Member programs and outreach
We're committed to keeping our providers informed and our patients healthy and engaged. Below is a menu of additional health benefits, wellness opportunities, programs and discounts available to the patients you serve.
Feel free to refer your patients to these programs and benefits if they’re eligible. We’re also including this list so you can be aware of other organizations that may be contacting you about your patient(s) and why.
Note: Where commercial plans are marked eligible, not all member plans may qualify, depending on whether or not employer groups opted into and out of said programs.
| Program/benefit | Vendor partner | Description | Eligibility |
|---|---|---|---|
| Advanced illness and chronic disease care | Tandem365, Carelon and Corewell Health Home Based Primary Care | A variety of advanced illness care programs are available to provide services and supports to members in advanced stages of chronic disease. | Medicare Advantage plan members who meet qualifications and live in participating counties |
| Behavioral health self-care | Teladoc Health | Teladoc Health Mental Health is an online mental health tool powered by Teladoc Health that offers coping tools, inspirational resources, community support and one-on-one coaching for depression, anxiety, substance abuse, stress and chronic pain. | All Priority Health members |
| Behavioral health support | All members’ benefits include free, 24/7 access to licensed behavioral health clinicians. They can help with emotional distress, substance use concerns and even connect members with a therapist. We’re continually expanding our network of virtual providers to meet unique mental health needs. New additions include Backpack Healthcare, offering pediatric (ages 4+) and family mental health services, and Folx Health, which specializes in LGBTQIA+ care with the largest network of experienced providers in this space. Learn more at priorityhealth.com/behavioralhealth. | All members | |
| Brain games | CogniFit | We offer an online brain exercise tool called CogniFit that provides brain training for members to help improve memory and focus. | Members with certain eligible PriorityMedicare plans |
| Cancer screening | Galleri (GRAIL) | The Galleri multi-cancer early detection test from GRAIL is a proactive blood test that screens for a “fingerprint” of 50+ cancers, including many with no recommended screening currently available. | To be eligible for the screening members must be on either PriorityMedicare Thrive or Thrive Plus plans, be 65 years or older and not be pregnant or in active cancer treatment. |
| Care after inpatient admission | Care managers educate patients with complex medical needs on disease self-management, assist with coordination of care and navigating the health care system, and connect patients with social, medical and behavioral health care to reduce avoidable hospital admissions, readmissions and emergency department visits. | Members are proactively targeted using Johns Hopkins ACG model. All D-SNP members have a care manager. Children with special needs who need extra support are also automatically included. | |
| Care management | Our care management program pairs eligible members with licensed nurses or social workers trained to help them manage chronic conditions including asthma, diabetes and depression. They can also help with new diagnoses, recent hospitalizations and more. Learn more at priorityhealth.com/caremanagement. | Any member with a chronic condition | |
| Caregiver support services | Carallel | Members/caregivers are matched with Care Advocates who have a vast knowledge of topics such as:
These Care Advocates, who have all been caregivers themselves, will be matched to specific advocates based on their unique needs. | Members with D-SNP and other eligible PriorityMedicare plans |
| Clinical trial enrollment | Medzown | Medzown helps eligible members with complex cancers and rare diseases enroll in cutting-edge therapies and clinical trials when they need options beyond standard care. | PriorityMedicare (except for Dual Premier) and individual ACA plan members |
| Community care management | Community Care Management is a program that offers individuals and families time-sensitive treatment and support to help avert a crisis or allow for a successful transition back home after a mental health hospitalization. | Any non-Medicaid member (except for D-SNP) who is at risk of rehospitalization and/or have experienced psychosocial barriers accessing outpatient therapy | |
| Cost Estimator | Healthcare Bluebook | Cost Estimator is Priority Health’s transparency tool that takes provider and facility pricing information combined with member benefit and deductible balances to calculate anticipated out-of-pocket costs. Learn more at priorityhealth.com/ cost-estimator. | All commercial (group and individual) members |
| Dental benefits | Delta Dental | Our Delta Dental plans offer access to two of the largest national dental provider networks: Delta Dental PPO and Delta Dental Premier. | Available to all plan types |
| Diabetes management | Livongo (Teladoc Health) | We offer a digital diabetes management program called Livongo, now owned by Teladoc Health, that provides a personalized experience for our members to better manage their type 2 diabetes. It includes telephonic health coaching, an app with 24/7 monitoring and support, a blood glucose meter that offers real-time feedback and unlimited test strips, a Bluetooth-connected weight scale and a blood pressure cuff. | Members 18 or older with type 2 diabetes who are not pregnant whose employer groups have the Livongo buy-up (most have Virta) |
| Diabetes management | Virta | Virta is a digital solution that offers customized care plans with dedicated coaching based on biomarker data and on-demand access to clinician-led care teams. Virta’s Diabetes Reversal* program offers members a way to put their type 2 diabetes into remission and reduce their blood sugar and diabetes medication through nutrition therapy. Virta’s solution focuses on nutrition therapy and lifestyle changes, personalized to each member’s preferences, budget and unique metabolic needs. All enrollees have 24/7 access to the tools and resources on Virta’s platform. *Type 2 Diabetes Reversal on Virta is defined as reaching an A1c below 6.5% without the use of diabetes medications beyond metformin. Diabetes and related issues can return if lifestyle changes are not maintained. | Any commercial group member at least 18 years old with an A1c of 6.5%+ and diagnosed with type 2 diabetes (aside from those with the Livongo buy-up) |
