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HealthTeam Advantage Eagle Plan (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for HealthTeam Advantage Eagle Plan (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on HealthTeam Advantage Eagle Plan (PPO) in 2026, please refer to our full plan details page.
HealthTeam Advantage Eagle Plan (PPO) is a PPO plan offered by Risant Health, Inc. available for enrollment in 2025 to people living in Piedmont-Coastal Plains area. This plan received an overall rating of 4 out of 5 stars in 2026.
It's important to know that HealthTeam Advantage Eagle Plan (PPO) is a Medicare Advantage (MA) Plan without drug coverage. That means that this plan covers medical services but doesn't cover prescription drugs. If you are looking for a plan with prescription drug coverage, please search for other MA and PDP plans offered in your area.
Key Plan Facts
Below are a few key facts and commonly-asked questions about HealthTeam Advantage Eagle Plan (PPO).
Plan Costs:
The cost of a Medicare Advantage Plan is made up of four main parts.
- First, the monthly premium — the amount you pay every month.
- Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
- Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
- Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.
For HealthTeam Advantage Eagle Plan (PPO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. This is the amount you must pay every month. Additionally, this plan comes with a Part B Premium reduction of $75.00. You must continue to pay paying your reduced Part B Premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
Drugs are not covered by this plan, so a prescription drug deductible is not applicable.
Out-of-Pocket Maximums
This plan has a combined Maximum Out-Of-Pocket cost of $7500.00 (in-network or out-of-network combined). You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $7500.00 for covered services, the plan will pay 100% of covered costs for the rest of the year.
The plan may have separate out-pocket-maximums for in-network and out-of-network services. See our full plan details page for more information.
You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.
Common Services:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
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Drug Coverage
Prescription drugs are not covered by HealthTeam Advantage Eagle Plan (PPO).
Additional Benefits
The HealthTeam Advantage Eagle Plan (PPO) offers robust medical coverage featuring no copays or coinsurance for primary care visits, home health services, and annual preventive care. Specialist visits require a $35 copay, while emergency room services have a $130 copay that is waived if you are admitted. For inpatient hospital stays, members pay a daily copay of $325 for acute stays or $300 for psychiatric stays for the first six days, with no copay for days 7 through 90. This plan also includes valuable extra benefits, such as preventive dental care with no copay and comprehensive dental coverage up to a $1,500 annual limit. Vision exams carry a $25 to $35 copay with a $125 annual allowance for eyewear, while hearing aids require a copay between $299 and $799. Additionally, members can access up to 20 free one-way transportation trips per year to approved health locations and receive a $50 quarterly reimbursement for over-the-counter items with no copay.
Inpatient Hospital See details
HealthTeam Advantage Eagle Plan (PPO) partially covers inpatient hospital services with no coinsurance, requiring a $325 daily copay for days 1-6 of acute stays and a $300 daily copay for days 1-6 of psychiatric stays, with no copay for days 7-90. Non-Medicare-covered stays, acute hospital upgrades, and additional psychiatric days are not covered.
Outpatient Services See details
HealthTeam Advantage Eagle Plan (PPO) covers outpatient hospital services with a $350 copay and ambulatory surgical center services with a $225 copay, both featuring no coinsurance. Outpatient substance abuse services also have no coinsurance with copays ranging from $20 to $35, while outpatient blood services are covered with no copay and a 20% coinsurance.
Partial Hospitalization See details
Partial hospitalization services are covered under the HealthTeam Advantage Eagle Plan (PPO) with a $50 copay and no coinsurance, though prior authorization is required.
Ambulance and Transportation Services See details
HealthTeam Advantage Eagle Plan (PPO) covers ground ambulance services with a $250 copay and air ambulance services with a $500 copay, both with no coinsurance. Transportation services are partially covered, offering up to 20 one-way trips per year to plan-approved health-related locations with no copay or coinsurance, while trips to any health-related location are not covered.
Emergency Services See details
HealthTeam Advantage Eagle Plan (PPO) covers emergency services with a $130 copay and no coinsurance, which is waived if you are admitted to the hospital within three days, and urgently needed services with a $40 copay and no coinsurance. Worldwide emergency and urgent care are partially covered up to a $50,000 maximum with no copay and no coinsurance, though worldwide emergency transportation is not covered.
