Out-of-network: 30% coinsurance
Prosthetics In-network: 20% coinsurance
Out-of-network: 50% coinsurance
In-network: 20% coinsurance
Out-of-network: 30% coinsurance

Medicare Part B Drugs

Chemotherapy and other Medicare Part B-covered drug costs by plan year.
Covered Service 2027 2026
Chemotherapy In-network: 0%-20% coinsurance
Out-of-network: 30% coinsurance
In-network: 0%-20% coinsurance
Out-of-network: 30% coinsurance
Other Part B drugs (Medicare-covered) In-network: 0%-20% coinsurance
Out-of-network: 30% coinsurance
In-network: 0%-20% coinsurance
Out-of-network: 30% coinsurance

Dental Services

Preventive and comprehensive dental service costs by plan year.
Covered Service 2027 2026
Oral exam In-network: $0 copay
Out-of-network: 50% coinsurance
In-network: $0 copay
Out-of-network: 50% coinsurance
Dental x-rays In-network: $0 copay
Out-of-network: 50% coinsurance
In-network: $0 copay
Out-of-network: 50% coinsurance
Cleaning In-network: $0 copay
Out-of-network: 50% coinsurance
In-network: $0 copay
Out-of-network: 50% coinsurance
Periodontics In-network: 50% coinsurance
Out-of-network: 75% coinsurance
In-network: 20%-50% coinsurance
Out-of-network: 50%-75% coinsurance
Endodontics In-network: 50% coinsurance
Out-of-network: 75% coinsurance
In-network: 50% coinsurance
Out-of-network: 75% coinsurance
Restorative services In-network: 50% coinsurance
Out-of-network: 75% coinsurance
In-network: 20%-50% coinsurance
Out-of-network: 50%-75% coinsurance
Implant services In-network: 50% coinsurance
Out-of-network: 75% coinsurance
In-network: 50% coinsurance
Out-of-network: 75% coinsurance
Orthodontics Not covered Not covered
Oral/Maxillofacial surgery In-network: 50% coinsurance
Out-of-network: 75% coinsurance
In-network: 20%-50% coinsurance
Out-of-network: 50%-75% coinsurance

Vision Services

Routine eye exams, contact lenses, and eyewear costs by plan year.
Covered Service 2027 2026
Routine eye exam In-network: $0 copay
Out-of-network: 75% coinsurance
In-network: $25 copay
Out-of-network: 20% coinsurance
Contact lenses In-network: $60 copay
Out-of-network: 75% coinsurance
In-network: $0 copay
Out-of-network: $0 copay, 0% coinsurance
Eyeglass frames only In-network: $0 copay
Out-of-network: 75% coinsurance
In-network: $0 copay
Out-of-network: $0 copay, 0% coinsurance
Eyeglass lenses only In-network: $0 copay
Out-of-network: 75% coinsurance
In-network: $0 copay
Out-of-network: $0 copay, 0% coinsurance
Eyeglasses (frames & lenses) In-network: $0 copay
Out-of-network: 75% coinsurance
In-network: $0 copay
Out-of-network: $0 copay, 0% coinsurance
Upgrades In-network: $0 copay
Out-of-network: 75% coinsurance
In-network: $0 copay
Out-of-network: $0 copay, 0% coinsurance

Hearing Services

Hearing exams, fittings, and hearing aid costs by plan year.
Covered Service 2027 2026
Hearing exam In-network: $0 copay
Out-of-network: 75% coinsurance
In-network: $25 copay
Out-of-network: $25 copay
Fitting/evaluation In-network: $0 copay
Out-of-network: 75% coinsurance
In-network: $0 copay
Out-of-network: $0 copay, 0% coinsurance
Prescription hearing aids In-network: $399-$899 copay
Out-of-network: 75% coinsurance
In-network: $299-$799 copay
Out-of-network: $299-$799 copay
OTC hearing aids Not covered Not covered

Additional and Special Needs Services

Additional and special needs service costs and benefits by plan year.
Covered Service 2027 2026
Adult day health services Not covered Not covered
Home-based palliative care In-network: $0 copay
Out-of-network: 30% coinsurance
In-network: $0 copay
Out-of-network: $0 copay, 0% coinsurance
Personal emergency response system Coming soon Not covered
Weight management programs Not covered Not covered
Wigs for chemotherapy-related hair loss Coming soon Not covered
Alternative therapies Not covered Not covered
Massage therapy Not covered Not covered
Home/bathroom safety devices Not covered Not covered

Certain preventive services are covered 100% by HealthTeam Advantage Plan II as a Part B benefit.

Prescription Drug Coverage

HealthTeam Advantage Plan II includes a Medicare Part D prescription drug plan (PDP). Plan type and coverage level are defined by CMS and may vary between basic and enhanced benefit designs.

This plan includes an enhanced benefit Medicare Part D plan (PDP), providing coverage beyond the standard CMS-defined minimum.

Prescription Drug Plan Premium

The Part D prescription drug plan premium is included in the overall Medicare Advantage plan cost. Additional adjustments may apply through the Low-Income Subsidy (LIS) program, also known as Extra Help, administered by Social Security. LIS benefits are separate from Medicare Special Needs Plan coverage.

