Priority Health uses Cost Estimator to cut prescription costs for Medicare members

(Grand Rapids, Mich. – June 25, 2018)  Today, Priority Health announced that its Cost Estimator now enables Medicare Advantage members to access real-time cost information about prescription drugs, helping members pay less by switching to a lower priced alternative, using a preferred pharmacy or opting for mail order.

"With the price of prescriptions continuing to increase at alarming rates, we feel it's imperative to help our members understand their options and navigate their costs," said Nathan Foco, senior director of market research and consumer analytics for Priority Health. "But it's not enough to provide general costs. The real power in informing members is our ability to personalize it to them – specific to their location, prescription and benefits – to help them make truly informed decisions about their costs."

Prices for the most commonly prescribed brand-name drugs for seniors have increased an average of 60 percent since 2013. For the first time, Cost Estimator will enable Medicare Advantage members to find out what they will pay for some prescriptions and help them determine how to pay less by switching to a lower priced alternative, using a preferred pharmacy or opting for mail order.

More than 6,000 prescriptions are available for Medicare beneficiaries to research through Cost Estimator, including pills, chewables and capsule drugs. When a medication is priced through the tool, members have the option to view more affordable alternatives and see exact costs at preferred pharmacies. For members who require some of the most expensive drugs on the market, Cost Estimator could help them find huge savings.  

Cost Estimator launched in 2015, providing Priority Health individual and commercial members instant access to cost information by facility for hundreds of health care procedures based on their individual health plan. Utilization has steadily increased to 10 percent of eligible commercial members currently using Cost Estimator, which exceeds the industry average of 2 to 3 percent. Earlier this year, some of the most searched and billed procedures were added to Cost Estimator. Since launching in 2015, Cost Estimator resulted in shared savings of more than $7 million. Today, more than 6,000 prescriptions are available to research through Cost Estimator. 

Members can access the tool by logging into their MyHealth account, then choosing the Cost Estimator tile. 

About Priority Health:

Priority Health is an award-winning, Michigan-based non-profit health plan nationally recognized for improving the health and lives of the people it serves. It continues to lead the industry in engaging members in their health, delivering effective health and disease management programs and working with physicians to improve health care outcomes and performance. Priority Health is one of only 20 health plans nationwide offering wellness programs accredited by the National Committee for Quality Assurance, an organization which also rated it among the best health plans in the nation. The State of Michigan named the Priority Health HMO the benchmark plan for all individual and group HMO plans to model.

Priority Health offers a broad portfolio of health benefit options for employer groups and individuals, including Medicare and Medicaid plans. Its network of health care providers features 95 percent of practicing physicians available in Michigan and more than 900,000 health care providers nationwide.