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Your coverage documents describe your rights and obligations as a member of a Priority Health insurance or managed care plan as well as what is covered by the plan. You're responsible for understanding the terms and conditions of your health benefits.
Careful! Employers make changesPlease note that employers may add or delete items included in these master documents to create their own version of the plans. See any rider you received when you enrolled for more details, or contact our Customer Service department for help.If you are a member of a self-funded plan, these documents will not apply.See your employer for your plan documents.Select your health plan's coverage document belowWhat Priority Health plan do you have?Jump down the page to:
Group PriorityHMO plans
Group PriorityEPO plans
Group PriorityPOS plans
Group PriorityPPO plansNote: Find if you have the PPO or the PPO Premier plan by looking at the Schedule of Copayments and Deductibles we sent you at the beginning of your plan year. Most of our PPO members have the Premier plan.
Priority Health Medicare plans (group and individual)Go to the Medicare plans section of this website.Individual plan coverage documentsIndividual coverage (state-mandated individual coverage, or SMIC, insurance plan)This plan is not purchased through an employer. It renews May 1 each year.
Individual coverage (group conversion plan)This plan covers individuals who had group Priority Health coverage through their employers and have converted it to individual coverage.
PriorityIndividual coverage documentsChoose your document(s) based on your "effective date", which is the date your coverage began (always the first day of a month).Effective dates of July 1 and August 1, 2009:
Medicaid plan
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You are responsible for copayments and deductibles listed in the Schedule of Copayments and Deductibles.
Last modified
08/18/10
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