HealthbyChoice Incentives Instructions

All new members, including spouses and covered dependents, start out with the Choice level of benefits for the first 90 days from their effective date of coverage. Here's what you (and your spouse, if covered by the plan) need to do within these 90 days to maintain the Choice level of benefits the remainder of the year. (The same instructions apply for qualifying for or requalifying for the Choice level of benefits if you're a renewing member.)

Print these instructions to use for reference. You can also call Customer Service for help.

Create your personal online account

If you don't already have a Priority Health online account, as soon as you receive your member ID cards (typically seven to ten days after your effective date of coverage), register your account. You need an online account in order to complete your first requirement. You only need to create your account once.

If you forget your username or password

If you've forgotten either your username, your password or both, click Forgot Password? and enter your contract number from your Priority Health member ID card and other information. You will be given your username and asked to create a new password. ALWAYS LOG OUT when you are finished visiting your personal online account to protect your personal health information. Simply click Logout in the upper right corner.

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Meet the Choice level requirements

Within 90 days (from your effective date of coverage or renewal date), you and your spouse, if covered by the plan, must meet these two requirements:

1. Health Risk Assessment: Log in to your account and click on HealthbyChoice. Complete the online health risk assessment (HealthQuotient^TM).  It will calculate your health risk levels, and provide recommendations for improving your health. All your answers are private and will never be shared with your employer.
   
2. Qualification form: Have your health care provider (typically your primary care physician) submit the HealthbyChoice Incentives qualification form showing your status on the three health indicators below. Your health care provider can submit the information online or by faxing us the form.
   Print a qualification form (68KB PDF).
   
   To qualify for the Choice level, your health care provider must tell us:

• You don't use tobacco of any kind.
  
• Your blood pressure is under 140/90.
• Your Body Mass Index (BMI) is under 30.

Alternative to Requirement 2
If you don't meet all three health indicator criteria in Requirement 2, you can still maintain the Choice level benefits if (within the same 90-day window) you agree to:

• Complete a fasting cholesterol test (requires lab testing)
• Complete a fasting blood sugar test (requires lab testing)
• Follow your health care provider's treatment plan

Your responsibilities
It's up to you to make sure you see your health care provider and get any tests you may need so your doctor or other health care provider can submit the results within your 90-day qualification window.

You will typically need to pay an office visit copay for meeting with your health care provider to measure the health indicators. Also, the costs of any additional tests may go against your deductible, depending on your specific benefits.

Using existing health data
If your doctor has already evaluated your health indicators within six months of your effective date of coverage, you can ask that the information be submitted to Priority Health so you don't have to make an office visit.

If you need to complete lab work to meet the alternative to Requirement 2, your doctor can submit test results from up to six months prior to your effective date of coverage.

Checking your status
You can go to your online account here at priorityhealth.com to check your progress in meeting the requirements.  You'll also be able to tell if your spouse has met his or her requirements.

• Log into your online account with your username and password.
• Find the HealthbyChoice area at the top of your personal page.
• Click the View Status button.

Learn what happens if your benefit level changes.
Learn what happens at renewal.