Member centers closed. Our member walk-in centers in Grand Rapids and Holland are closed to keep our communities safe and help slow the spread of COVID-19. Signage will alert members to alternative options for paying their premium and getting any other help needed.

If you are experiencing life-threatening symptoms call 911. 

Last updated: 3/26/2020

On March 10, the first confirmed cases of COVID-19 in Michigan were announced and Governor Whitmer declared a state of emergency to maximize efforts to slow the spread. For more information about COVID-19, visit our information page, or the Centers for Disease Control and Prevention at cdc.gov.

Things to know about COVID-19

What is COVID-19?

According to the Centers for Disease Control and Prevention (CDC), Coronavirus disease 2019 (COVID-19) is a respiratory illness that can spread from person to person. The virus that causes COVID-19 is a novel coronavirus, or SARS-CoV-2, that was first identified during an investigation into an outbreak in Wuhan, China. This flu-like virus is very serious and contagious.

Priority Health continues to monitor the CDC’s recommendations and work with the Michigan State Health Department and Department of Health and Human Services to ensure appropriate information is obtained and shared with our members.

What are the symptoms?

As the concern for COVID-19 continues to grow, it’s important to know the symptoms involved:

  • Fever
  • Cough
  • Shortness of breath

Similar to influenza, people at a serious risk for developing severe COVID-19 symptoms are those who suffer from chronic disease and weakened immune systems. Older demographics are also at a more serious risk.

How is COVID-19 transmitted?

The virus is thought to spread from person-to-person through respiratory droplets produced when an infected person coughs or sneezes.

How can you reduce the risk of getting COVID-19?

The best way to prevent becoming ill is to avoid being exposed to the virus in the first place.

To reduce the risk, health experts recommend taking the following everyday precautions:

  • Wash hands frequently with soap and water for 20 seconds minimum.
  • Clean and disinfect any surfaces you frequently touch (like your phone).
  • When sneezing or coughing, always cover your nose and mouth with a tissue, then throw the tissue away and wash your hands.
  • Stay home if you are feeling sick (cough, fever, trouble breathing).
  • Avoid close contact of any kind with sick individuals.
  • Avoid touching your eyes, nose and mouth.

You can find more information on the CDC prevention webpage.

What if I am experiencing symptoms?

Right now, it is up to state and local health departments to decide which individuals receive COVID-19 tests. If you have symptoms, you must first consult with a physician (a virtual visit can qualify as a screening). Your physician can then help you understand if you qualify for testing and how to proceed.

Use virtual care for screening

We encourage our members to use virtual care if they have any symptoms to avoid overwhelming health care providers and to help reduce the risk of spreading or contracting the illness during an emergency room or physician’s office visit. 

Check with your doctor’s office to see if they offer virtual care. If you’re a Priority Health member, download the Priority Health app (available on the App Store and Google Play) or log in to your member account to access virtual care options.

For all other virtual care

Priority Health covers the cost of in-network virtual care (with the exception of behavioral health*) for all members and starting immediately will temporarily waive costs before deductible for HSA plan members, through Apr. 30, 2020.

*Priority Health will cover the cost of Behavioral Health virtual visits for Medicare Advantage through Apr. 30, 2020.

Testing

As mentioned, your physician will help you understand how to receive testing for COVID-19. You cannot request a test without a screening at this time. Testing for COVID-19 needs to be ordered by a doctor or other health care provider and must be deemed medically necessary.

What if my PCP does not have a virtual care option?

If you’re a Priority Health member, download the Priority Health app (available on the App Store and Google Play) or log in to your member account to access virtual care options. Spectrum Health is offering free screenings to anyone in Michigan. Call 616.391.2380

COVID-19 related coverage through Priority Health

Does Priority Health cover the following COVID-19 services?

COVID-19 Screening

Screening is defined as a series of questions a medical professional uses to determine if a COVID-19 test is appropriate.

  • Co-pays and deductibles waived if screening is virtual (phone, email, video), whether or not a COVID-19  test is warranted or ordered. 
  • Co-pays and deductibles waived for an in person visit if your screening results in your doctor ordering or administering a COVID-19 test.
  • Above is true for out of state as well.
  • Check with your doctor’s office to see if they offer virtual care.
  • If you’re a Priority Health member, download the app (available on the App Store and Google Play) or log in to your member account to access virtual care options.
  • If you’re in the state of Michigan, Spectrum Health is offering a free screening when you call 616.391.2380.
  • This applies for all Priority Health plans.

