Understanding your benefits

Priority Health makes important information available to help you understand how your health plan works and maximize your benefits. This information is available for most members online and in print. To access the information, please follow the directions below:

• Medicare members: Check your Medicare Handbook or call Customer Service at  888 389-6648. TTY/ TDD users, please call  888 551-6761.
• Members in self-funded plans: Check with your plan sponsor on your plan specifics.
• All other members: Visit priorityhealth.com and type the keyword(s) provided below in the SEARCH box. For print copies, call Customer Service at  800 446-5674.

Disease management programs

Learn what programs are available to help you manage chronic illnesses, how to use the services and how to become eligible.
Search keyword: programs

Fraud and abuse

Find out how you can help combat health care fraud and abuse.
Search keyword: fraud

Grievance procedure

Learn how our three-step grievance procedure works.
Search keyword: grievance

Plan basics

Review your Certificate of Coverage and Member Handbook for information about benefits, procedures, obtaining care and services, and providers who participate with your plan.
Search keywords: coverage, handbook

Prescription drug updates

Priority Health regularly reviews new drugs to help make sure that you are receiving safe and effective care. If you take prescription drugs, it’s important that you review our Approved Drug List occasionally in order to note changes or updates.
Search keyword: drugs

Privacy statement

Learn how Priority Health is committed to keeping your health information private.
Search keyword: privacy

Quality performance

Review Priority Health’s most recent Quality Improvement Workplan, the Quality Improvement Program Description and our Annual Quality Improvement Evaluation by calling Customer Service for print copies.

Rights and responsibilities

Know what you can expect from Priority Health and what Priority Health expects from you.
Search keywords: member rights

Benefit decisions

Priority Health has a policy to ensure that medical coverage decisions are made fairly. Contact us about our utilization management process and decisions. Know that utilization management decisions are based on appropriateness of care and service and that no financial rewards exist for issuing denials.
Search keyword: utilization

Get the latest preventive health care guidelines

Following preventive health care guidelines can help you maintain your well-being. Every year, Priority Health publishes the latest recommended screening, immunization and physical examination guidelines for the whole family. Get your FREE copy at priorityhealth.com.
Search keyword: preventive

Topics: Benefits, Health care quality, Preventive care