Thank you for enrolling with HealthTeam Advantage!

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Your Confirmation Number is . If you would like to keep a copy for your records, download/save a PDF copy of your completed enrollment form or print the completed enrollment form.

Download PDF  Print enrollment form 

WHAT'S NEXT

 

THE DAY YOU ENROLL

• Receipt of completed enrollment form: The agent will provide a receipt that confirms you submitted an enrollment form. If you enroll online, you will receive a confirmation number and you will have the ability to print an electronic copy of your completed application for your files.

WITHIN 10 DAYS OF SUBMITTING ONLINE ENROLLMENT FORM

• Letter confirming receipt of your enrollment and enrollment approval or denial from Medicare to the HealthTeam Advantage plan you selected.

WHEN YOU BECOME A HEALTHTEAM ADVANTAGE MEMBER

• HealthTeam Advantage Evidence of Coverage is mailed to you - this book is your detailed coverage of your plan
• HealthTeam Advantage member identification cards - you will receive your HealthTeam Advantage member identification card.
• A Personal Healthcare Concierge at your service - if you would like assistance finding a provider, scheduling an appointment, have questions about your benefits, or need a replacement identification card, simply email your concierge at conciergehta@healthteamadvantage.com, or call: PPO member call 888-965-1965 and HMO CSNP members call 833-324-3242 (TTY 711). Our hours of operation are:
  • October 1 - March 31: 8am to 8pm, ET, seven days a week
  • April 1 - September 30: 8am to 8pm, ET, Monday through Friday.