Primary Care See details
HealthTeam Advantage Eagle Plan (PPO) covers primary care physician services with no copay and no coinsurance, and specialist visits with a $35 copay and no coinsurance. Other services like occupational therapy, physical therapy, mental health, and telehealth have copays ranging from $0 to $35 and no coinsurance, but podiatry is not covered and only some chiropractic services are covered, as routine and other chiropractic services are not covered.
Preventive Services See details
HealthTeam Advantage Eagle Plan (PPO) covers preventive services, including annual physical exams and kidney disease education, with no copay and no coinsurance. Additional preventive benefits are partially covered; home-based palliative care, fitness benefits, and remote access technologies are included, while services like health education, weight management, and in-home safety assessments are not covered.
Hearing Services See details
HealthTeam Advantage Eagle Plan (PPO) covers hearing exams with a $25 to $35 copay and no coinsurance, and prescription hearing aids with a $299 to $799 copay and no coinsurance. This benefit is partially covered, as over-the-counter (OTC) hearing aids, as well as inner ear, outer ear, and over-the-ear prescription hearing aid types, are not covered.
Vision Services See details
HealthTeam Advantage Eagle Plan (PPO) offers partially covered vision services with no deductibles, featuring a $25 copay for annual routine eye exams and a $35 copay for other covered exams with no coinsurance, though other eye exam services are not covered. Eyewear is covered with no copay and no coinsurance, providing a combined maximum benefit of $125 per year for contacts or eyeglasses.
Dental Services See details
HealthTeam Advantage Eagle Plan (PPO) offers partially covered dental services, featuring a $35 copay and no coinsurance for Medicare-covered dental, and no copay or coinsurance for preventive care like exams and cleanings. Comprehensive services are covered with no copay and 0% to 50% coinsurance up to a $1,500 annual limit, while fluoride treatments, other preventive services, maxillofacial prosthetics, and orthodontics are not covered.
Home Infusion bundled Services See details
HealthTeam Advantage Eagle Plan (PPO) covers home infusion bundled services with no copay. Under this benefit, Medicare Part B insulin drugs require a $35 copay and no coinsurance, while other covered Part B chemotherapy, radiation, and miscellaneous drugs have no copay and a coinsurance ranging from 0% to 20%.
Dialysis Services See details
HealthTeam Advantage Eagle Plan (PPO) covers dialysis services with no copay and a 20% coinsurance. Prior authorization is required to receive these covered services.
Medical Equipment See details
HealthTeam Advantage Eagle Plan (PPO) partially covers medical equipment with no copays, though prior authorization is required. Covered durable medical equipment, prosthetics, and medical supplies require a 20% coinsurance, and diabetic supplies carry between no coinsurance and 20% coinsurance, while diabetic therapeutic shoes and inserts are not covered.
Diagnostic and Radiological Services See details
HealthTeam Advantage Eagle Plan (PPO) covers diagnostic and radiological services, with prior authorization required for both. Diagnostic services feature no coinsurance, a $10 copay for lab services, and copays ranging from no copay to $100 for procedures, while radiological services require a $10 copay for X-rays, a minimum 20% coinsurance for therapeutic services, and diagnostic radiology starting at no copay.
Home Health Services See details
Home health services are covered by the HealthTeam Advantage Eagle Plan (PPO) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered under the HealthTeam Advantage Eagle Plan (PPO) with no copay and no coinsurance, but in practice some services are covered while cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered.
Skilled Nursing Facility (SNF) See details
HealthTeam Advantage Eagle Plan (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, requiring prior authorization but allowing admission without a prior three-day hospital stay. There is no copay for days 1 through 20 and a $218 daily copay for days 21 through 100, though additional days beyond the Medicare-covered limit are not covered.
Other Services See details
HealthTeam Advantage Eagle Plan (PPO) provides partial coverage for other services, offering a meal benefit for chronic illnesses and over-the-counter (OTC) items with no copay and no coinsurance. While acupuncture is not covered under this benefit, eligible OTC items are covered via reimbursement up to $50 every three months.
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