Enrolling in one of our TEAMStar Part D Plans is easy!

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Online Form

Fastest and easiest way to enroll.

Choose a plan below and click 'Enroll' to begin the enrollment process. The system will take you through a few easy steps and confirm your enrollment.

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Phone

Call our Customer Service Department to enroll over the phone.

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Paper Form

Click to download a printable Enrollment Form that can be mailed to us. You can also click the 'Request Information' button above to request an enrollment packet

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 a TEAMStar Medicare Part D Plan

Bronze

Silver

Platinum

Monthly Premium $37* $74* $135*
Deductible $400 $0 $0
Low Cost Generics at Union-Designated Pharmacies
Retail:
30-day supply
$2 $2 $2
TIER 1: Preferred Generics
Retail:
30-day supply
$6 $6 $6
Mail:
90-day supply
$12 $12 $12
TIER 2: Generics
Retail:
30-day supply
$9 $9 $9
Mail:
90-day supply
$18 $18 $18
TIER 3: Preferred Brands
Retail:
30-day supply
$45 $45 $35
Mail:
90-day supply
$90 $90 $70
TIER 4: Non-Preferred Brands
Retail:
30-day supply
25% $70 $55
Mail:
90-day supply
25% $140 $110
TIER 5: Specialty Drugs
Retail:
30-day supply
25% $70 $55
Mail:
90-day supply
25% $140 $110
Enroll »Bronze Plan Enroll »Silver Plan Enroll »Platinum Plan

Summary of Benefits

Deductible Phase

With the TEAMStar Silver or Platinum Part D Plans, there is no deductible. With the TEAMStar Bronze Plan, there is a $400 deductible. However, this deductible does not apply to certain Preferred Generics filled at Union Preferred Pharmacies .

2017 Summary of Benefits

Initial Coverage

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 until the calendar year total of your payments and the plan payments equal $3,700. Then your payments will depend upon the type of drug and which plan you select.

*Monthly premium will be reduced to $36 for Bronze Plan, $73 for Silver Plan and $134 for 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 or extra Part D amount based on your income.

Coverage Gap

While you are in the Coverage Gap, you will receive a discount on brand-name drugs and you pay only 51% of the cost for generic drugs until your total calendar year out-of-pocket costs equal $4,950 in true out-of-pocket. With the Platinum Plan, you will pay no more than $6 for a 30-day supply of Tier 1 Preferred Generic drugs.

Catastrophic Coverage

After your true out-of-pocket costs reach $4,950, you pay the greater of 5% coinsurance or a $3.30 copay for generic (including brand-name drugs treated as generic) and a $8.25 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 during the catastrophic phase.

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.

2017 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.

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)

Explanation of Benefits

You receive an Explanation of Benefits (EOB) each month you have a claim. The EOB shows what drug costs were covered. The EOB also tracks spending, so you always know how close you are to the Coverage Gap.

Part D with Other Coverage

Part D with Other Coverage

When deciding if a Part D plan is right for you, it's important to understand how it may affect other benefits you also receive.

Pharmacy Locator

Pharmacy Locator

Visit a Union Preferred Pharmacy to get generic drugs at a low cost or find a retail pharmacy near you.