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Compare our Medicare Advantage plans

Of all the options available, a Medicare Advantage plan with prescription drug coverage makes the most sense for most people.

  • You get Medicare Parts A, B, C and D in one convenient plan.
  • You can put your government-issued Medicare card away and use your PriorityMedicareSM card for everything from doctor visits to prescriptions drugs.
  • If you have a Medicare Advantage plan, you don't need Medigap coverage.
  • You'll save money by using in-network doctors, hospitals, and other health care providers. Learn more.
  • Use out-of-network providers if you like. Learn how it works.
  • Availability and premiums vary by county. View plans and premiums in your area.


Compare Our Medicare Advantage Plans
Benefits PriorityMedicare Value PriorityMedicare PriorityMedicare Plus

Deductible
(medical)

 In-network:
  • None
Out-of-network:
  • $300
 In-network:
  • None

Out-of-network:

  • $300
 In-network:
  • None

Out-of-network:

  • $300
Out-of-pocket maximum - medical1 In-network:
  • $3,350
Out-of-network:
  • $3,350
 In-network:
  • $3,350
Out-of-network:
  • $3,350
 In-network:
  • $3,350
Out-of-network:
  • $3,350
Doctor visit
In-network
  • $15 copay for primary care physician
  • $30 copay for specialist
Out-of-network:
  • $35 copay
 In-network
  • $10 copay for primary care physician
  • $20 copay for specialist
Out-of-network:
  • $25 copay
 In-network
  • $15 copay for primary care physician

  • $20 copay for specialist
Out-of-network:
  • $25 copay
Hospitalization
In-network
  • $500 copay for each Medicare-covered hospital stay (plan covers 90 days each benefit period)
Out-of-network:
  • $700 copay per hospital stay
 In-network
  • $50 copay per day for days 1-5
  • $0 copay per day, days 6+
Out-of-network:
    • $150 copay per day for days 1-5
    • $0 copay per day, days 6+
 In-network
  • $250 copay for each Medicare-covered hospital stay

Out-of-network:

  • $500 copay per hospital stay
Skilled nursing facility care
In-network
  • $0 copay per day, days 1-10
  • $100 copay per day, days 11-100
Out-of-network:
  • $0 copay per day, days 1-10
  • $120 copay per day, days 11-100
 In-network
  • $0 copay per day, days 1-10
  • $75 copay per day, days 11-100
Out-of-network:
  • $0 copay per day, days 1-10
  • $100 copay per day, days 11-100
 In-network
  • $0 copay per day, days 1-10
  • $75 copay per day, days 11-100
Out-of-network:
  • $0 copay per day, days 1-10
  • $100 copay per day, days 11-100
Home health care
In-network
  • $0 copay
Out-of-network:
  • $0 copay
 In-network
  • $0 copay
Out-of-network:
  • $0 copay
 In-network
  • $0 copay
Out-of-network:
  • $0 copay

Physicals
(Routine, limited to 1 exam per year)

 In-network
  • $15 copay
Out-of-network:
  • $20 copay
 In-network
  • $10 copay
Out-of-network:
  • $15 copay
 In-network
  • $15 copay
Out-of-network:
  • $20 copay
Routine screenings
(Mammograms, colorectal exams, etc.)		 In-network
  • $0 copay
Out-of-network:
  • $10 copay
 In-network
  • $0 copay
Out-of-network:
  • $10 copay
 In-network
  • $0 copay
Out-of-network:
  • $10 copay
Hearing services 
In-network
  • $30 copay for Medicare-covered    diagnostic hearing exams (see your plan's Summary of Benefits for details)

Out-of-network

  • $35 copay
In-network
  • $0 copay for up to 2 hearing aid(s) every 3 years
  • $20 copay for Medicare-covered diagnostic hearing exams
  • $20 copay for up to 1 routine hearing test(s) every year
  • $300 limit for hearing aids every 3 years

Out-of-network

  • $25 copay
 In-network
  • $0 copay for up to 2 hearing aid(s) every 3 years
  • $20 copay for Medicare-covered diagnostic hearing exams
  • $20 copay for up to 1 routine hearing test(s) every year
  • $300 limit for hearing aids every 3 years

Out-of-network

  • $25 copay
Vision services 
In-network
  • $0 copay for 1 pair of eyeglasses or contact lenses after each cataract surgery (see your plan's Summary of Benefits for details)
  • $30 copay for exams to diagnose and treat diseases and conditions of the eye