COVID-19 Testing: Fully covered

  • Patients can only be tested for COVID-19 if a doctor deems a test medically necessary after an initial screening
  • Co-pays and deductibles are waived for COVID-19 tests deemed medically necessary by a doctor. This means there is no member cost (copays, deductibles, coinsurance) for diagnostic testing of COVID-19. 
  • Once a doctor has deemed the service medically necessary, we will not require a Prior Authorization.

COVID-19 Treatment: Covered subject to the terms of your plan

  • Your standard plan benefits apply for any care received while in treatment for COVID-19.
  • The exact coverage details and cost-sharing amounts for individual services may vary by plan.
  • See your plan details in your member account for more information on standard cost of care.

Is this true for all plans?

The above is true for all plans.

What if I am travelling out of state?

If you are out of state and need emergency medical assistance related to COVID-19, testing and diagnosis of COVID-19 will be covered in full as outlined above. Once COVID-19 is diagnosed, treatment is covered subject to your deductible and other terms of your plan.

Included in most Priority Health plans is Assist America® for emergency travel assistance. Assist America covers the costs of all services related to getting quality emergency medical care while traveling, such as medical referrals, critical care monitoring, emergency evacuation and other support measures. Assist America is not insurance. Their services do not replace medical insurance.

Note: Once a qualified doctor or hospital begins care, all treatment costs are subject to the coverage rules of your plan.

What if I’m out of the country (OOC)?

  • OOC members are covered* for Urgent and Emergency care as stated by their plan.
  • Contact Assist America first, they will provide guidance on what options the member has.
  • The usual process will apply where if the member seeks care they may be asked to pay up front.
  • The member should get a detailed receipt and then they file a form to get reimbursed with us.
  • Testing will be covered, and co-pays and deductibles for the COVID-19 will be waived.

*Note: Priority Health Medicaid members do not have any out-of-country benefits and services received outside of the United States cannot be reimbursed.

Prescription options

Priority Health members can get free at-home delivery for a limited time through the following pharmacy vendors.

CVS pharmacy logo 

How does it work?

  • Contact CVS* to ask about these home delivery options using CVS.com, CVS mobile app, or by contacting your local CVS pharmacy directly.
  • Once you’re set up, CVS uses UPS or FedEx to deliver your prescriptions within 1-2 days.
  • There are is no limit to a specific amount of days’ supply. You can get anything from a few days up to a 90-day supply (although we recommend setting up 90-day refills).

*CVS is not an in-network pharmacy for Medicaid and Healthy Michigan members. CVS is not a preferred Medicare pharmacy which means your cost share for drugs may be higher.

How long will this be available?

Now through Apr. 17, 2020

 Walgreens logo 

How does it work?

  • Walgreens Express™ delivery is available for all Priority Health members.
  • Contact your local Walgreens for details.
  • Once you’re set up you’ll be able to prepay for your prescriptions and receive them as soon as the next day via FedEx.
  • Orders received by 4pm on Friday, as well as requests made during the weekend, have an expected delivery day of Tuesday or Wednesday.
  • Prescriptions are not delivered on Sundays or holidays.

How long will this be available?

Now through April 21, 2020

 Meijer pharmacy logo 

How does it work?

  • Contact your primary Meijer pharmacy to set up your home delivery option.
  • The standard Rx delivery time varies between 1-2 days.
  • Rx next day delivery is available from select Meijer pharmacies and the usual $8 fee is being waived at this time.
  • Also, "Touch free" service is being offered. This means no signature is required at the time of delivery. Payment for the prescription copay is on your mobile device of over the phone.
  • Meijer is delivering controlled substances and refrigerated items.
  • Available for all Priority Health members.

How long will this be available?

Starting on Mar. 30. Check back for an end date.

What if I have prescriptions with another pharmacy?

Other local pharmacies may have a “home-delivery” option. Check with your pharmacist for options.

How is this different than my current 90-day refills through mail order*?

If you already have an automatic 90-day refill set up, then no need to change a thing. You get discounted rates and your prescriptions delivered in the mail to your home already. Note: If you have a Medicare plan, you can find your 90-day refill information here.

*Mail order is not available for Medicaid members.

For Medicaid members:

You can use the Find a Doctor tool to find an in-network pharmacy for your plan. Out-of-state pharmacies dispensing medications for the Medicaid population who are not actively enrolled in Michigan's CHAMPS program may need additional assistance for Priority Health to process a prescription claim.