PriorityMediare® Dual Premier is a Highly Integrated Dual Eligible Special Needs Plan. You can enroll in the Dual Premier plan if you qualify for full Medicaid (QMB+, SLMB+ FBDE) based on standards established by the State of Michigan and federal requirements. Medicaid will provide assistance with Medicare cost-sharing and will also provide full Medicaid benefits. Your cost share is $0 when the service is covered by both Medicare and Medicaid. There may be cases where you have to pay cost sharing when a service or benefit is not covered by Medicaid.
You’re eligible to join a Priority Health Dual Premier if:
- You live in the service area, which includes these 10 counties in Michigan: Barry, Berrien, Branch, Calhoun, Cass, Kalamazoo, Macomb, St. Joseph, Van Buren and Wayne;
- You are enrolled in Medicare Parts A and B;
- You are eligible for full Medicaid benefits; and
- You are 21 years of age or older
If your category of Medicaid eligibility changes, your eligibility for these plans will change. You will have a 3-month deeming period to regain full Medicaid eligibility and will continue to be covered under this plan. During this deeming period, Priority Health will continue to provide your Medicare Advantage plan-covered Medicare benefits.