PriorityMedicare IdealSM 2017 annual changes
Scroll down to find everything you need to know about your PriorityMedicare Ideal (PPO) plan for 2017:
- Summary of medical plan changes
- Links to your plan documents
- Information about our doctor and pharmacy network
- Drug coverage
- Information about how to renew your plan.
Summary of medical plan changes
|Deductible||$150 for in-network and out-of- network||$160 for in-network and out-of-network|
|Inpatient hospital care and inpatient mental health care||Days 1-5: $250 copay per day, after deductible||Days 1-6: $260 copay per day, after deductible|
|Part D prescription drug coverage deductible||$360||$400|
|Cardiac rehabilitation services||$50, after deductible||$30, after deductible|
|Hospice (consultation)||$0, after deductible||$0, deductible does not apply|
|Pulmonary rehabilitation services||$50, after deductible||$30, after deductible|
|Medicare Part B prescription drugs||$0 copay for administration of chemotherapy drugs, after deductible||$0 copay for administration of chemotherapy drugs, deductible does not apply|
|Outpatient diagnostic tests and therapeutic services and supplies||$0 for radiation therapy services after deductible, $100 for Medicare- covered diagnostic radiology service after deductible||$30 for radiation therapy services after deductible, $125 for Medicare- covered diagnostic radiology service after deductible|
|Screening for lung cancer with low dose computed tomography (LDCT)||Not covered||$0|
This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, premium and or copayments/coinsurance may change on Jan. 1 of each year.
Your 2017 plan documents
2017 doctor/provider and pharmacy networks
Save money when you use the Priority Health Medicare network of doctors, labs, equipment rental businesses and other health care providers. Search it online by name, ZIP code, city, or other options. Or page through the print version.
Search the online Find a Doctor tool.
New for 2017 - Members in most plans can take advantage of preferred pharmacy pricing. Review the preferred pharmacy list.
Regional provider and pharmacy directories coming soon.
2017 drug coverage
Our MAPD (Medicare Advantage + Prescription Drug) plans cover both Medicare Part B and Medicare Part D prescription drugs.
How to renew your plan
To keep your current plan
To keep the plan you have now through 2017 you don't have do anything. You will automatically stay enrolled as a member of that plan.
How to switch to a different plan
To switch to a different Priority Health Medicare plan, or to another insurance company's plan, or back to Original Medicare (Parts A & B) only, you just need to enroll in the new plan between Oct. 15 and Dec. 7, 2016. You don't need to notify your 2016 plan that you're switching for 2017.