Go to Step 1: Choose a plan
Complete Step 2: Review the eligibility and enrollment information
Go to Step 3: Print an enrollment
form
Go to Step 4: Send us your completed
form
Step Two: Review the following information carefully before you decide to
enroll.
Members may enroll in a plan only during specific times of the year.
Plans May Change from Year to Year
To make sure we're providing the coverage you need at a rate you can
afford, each year we review our plans and we may make adjustments. Plan
benefits, approved drug list, pharmacy network, the counties where we offer
plans, our monthly premiums and/or copayments and coinsurance may change
each year on January 1. We will send you information about any
upcoming changes in October of each year to give you time to review them
before the annual enrollment period each November.
About PriorityMedicare and PriorityMedicarePlus:
- You must be entitled to Medicare Part A and enrolled in Part B
in order to apply for PriorityMedicare or
PriorityMedicarePlus. You also must continue to pay your monthly
Part B premium unless it is otherwise paid for under Medicaid or by another
third party.
- You must live in one of the following 14 Michigan counties to
join: Allegan, Antrim, Benzie, Crawford, Grand Traverse, Kalkaska,
Kent, Leelanau, Manistee, Montcalm, Muskegon, Oceana, Osceola, Ottawa. If
your employer offers one of these plans, you may be able to join even if
you live outside these counties; contact your employer.
- These two plans are HMOs with a point-of-service option
operating under a Medicare Advantage contract. They include Medicare Part D
Prescription Drug Plan coverage.
- The prescription drug benefit is only available to
members of these plans. If you are already enrolled in another Medicare
Advantage Prescription Drug Plan, you must receive your Drug Benefit
through that plan.
- Members must use in-network doctors and other health care
providers to receive full plan benefits, except under emergency
circumstances, post-stabilization care and renal dialysis. You may choose
to see providers outside of the network, but you will pay 20% coinsurance
(or more) and one initial deductible of $500 for all Medicare-covered plan
services when received out-of-network only. Some services will require
authorization in advance.
About PriorityMedicareRx:
- PriorityMedicareRx is a Medicare Part D Prescription Drug Plan
operating under a contract with the Federal government. This plan offers no
other benefits, such as hospitalization or doctor visits.
- You must be entitled to Medicare Part A and/or enrolled in Part
B in order to apply for a Part D Prescription Drug Plan. If you are
enrolled in Medicare Part B, you must continue to pay your monthly Part B
premium unless it is otherwise paid for under Medicaid or by another third
party.
- PriorityMedicareRx is available to residents of the state of
Michigan.
- Medicare beneficiaries may be enrolled in only one Part D plan at a
time. If you are enrolled in a Medicare Advantage coordinated care (HMO
or PPO) plan or Medicare Advantage private fee-for-service (PFFS) plan that
includes Medicare prescription drugs, you may not enroll in a Prescription
Drug Plan unless you disenroll from the HMO, PPO, or PFFS plan. If you are
enrolled in a PFFS plan that does not provide Medicare prescription
drug coverage, or an Medicare Advantage Medical Savings Account (MSA) plan,
you may enroll in a Prescription Drug Plan. Also, if you are enrolled in an
1876 Cost Plan, you may enroll in a Prescription Drug Plan.
About using network pharmacies (all plans):
- You must use network pharmacies to receive full plan benefits.
If you choose to use a non-network pharmacy, you will be required to pay up
front. You may then ask for reimbursement by filing a claim form. We will
reimburse you for what you paid up to our negotiated in-network pharmacy
cost, less your copayment or coinsurance amount.
Extra help for people with limited incomes and resources:
You may be able to get extra help to pay for your prescription drug premiums
and costs. To see if you quality for getting extra help, call:
- The Social Security Administration at 1-800-772-1213 between 7 a.m. and
7 p.m., Monday through Friday. TTY/TDD users should call
1-800-325-0778.
- The State of Michigan Medicaid Office
- 1-800 MEDICARE (1-800-633-4227), (TTY/TDD users should call
1-877-486-2048, 24 hours a day/7 days a week)
For more information about any PriorityMedicare plan:
- Call 616 464-8850 or toll-free 888 389-6676, 24 hours a day, 7 days a
week.
- Hearing- or speech-impaired? Call 616 464-8485 or toll-free 888
551-6761, Monday-Friday, 8:30 a.m. to 5:00 p.m. Eastern time.
- Send us your questions by
e-mail.
- Write to us at PriorityMedicare, MS 1125, 1231 East Beltline NE,
Grand Rapids, MI 49525.
Last modified
09/06/07
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