PriorityMedicare® Dual Premier

Page last updated on: 10/16/25

Thank you for being a Priority Health Medicare Advantage 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 is here to help.

For PriorityMedicare D-SNP members in Barry, Berrien, Branch, Calhoun, Cass, Kalamazoo, Macomb, St. Joseph, Van Buren and Wayne counties:

Effective January 1, 2026, your PriorityMedicare® D-SNP plan is changing to PriorityMedicare® Dual Premier. This change will be made automatically and there is nothing you need to do. While the plans are similar, there are some differences.

PriorityMedicare Dual Premier is a highly integrated dual eligible special needs (HIDE) plan, which means a more simple member experience for you. This new plan combines your Medicare and Medicaid plans into one along with long term support services (LTSS). Your plan is even easier to use – you only need one card to access all your Medicare and Medicaid benefits.

Any changes you'd like to make to your Medicare coverage 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.

2026:

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.

To qualify, you must meet Special Supplemental Benefit for Chronically Ill (SSBCI) requirements and complete the survey at priorityhealth.com/qualify

 

  • 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

H8379_400040062602_M_20206

*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.