HealthTeam Advantage Plan II (H9808-005-0) Prescription Drug Plan Premium Details
Part D Premium Component Amount
Basic Part D Premium:$30.00
Supplemental Part D Premium:$$0.00
Total Part D Premium:$30.00
Low-Income Premium Subsidy:$13.25
Low-Income Premium Subsidy Paid by CMS:$13.30
Low-Income Subsidy Premium:$16.70

For more details, visit the Social Security Extra Help program .

Prescription Drug Plan Deductible

This plan has a $550.00 annual Part D deductible. You'll pay this deductible at the pharmacy before HealthTeam Advantage starts contributing towards your prescription costs.

Prescription Drug Plan Out-of-Pocket Costs

Beyond premiums and deductibles, HealthTeam Advantage Plan II may have additional costs at pharmacies. The table below outlines out-of-pocket expenses by drug tier.

HealthTeam Advantage Plan II (H9808-005-0) Pharmacy Out-of-Pocket Costs by Drug Tier
Drug Tier Retail Mail Order
Preferred Generic$0.00 copayComing soon
Generic$0.00 copayComing soon
Preferred Brand20% coinsuranceComing soon
Non-Preferred Drug28% coinsuranceComing soon
Specialty Tier27% coinsuranceComing soon
*Deductible does not apply.

CMS 5-Star Performance Ratings (Contract ID: H9808)

CMS evaluates Medicare Advantage (Part C) and Part D plans annually using a 5-star rating system. Ratings reflect performance in preventive care, chronic condition management, and member experience.

2027 Medicare Star Ratings for Contract H9808
CMS Measure Star Rating
2027 Overall Rating ☆☆☆☆☆
Staying Healthy: Screenings, Tests, Vaccines ☆☆☆☆☆
Managing Chronic (Long Term) Conditions ☆☆☆☆☆
Member Experience with Health Plan ☆☆☆☆☆
Complaints and Changes in Plans Performance ☆☆☆☆☆
Health Plan Customer Service ☆☆☆☆☆
Drug Plan Customer Service ☆☆☆☆☆
Complaints and Changes in the Drug Plan ☆☆☆☆☆
Member Experience with the Drug Plan ☆☆☆☆☆
Drug Safety and Accuracy of Drug Pricing ☆☆☆☆☆

Contact Information for HealthTeam Advantage

Website
HealthTeam Advantage Plan Page
Providers
HealthTeam Advantage Providers Page
Formulary
HealthTeam Advantage Formulary Page
Pharmacy
HealthTeam Advantage Pharmacy Page
New Member Health Plan Help
(877)905-9216
New Member Health Plan TTY
711
New Member Part D Help
(877)905-9216
New Member Part D TTY Users
711

Enrollment status and eligibility information are available through the Social Security Administration. Additional information about Medicare Advantage is available at Medicare.gov.

Plan Availability

HealthTeam Advantage Plan II (H9808-005-0) is available in the following locations:

North Carolina Counties Served
  • Alamance
  • Caswell
  • Davidson
  • Davie
  • Forsyth
  • Guilford
  • Montgomery
  • Orange
  • Randolph
  • Rockingham
  • Stokes
  • Yadkin

Frequently Asked Questions

Here are some of the most frequently asked questions about this plan (click to open).

Frequently Asked Questions About HealthTeam Advantage Plan II (PPO)

What is the monthly premium for HealthTeam Advantage Plan II (PPO)?

The 2027 monthly premium is $34.00. The Medicare Part B premium is paid separately.

What is the in-network MOOP for plan H9808-005?

For 2027, the in-network maximum out-of-pocket is $4700.00. The plan pays 100% of covered in-network services beyond this amount.

What is the star rating for plan H9808-005 in 2027?

For 2027, plan H9808-005 has a CMS star rating of ★3.5 out of 5 stars.

What is the total enrollment for plan H9808-005?

Total enrollment is 706 beneficiaries based on the latest CMS data.

Is there a Part D deductible for this plan?

The Part D deductible is $550.00.

Medicare Plan Data Sources and Methodology
Primary CMS datasets used for this Medicare Advantage Plan resource.
Data Source Publisher Last Accessed
Landscape Source Files Centers for Medicare & Medicaid Services October 5, 2026
Medicare Part C & D Performance Centers for Medicare & Medicaid Services October 5, 2026
Plan Benefits Package Centers for Medicare & Medicaid Services October 5, 2026
Monthly Enrollment by Contract/Plan/State/County Centers for Medicare & Medicaid Services October 5, 2026

Data sources and methodology documentation.

Official plan information and secondary Medicare references.
Publisher Reference Last Accessed
HealthTeam Advantage (official source) http://www.htanc.com October 4, 2026
CMS.gov Medicare Advantage Plan Fact Sheet 25 May, 2025
Medicare.gov Joining a plan 25 May, 2025
Medicare.gov Your coverage options 25 May, 2025

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Data provenance documentation is maintained in alignment with the U.S. Core Data for Interoperability (USCDI) Provenance standard.

Page content independently curated and maintained by David W. Bynon, Editorial Steward, using a standardized, data-driven methodology for accurate, non-commercial Medicare plan interpretation and resolution.

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