Overview of PriorityMedicare plan benefits

Priority Health has contracted with the Centers for Medicare and Medicaid Services (CMS) to offer PriorityMedicare^SM to Medicare beneficiaries living in select Michigan counties.

This Medicare Advantage product is a replacement product for Original Medicare. In addition to Original Medicare benefits, it includes limited coverage for:

• Preventive services
• Wellness programs
• Some out-of-network benefits not otherwise available to Medicare recipients
• Prescription coverage

Learn more about all PriorityMedicare plans

• Go to the PriorityMedicare website home page
• Plan summaries (copays & benefit overview)
• Formulary information

Benefit notes

PriorityMedicare members have direct access to these services:

• Mammography screenings
• Influenza vaccinations (covered in-network at $0 copay)
• In-network women's health specialists for routine and preventive health services

In addition, pneumococcal vaccinations are also covered in-network at a $0 copay.

Health risk appraisals and high-risk members

Within 90 days of enrollment, PriorityMedicare plan members are mailed a Health Risk Appraisal (HRA) survey to complete. Members who are identified as high-risk according to the HRA information are assigned to a Priority Health nurse case manager. The case manager coordinates services for the member and develops a care plan for him/her in consultation with the member's primary care physician's office.

Evidence of Coverage documents

These documents describe the benefits of the three Priority Health Medicare products for individual subscribers. The documents describing benefits offered by employers to their retiree groups will vary; call the Provider Help Line for more information.

• PriorityMedicare Value Evidence of Coverage for 2009 (700KB PDF)
• PriorityMedicare Evidence of Coverage for 2009 (710KB PDF)
• PriorityMedicare Plus Evidence of Coverage for 2009 (717KB PDF)

Member Handbooks

These documents guide members through their individual PriorityMedicare coverage. Information about benefits offered by employers to their retiree groups will vary; call the Provider Help Line for more information.

• PriorityMedicare Value Member Handbook (1.5MB PDF) - Updated 12/2008
• PriorityMedicare Member Handbook (1.5MB PDF) - Updated 12/2008
• PriorityMedicare Plus Member Handbook (1.5MB PDF) - Updated 12/2008
• PriorityMedicare Rx Member Handbook (1.5MB PDF) - Updated 12/2008

Federal requirements of Medicare plan providers

Learn more about what the federal government requires of Priority Health and all Medicare Advantage Plan and Medicare Prescription Drug Plan providers.
Go to the Priority Health obligations under Medicare page

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