Out-of-network

  • $35 copay

 In-network
  • $0 copay for 1 pair of eyeglasses or contact lenses after each cataract surgery (see your plan's Summary of Benefits for details)
  • $0 copay for glasses
  • $0 copay for contacts
  • $20 copay for exams to diagnose and treat diseases and conditions of the eye
  • $20 copay for up to 1 routine eye exam(s) every year
  • $75 limit for eye wear every 2 years 

Out-of-network

  • $25 copay
  • In-network
    • $0 copay for 1 pair of eyeglasses or contact lenses after each cataract surgery (see your plan's Summary of Benefits for details)
    • $0 copay for glasses
    • $0 copay for contacts
    • $20 copay for exams to diagnose and treat diseases and conditions of the eye
    • $20 copay for up to 1 routine eye exam(s) every year
    • $75 limit for eye wear every 2 years 

    Out-of-network

    • $25 copay
Urgent & emergency care (worldwide)
  • $50 copay for Medicare-covered emergency room visits
  • $40 copay for Medicare-covered urgent care visit (see your plan's Summary of Benefits for details)
  • For other non-contracted services, out-of-pocket costs vary by plan (see your plan's Summary of Benefits for details.)
  • $50 copay for Medicare-covered emergency room visits
  • $40 copay for Medicare-covered urgent care visit (see your plan's Summary of Benefits for details)
  • For other non-contracted services, out-of-pocket costs vary by plan (see your plan's Summary of Benefits for details.)
  • $50 copay for Medicare-covered emergency room visits
  • $40 copay for Medicare-covered urgent care visit (see your plan's Summary of Benefits for details)
  • For other non-contracted services, out-of-pocket costs vary by plan (see your plan's Summary of Benefits for details.)
Cost per prescription2
Between $0 - $2,700 in total drug costs3
  • $0 deductible
  • Generics6: $8 copay for 31-day supply
  • Preferred brand-name6: $30 copay for 31-day supply
  • Non-preferred brand: $60 copay for 31-day supply
  • Specialty: 25%  for 31-day supply
  • $0 deductible
  • Generics6: $8 copay for 31-day supply
  • Preferred brand-name6: $30 copay for 31-day supply
  • Non-preferred brand: $60 copay for 31-day supply
  • Specialty: 25%  for 31-day supply
  • $0 deductible
  • Generics6: $8 copay for 31-day supply
  • Preferred brand-name6: $30 copay for 31-day supply
  • Non-preferred brand: $60 copay for 31-day supply
  • Specialty: 25%  for 31-day supply
Cost per prescription2
Between $2,700 in total drug costs3 and $4,350 in out-of-pocket drug costs4 (the "donut hole")		 100% of discounted cost5 100% of discounted cost5
  • Generics6 at retail pharmacy: $8 copay for 31-day supply
  • Generics6 at long-term care pharmacy: $8 copay for 31-day supply
  • Generics6 by mail order: $20 for 90-day supply
  • All other drugs: 100% of discounted cost5
Cost per prescription2
after you reach $4,350 in out-of-pocket costs4
  • $2.40 copay for generics and a few brand-names
  • $6.00 copay all other drugs
OR
  • 5% of discounted cost5
    (whichever is greater)
  • $2.40 copay for generics and a few brand-names
  • $6.00 copay all other drugs
OR
  • 5% of discounted cost5
    (whichever is greater)
  • $2.40 copay for generics and a few brand-names
  • $6.00 copay all other drugs

OR

  • 5% of discounted cost5
    (whichever is greater)

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1Except for costs related to outpatient drugs
2 Medicare insurance benefits may vary when provided through an employer.
3Total prescription costs include the copays you pay AND the costs the plan pays in 2009.
4 Your out-of-pocket costs include what you pay for prescription drugs (copays and/or the percentage of the cost you pay) in 2009.
5 Priority Health's discount averages 16% on most brand-name drugs, 58% or more on generics.
6 Applies only to prescription drugs on the Priority Health approved drug list (formulary). Note: You may pay more than the copay if you get your drugs at an out-of-network pharmacy.


    H2320_4000_4006_67 CMS (05/2009) S5857_4000_4006_67 CMS (05/2009)
    Last modified 07/20/09