Enroll in one of our TEAMStar Medicare Part D Plans
Enrolling in one of our Plans is easy. You may enroll online, over the telephone, or by paper enrollment form.
To enroll online, simply click ‘Enroll Now’ below the Plan you choose. This is the fastest and easiest way to enroll. Once you click the submit button, the system will walk you through the enrollment process in three easy steps.
To enroll over the telephone or to request a paper enrollment form, please call our Customer Service Department, 7 days a week, from 8:00am to 8:00pm in your local time zone.
Toll-free: 1-866-524-4173
Hearing-impaired callers using TTY/TDD equipment: 1-866-524-4174
When you are finished with your enrollment, we will submit your information to the Centers for Medicare & Medicaid Services (CMS) for approval. When we receive approval of your enrollment form from CMS, we will send your member identification card and Plan information in the mail within 7-10 business days.
Choose from three (3) TEAMStar Medicare Part D Plans:
Monthly Premium |
||||||
Copayment |
Copayment |
Copayment |
||||
DRUG TYPE |
RETAIL 30-Day Supply |
MAIL 90-Day Supply |
RETAIL 30-Day Supply |
MAIL 90-Day Supply |
RETAIL 30-Day Supply |
MAIL 90-Day Supply |
Preferred Generics Tier 1 |
$6 |
$12 |
$6 |
$12 |
$6 |
$12 |
Preferred Brands Tier 2 |
$45 |
$90 |
$45 |
$90 |
$35 |
$70 |
Non-Preferred Generics & Brands Tier 3 & 4 |
$65 |
$130 |
$65 |
$130 |
$55 |
$110 |
Deductible Applies to Tier 2, 3 and 4 |
$250 |
$0 |
$0 |
|||
*Monthly premiums will be reduced to $33 for the Bronze plan, $39 for the Silver plan, and $114 for the Platinum plan if you elect to pay premiums by monthly bank draft.
Note: Monthly premiums shown do not reflect any Medicare imposed penalties for late enrollment.
With any of the TEAMStar Plans, you pay a fixed co-payment for each prescription starting at just $6 for Preferred Generic retail drugs. If you select the Bronze Plan, you must pay the first $250 towards the cost of all Brands and Non-Preferred Generics before the plan pays. This Bronze Plan deductible does not apply to Preferred Generics. The Silver and Platinum Plans do not have a deductible. While you are in the initial coverage stage, you will pay the co-payments shown above and the plan will pay the balance until the calendar year total of your payments and the plan payments equals the Initial Coverage Limit of $2,830. After you meet your Initial Coverage Limit, your payments will depend on which plan you select. With the Bronze or Silver Plan, you will pay 100% of your drug costs until your total calendar year out-of-pocket costs equal $4,550 in true out-of-pocket (TrOOP). With the Platinum Plan, you pay a $6 co-payment for Preferred Generic retail drugs and 100% of your drug costs for all Brands and Non-Preferred Generics until your total calendar year out-of-pocket costs (including co-payments) equal $4,550. After your true out-of-pocket costs reach $4,550, you pay just 5%** and the plan pays the rest.
Premiums and costs for prescription drugs that are not in the plan formulary do not qualify as
out-of-pocket expenses for purposes of this calculation.





