PriorityMedicare® Dual Premier (HMO D-SNP) Annual Notice of Change information

Thank you for being a Priority Health Medicare member.

You can find important plan information below. If you have questions or would like to request printed copies of your plan documents, our customer care team can help.

You don't need to do anything to continue your coverage, your plan will automatically renew on January 1, 2027.

If you do have changes you'd like to make to your Medicare coverage, they need to be made during the Annual Enrollment Period (AEP) of October 15 – December 7. Connect with your agent of record, or our Medicare benefit advisors, who are happy to help with plan changes. Please call toll-free at 844.801.4721.

2027	2026
Annual Notice of Change Annual Notice of Change (Spanish) coming soon	Annual Notice of Change Annual Notice of Change (Spanish) Member Handbook Member Handbook (Spanish) Dual Premier prior authorizations list

PriorityFlex card, how to qualify for additional benefits

In addition to using your card for over-the-counter purchases, if you qualify* your allowance can also be used toward healthy food and produce, home utilities, pest control services, meal delivery, personal care items and household supplies.

Qualifying SSBCI conditions

Chronic alcohol use disorder and other substance use disorders
Autoimmune disorders:
- Polyarteritis nodosa
- Polymyalgia rheumatica
- Polymyositis
- Dermatomyositis
- Rheumatoid arthritis
- Systemic lupus erythematosus
- Psoriatic arthritis
- Scleroderma
Cancer
Cardiovascular disorders:
- Cardiac arrhythmias
- Coronary artery disease
- Peripheral vascular disease
- Valvular heart disease
- Chronic heart failure
Dementia
Diabetes
Overweight, Obesity and Metabolic Syndrome
Chronic gastrointestinal disease:
- Chronic liver disease
- Non-alcoholic fatty liver disease (NAFLD)
- Hepatitis B
- Hepatitis C
- Pancreatitis
- Irritable bowel syndrome
- Inflammatory bowel disease
Chronic Kidney Disease (CKD):
- CKD requiring dialysis/End-stage renal disease (ESRD) (SDRD)
- CKD not requiring dialysis
Severe Hematologic Disorders:
- Aplastic anemia
- Hemophilia
- Immune thrombocytopenic purpura
- Myelodysplastic syndrome
- Sickle-cell disease (excluding sickle cell trait)
- Chronic venous thromboembolic disorder
HIV/AIDS
Chronic Lung Disorders:
- Asthma
- Chronic bronchitis
- Cystic Fibrosis
- Emphysema
- Pulmonary fibrosis
- Pulmonary hypertension
- Chronic Obstructive Pulmonary Disease (COPD
Chronic and disabling mental health conditions:
- Bipolar disorders
- Major depressive disorders
- Paranoid disorder
- Schizophrenia
- Schizoaffective disorder
- Post-traumatic stress disorder (PTSD)
- Eating Disorders
- Anxiety disorders
Neurologic Disorders:
- Amyotrophic lateral sclerosis (ALS)
- Cerebral palsy
- Epilepsy
- Extensive paralysis (that is, hemiplegia, quadriplegia, paraplegia, monoplegia)
- Huntington's disease
- Multiple sclerosis
- Parkinson's disease
- Polyneuropathy
- Fibromyalgia
- Chronic fatigue syndrome
- Spinal cord injuries
- Spinal stenosis
- Stroke-related neurologic deficit
- Traumatic brain injury
Stroke
Post-organ transplantation care
Conditions that may cause cognitive impairment:
- Alzheimer's disease
- Intellectual and developmental disabilities
- Traumatic brain injury
- Disabling mental illness associated with cognitive impairment
- Mild cognitive impairment
Conditions that may cause similar function challenges and require similar services:

Spinal cord injuries
Paralysis
Limb loss
Stroke
Arthritis
Chronic Conditions that impair vision, hearing (deafness), taste, touch and smell
Conditions that require continued therapy services in order for individuals to maintain or retain functioning

Chronic Hypertension

Osteoporosis

Chronic lower back pain

Provider and pharmacy directories

Use the Find a Provider tool or download the directories to see in-network providers and pharmacies, including DME suppliers.

Find a Provider

Coverage exceptions, decisions and appeals

For coverage decisions, appeals and payment decisions for medical care or Part D drugs, and the appeals forms visit this page.

PriorityMedicare^® Dual Premier (HMO D-SNP) is a health plan that contracts with both Medicare and Michigan Medicaid to provide benefits of both programs to enrollees. Enrollment depends on contract renewal.

H8379_400040062700_M_2027

*Benefit mentioned is part of a special supplemental benefit for chronically ill members with one of the following conditions: diabetes, chronic obstructive pulmonary disease (COPD), arrhythmia, depression, heart failure, prostate/breast/other cancers and bipolar disorder. This is not a complete list of qualifying conditions. Even if you have a qualifying condition, you will not necessarily qualify to receive the benefit because coverage of the item or service depends on if you are chronically ill as defined by CMS and meet all applicable eligibility requirements. To see if you qualify, contact our Customer Care team by calling the number on this page.