Managing a condition?
We want to help make your transition to a new health plan seamless. That means providing one-on-one support during the process so you can feel confident in your coverage.
Transition fills for your medications
We understand you may need additional time to work with your doctor for any medications that require step therapy or prior authorization. Most prescriptions that require step therapy or prior authorization can be filled one time without fulfilling those requirements if they are filled within 120 days of your plan's start date; the drugs are typically given in a 30-day supply unless they have quantity or dosage limits.
After the prescription is filled, you'll receive a letter in the mail from Priority Health if your drug requires step therapy or prior authorization. If so, you'll need to obtain prior authorization or complete the step therapy requirements before filling that prescription again.
Search our approved drug list for a list of covered medications.
MTM: A medication review that can save you money
If you're managing a chronic condition, you may be taking several medications. Our Medication Therapy Management (MTM) program connects you with a certified pharmacist to make sure you're still taking the right drugs, and keep you from overpaying for them (when generic alternatives are available).
When you become a member, you'll have a certified care manager available to help you meet your health needs. This service is available at no cost to you. If you have a serious or chronic condition, we'll help you manage it in the ways that work best for you and your situation. Additionally, if you have questions about transitioning your care through a new health plan, your care manager can help answer questions.
To connect with a care manager, call 833.207.3211 and ask to speak with a care manager.
We check in with you after a hospital stay to make sure you’re getting back on your feet. If you need anything after a procedure or operation, our outreach helps us pair you with the right health profession to make sure you’re getting the help you need.