Priority Health

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Cardiovascular health management Program

Coverage for supplies, health services and education

This summary highlights your coverage for cardiovascular health care.

Refer to your coverage documents for a complete list of benefits, limitations, exclusions, and possible cost.

If your plan has a deductible, you must pay the deductible before any copayment applies.

SERVICES	COVERAGE
Cardiovascular Health Management Program Priority Health Registered Nurse telephone counseling and education Customized educational mailings High blood pressure and high cholesterol reminder postcards Home health care referrals (Your doctor must obtain prior authorization from Priority Health.) Community resource referrals Cardiovascular resource list HealthFit Discounts on health club memberships, training, equipment, and clothing ACE/ARB medication reminders	Covered program.
Cardiac rehabilitation Classes at hospitals that participate with Priority Health	Covered benefit. A doctor's order may be required. A copayment may apply.
Dietician consult	Covered benefit. A doctor's order is required.
Doctor visits Routine physical exam Well child care	Covered benefit. A copayment may apply.
Cardiologist/specialist visit	Covered benefit at In-Plan* doctor. A copayment may apply.
Immunizations Flu shot Pneumonia shot Pneumonia booster shot	Covered benefit. An office visit copayment may apply. Talk to your doctor about what is best for you.
Durable medical equipment (DME)	Covered benefit at In-Plan* provider. A copayment may apply.
Medications Medicines by mouth Fill prescriptions at retail pharmacies or by mail	Your benefit plan may include coverage for prescriptions as an optional benefit at an In-Plan* pharmacy. Please verify your coverage by checking your Member ID card. A copayment may apply.
Mental health/substance abuse care If you have feelings of depression for more than two weeks or suffer from substance abuse, call our Behavioral Health Department at 800 673-8043.	Our Behavioral Health Department will determine what is clinically necessary and may authorize services. It is not necessary to contact your PCP to receive mental health and substance abuse services. All communications and treatments are completely confidential.

* In Plan: Refer to the Find a Doctor online directory for a list of participating doctors, hospitals, pharmacies, medical supplies and equipment sellers, and other health care providers.