PriorityMedicare MeritSM 2017 annual changes

Scroll down to find everything you need to know about your PriorityMedicare Merit (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

In-network benefit 2016 2017
Monthly premium $30-$95 $37-$95
Deductible $0 for in-network and out-of-network services $125 for in-network and out-of-network services
Maximum out-of-pocket amount $4,500 $3,750
Inpatient hospital care Days 1-7: $225 copay per day Days 1-7: $220 copay per day, after deductible
Enhanced Vision, Dental and Hearing Package premium $19 $20.50
Inpatient mental health care Days 1-6: $225 copay per day Days 1-6: $220 copay per day, after deductible
Screening for lung cancer with low dose computed tomography (LDCT)







Not covered $0
Part D prescription drug coverage Retail
  • Drug tier 1: $4
  • Drug tier 2: $12
  • Drug tier 3: $45
  • Drug tier 4: $95
  • Drug tier 5: 31%

Preferred retail

  • Drug tier 1: $2
  • Drug tier 2: $10
  • Drug tier 3: $42
  • Drug tier 4: $95
  • Drug tier 5: 31%

Standard retail

  • Drug tier 1: $7
  • Drug tier 2: $15
  • Drug tier 3: $47
  • Drug tier 4: $100
  • Drug tier 5: 31%

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.