HealthTeam Advantage Diabetes & Heart Care (C-SNP) Plan Details for Rockingham County, NC
This page provides coverage and cost details for CARE N\' CARE INSURANCE COMPANY OF NORTH CAROLINA’s H2624-001-0 Medicare SNP plan for 2025. Enrollment is subject to eligibi
*CMS rated this CARE N\' CARE INSURANCE COMPANY OF NORTH CAROLINA plan (H2624-001-0) 4 (Good) out of 5 stars.
This private health insurance option offers all of the same basic benefits as Original Medicare, but out-of-pocket costs are different. It may include additional benefits that Medicare Part A and Part B do not cover.
Individuals must meet all Chronic or Disabling Condition SNP qualification requirements to join this C-SNP plan.
HealthTeam Advantage Diabetes & Heart Care Basic Plan Details
- Plan ID
- H2624-001-0
- Plan Type
- HMO C-SNP
- Plan Year
- 2025
- Premium
- $0.00/mo
Plus your Medicare Part B premium. - Health Plan Deductible
- $0.00
- Out-of-Pocket Maximum
- 3,500.00 /yr (in-network)
- Part B Reduction
- $0.00/mo
- Drug Plan Benefit
- Enhanced
$95.00 deductible - Supplemental Benefits
- Vision, Hearing
- Availability
- Rockingham County, NC
- Insured By
- CARE N\' CARE INSURANCE COMPANY OF NORTH CAROLINA
| Summary of Benefits |
|---|
Health Plan Out-of-Pocket Costs
The following table is a summary of the most common out-of-pocket costs you will incur if you join this CARE N\' CARE INSURANCE COMPANY OF NORTH CAROLINA plan:
Doctor's Office Visits
- Primary
- Not Covered
- Specialist
- $15 Copay
Emergency, Urgent, and Inpatient Hospital Coverage
- Emergency room care
- $120 Copay
- Urgent care
- $20 Copay
- Ground ambulance
- $250 Copay
- Inpatient hospital care
- $225.00 per day for days 1 through 6
$0.00 per day for days 7 and beyond - Skilled Nursing Facility
- $0.00 per day for days 1 through 20
$203.00 per day for days 21 and beyond
Foot Care
- Foot Exams and Treatments (Medicare-covered)
- Not Covered
- Routine Foot Care
- Not Covered
Chiropractic Care
- Medicare-covered chiropractic
- $15 Copay
- Routine chiropractic
- $15 Copay
Mental Health Services
- Outpatient individual therapy
- $15 Copay
- Outpatient group therapy
- $15 Copay
- Inpatient psychiatric hospital care
- $225.00 per day for days 1 through 8
$0.00 per day for days 9 and beyond
Rehabilitation Services
- Physical therapy and speech and language therapy
- $15 Copay
- Occupational therapy
- $15 Copay
Medical Equipment and Supplies
- Diabetes supplies
- 20% Coinsurance
Prior Authorization Required - Durable medical equipment
- 20% Coinsurance
Prior Authorization Required - Prosthetics
- 20% Coinsurance
Diagnostics, Lab Services, and Imaging
- Diagnostic radiology services
- $300 Copay
Prior Authorization Required - Lab services
- $10 Copay
Prior Authorization Required - Outpatient x-rays
- $10 Copay
Prior Authorization Required - Diagnostic tests and procedures
- $100 Copay
Prior Authorization Required
Medicare Part B Drugs
- Chemotherapy
- 20% Coinsurance
- Other Part B drugs (Medicare-covered)
- 20% Coinsurance
Dental Services
- Medicare Covered Preventive Dental
- $15 Copay
- Oral exam
- $0
- Dental x-rays
- 0% to 20% Coinsurance
- Cleaning
- $0
- Periodontics
- Not Covered
- Endodontics
- Not Covered
- Restorative Services
- Not Covered
Hearing Aids and Services
- Fitting/evaluation
- Covered
Limits may apply - Hearing aids
- Not Covered
- Hearing exam
- Covered
Limits may apply
Vision Services
- Medicare-covered eye exam
- $ to $15 Copay
- Routine eye exam
- Covered
Limits may apply - Eyewear benefits
- None
Prescription Drug Costs & Benefits
HealthTeam Advantage Diabetes & Heart Care includes enhanced benefit Medicare Part D. Enhanced benefits offer greater coverage than basic, typically providing lower cost-sharing, broader drug coverage, and additional benefits, such as covering drugs not included in the standard formulary. These plans usually have higher premiums due to the extra coverage and flexibility they provide, but they cover a larger percentage of overall drug costs.
As of 2023, approximately 75% of people on Medicare are enrolled in enhanced plans.
