Enroll in one of our TEAMStar Part D Plans
Enrolling in one of our TEAMStar Plans is easy. You may enroll online, over the telephone, or by paper enrollment form.
To enroll online, simply click 'Enroll' 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, weekdays, from 8 am to 8 pm 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:
For a copy of the 2012 Summary of Benefits click here
Select Plan
(learn more) |
 |
 |
 |
Monthly
Premium |
$29* |
$46* |
$118* |
Union Preferred Pharmacies Certain Preferred Generics
Tier 1 Copay |
Retail
30-Day Supply
$2 |
Retail
30-Day Supply
$2 |
Retail
30-Day Supply
$2 |
Other Network Pharmacies
Copay/Coinsurance |
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 |
25% |
25% |
$65 |
$130 |
$55 |
$110 |
Deductible
Applies to Tier
2, 3 & 4 |
$250

|
$0

|
$0

|
*Monthly premium will be reduced to $28 for Bronze, $45 for Silver and $117 for Platinum if you elect monthly bank draft.
Note: Monthly premiums shown do not reflect any Medicare imposed charges for late enrollment or IRMAA.
With the TEAMStar Silver or Platinum Part D Plans, there is no deductible. With the TEAMStar Bronze Plan, there is a $250 deductible; however, the deductible only applies to Tiers 2, 3, and 4. Your coverage for Preferred Generics, during the Initial Coverage Phase, will be the same regardless of which plan you choose. You pay a low fixed copayment for Preferred Generic drugs. The chart above shows what you will pay, and what the plan will pay until the calendar year total of your payments and the plan payments equal $2,930. Then your payments will depend upon the type of drug and which plan you select. While you are in the Coverage Gap, you will receive a discount on brand name drugs and you pay only 86% of the cost for generic drugs until your total calendar year out-of-pocket costs equal $4,700 in true out-of-pocket. With the Platinum Plan, you will pay no more than $6 for Tier 1 Preferred Generic drugs. After your true out-of-pocket costs reach $4,700, you pay the greater of 5% coinsurance or a $2.60 copay for generic (including brand drugs treated as generic) and a $6.50 copay for all other drugs and the plan pays the rest. However, with TEAMStar Part D, you will pay no more than $100 per prescription.
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.
2012 Low Income Subsidy (LIS) Information
If you meet certain income and resource guidelines, you may qualify for Extra Help from Medicare to pay the costs of Medicare prescription drug coverage. If you qualify for Extra Help, your monthly plan premium is lower. The amount of Extra Help you get determines your total monthly plan premium as a member of one of our plans. In addition, your deductible, copays, and coinsurance will be reduced. The LIS amount for 2012 is $32.50.
If you aren't getting Extra Help, you can see if you qualify by calling:
- 1-800-Medicare/1-800-633-4227 (TTY/TDD: 1-877-486-2048)
- Your state Medicaid office
- Social Security Administration at 1-800-772-1213 (TTY/TDD: 1-800-325-0778)
updated 10/01/11