Prescription Drug Premium with Extra Help
Extra Help is a Social Security program that helps people with limited income and resources lower or cut Part D costs. The following table outlines premium assistance details with Extra Help.
| Low Income Premium Subsidy: | ${part_d_lips_amount} |
|---|---|
| Low Income Premium Subsidy CMS Pays: | $0.00 |
| Low Income Subsidy Premium: | $0.00 |
If you would like more information about the Extra Help program, you can refer to the Social Security Extra Help page.
Prescription Drug Deductible
The Medicare Part D annual deductible with this plan is $95.00. You must pay this amount at the pharmacy before CARE N\' CARE INSURANCE COMPANY OF NORTH CAROLINA begins paying its share.
Prescription Drug Out-of-Pocket Costs
In addition to the plan's monthly premium and deductible, HealthTeam Advantage Diabetes & Heart Care has out-of-pocket costs you must pay when you pick up your prescriptions.
| Drug Tier | Retail | Mail Order |
|---|---|---|
| Preferred Generic* | $0.00 | $0.00 |
| Generic* | $0.00 | $0.00 |
| Preferred Brand* | $47.00 | $47.00 |
| Non-Preferred Drug | $100.00 | $100.00 |
| Specialty Tier | 31.00% | 31.00% |
| Select Care Drugs* | $0.00 | $0.00 |
| *The Part D deductible does not apply. | ||
CMS 5-Star Rating Marks
Each year Medicare rates C-SNP plans, using a 5-star rating system, in nine major categories. These ratings are designed to help you understand the quality of care and service you can expect if you qualify and choose to join HealthTeam Advantage Diabetes & Heart Care .
| CMS Measure | Star Rating |
|---|---|
| 2025 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 | Not enough data available |
| Drug Plan Customer Service | |
| Complaints and Changes in the Drug Plan | |
| Member Experience with the Drug Plan | |
| Drug Safety and Accuracy of Drug Pricing |
How to Qualify to Enroll in
HealthTeam Advantage Diabetes & Heart Care
To be eligible to enroll in HealthTeam Advantage Diabetes & Heart Care , you must meet these requirements:
- You are eligible for Medicare;
- You live in Rockingham County (the plan’s service area); and
- You have been diagnosed with one or more severe or disabling chronic conditions.
A disabling chronic condition (disease) is one that lasts one or more years and requires ongoing medical attention and/or limits activities of daily living. They include:
- Autoimmune disorders
- End-stage renal disease
- Cancer
- Cardiovascular disorders
- Hematologic disorders
- HIV/AIDS
- Chronic heart failure
- Chronic lung disorders
- Neurologic disorders
- Dementia
- Diabetes
- End-stage liver disease
- Neurologic disorders
- Stroke
- Mental health conditions
Additional C-SNP Plan Options
Here are some additional Medicare SNP plans that might be worth reviewing:
Contact Us About CARE N\' CARE INSURANCE COMPANY OF NORTH CAROLINA
| Website: | CARE N\' CARE INSURANCE COMPANY OF NORTH CAROLINA Plan Page (opens in new tab) |
|---|---|
| Providers: | CARE N\' CARE INSURANCE COMPANY OF NORTH CAROLINA Providers Page (opens in new tab) |
| Formulary: | CARE N\' CARE INSURANCE COMPANY OF NORTH CAROLINA Formulary Page (opens in new tab) |
| Pharmacy: | CARE N\' CARE INSURANCE COMPANY OF NORTH CAROLINA Pharmacy Page (opens in new tab) |
| 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 |
If you qualify for Medicare benefits but have not yet enrolled or verified your enrollment status, you can do so on the Social Security Administration website. You can learn more about the Medicare Advantage program on www.medicare.gov.
Health Plan Compatibility
Special Needs Plans (SNPs) under Medicare Advantage typically do not work with other types of health insurance. If you have Medicare Part A or Part B and decide to join an SNP plan, you will be removed from Original Medicare. Furthermore, you cannot be enrolled in an SNP plan and hold a Medigap Insurance policy at the same time.
Members of a D-SNP maintain their current Medicaid plan and Medicaid benefits. Veterans with VA Health Benefits might have the option to receive care at a nearby VA hospital.
Citations & References
- CARE N\' CARE INSURANCE COMPANY OF NORTH CAROLINA, http://www.htanc.com, Last Accessed October 13, 2024
- Medicaid.gov, "Medicaid & CHIP in North Carolina", Last Accessed October 1, 2024
- CMS.gov, Landscape Source Files, Last Accessed October 2, 2024
- CMS.gov, Medicare Part C & D Performance, Last Accessed October 2, 2024
- CMS.gov, Plan Benefits Package, Last Accessed October 5, 2024
Research Note: This content is based on independent analysis of CMS data by David Bynon, Medicare analyst and founder of MedicareWire.
For details on how this plan was analyzed and constructed using CMS data, see our Medicare Plan Research Methodology.
Disclaimer: MedicareWire does not endorse or rank Medicare plans. Plan information is provided for educational and research purposes only and may not reflect the most current data available from CMS or the plan provider.
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