| Diabetes prevention | Omada and/or National Diabetes Prevention Program | We offer programs that helps patients with healthy lifestyle changes like eating healthy, exercising and managing stress. All programs include peer support. More member information can be found on the Priority Health website. | Employer group, Medicare and Medicaid members at risk for diabetes are eligible for the National Diabetes Prevention Program. All commercial members diagnosed with pre-diabetes are eligible for Omada. |
| Digestive health support | Ayble | Ayble’s platform provides GI-specialized nutrition guidance, behavioral skills training, health coaching and additional care team support to a wide range of digestive health patients. | Members on group commercial or MyPriorityHMO plans who are 18 or older with digestive health symptoms and/or diagnoses |
| Fertility support | Carrot Fertility | The Carrot buy-up and rider offers members additional options for:
| Commercial members whose employer groups have purchased the Carrot Core Buy-Up or the Carrot Pro Rider |
| Fitness and physical wellness program | One Pass (Optum) | Priority Health Medicare members with One Pass will have access to a number of fitness locations and other benefits, including:
| Most Medicare members |
| Fitness center discounts | Active&Fit Direct | Through Active&Fit Direct, members can choose from 11,000+ participating fitness centers nationwide for $25 a month (plus a $25 enrollment fee and taxes). Members can choose from 11,000+ participating fitness centers nationwide for $25 a month (plus a $25 enrollment fee and taxes). | All commercial (group and individual) members |
| Health Savings Accounts (HSAs) | HealthEquity | HSAs, linked with high-deductible health plans, offer members the opportunity to set aside money, pre-tax, into an interest-bearing savings account that can be used to cover qualified medical expenses. | Any member covered by a high-deductible health plan |
| Healthy Rewards program | Lynx | The Healthy Rewards program is designed to encourage and celebrate PriorityMedicare members' commitment to wellness. When the member completes eligible healthy activities like getting flu shot or annual physical, they earn rewards they can spend at popular retailers. More information can be found at priorityhealth.com/member/getting-care/healthy-rewards. | All Medicare members are invited to sign up at priorityhealth.com/rewards. |
| Hearing care discounts | TruHearing | This program provides members and their extended family access to a $75 discounted hearing examination with a TruHearing hearing provider and discounts on hearing aids. | All non-Medicaid members |
| In-home health assessments | Signify Health and Porter | A health care provider visits the member in their home and reviews medical history, medications and answers questions. All results from the visit are shared with their primary care provider. | Any member with a Medicare, Medicaid or MyPriority plan |
| LGBTQIA+ support | Folx Health | Folx offers virtual care for LGBTQIA+ members, including mental health care and prescription management for anxiety and depression, as well as gender-affirming care. When appropriate, Folx providers refer members to in-person care. | All commercial (group and individual) members |
| Member portal | We offer all members a member portal at member.priorityhealth.com, where they can see coverage information, provider information, EOBs and much more. | All members | |
| Musculo-skeletal Centers of Excellence (MSK COE) | Our optional MSK COE rider will offer groups and their employees a comprehensive and coordinated approach to the diagnosis, treatment, and management of MSK conditions, including:
This is an optional program. Members with the rider are still free to see their preferred orthopedic surgeon, even if the provider isn’t included in the MSK COE. Their care will be covered according to their plan. Benefits include reduced member cost share and travel cost coverage. | Commercial members whose employer groups have purchased the MSK COE Rider | |
| Over-the-counter allowance | Lynx | Select PriorityMedicare members will have an over-the-counter (OTC) benefit with which they can purchase OTC medications and health and wellness products such as bathroom safety bars, toothpaste, sunscreen, incontinence supplies, etc. All cards include access to an easy-to-use mobile app called Priority Health OTC. | Members with D-SNP and other eligible PriorityMedicare plans |
| Pain management | Flowly | Flowly is a virtual clinic delivering the latest in pain science for members who have struggled to find relief. | All commercial (group and individual) and Medicare members |
| Pathways community connections | Community health workers connect high risk patients to medical, social and behavioral health services to reduce risk factors. | Any Medicare or Medicaid members identified by Priority Health care managers as standing to benefit from this program | |
| Pediatric mental health care | Backpack Healthcare | Backpack Healthcare offers comprehensive pediatric (4+ years) and family mental health care through a virtual platform. | All members |
| Perks and discounts (BenefitHub) | Members can enjoy discounts, rewards, and other perks on thousands of brands from apparel to entertainment. Learn more at priorityhealth.com/member/plan-features/benefithub. | All non-Medicare members | |
| Personal emergency response for falls | Connect America | Connect America® provides 24/7 connection for members to family, caregivers, emergency services or their caring center team. Through their PERS device, members can:
Connect America can also assist in triaging calls to help prevent unnecessary emergency room visits, hospitalizations, frequent physician office visits and premature institutionalization. | D-SNP members and other non-Medicaid members identified by Priority Health care managers according to set criteria |
| Postnatal support | PriorityBABY is a program designed to support children and their caregivers during a child’s first two years. It is a continuation of the successful PriorityMOM program (see below) and includes health care information, gifts and incentives. | All members with a child under six months old | |
| Pregnancy support | PriorityMOM supports expectant mothers in their pregnancy journey. The goal is to reduce OB costs, preterm births, postpartum readmissions and improve health outcomes for mom and baby. | Pregnant members | |
| Prescription discount program | PriceMyMeds | PriceMyMeds allows our commercial members to compare the cost of their medications across local, in-network pharmacies to get the lowest available price for their prescriptions. | All commercial (group and individual) members |
| Remote health condition monitoring | Members who need close clinical monitoring are provided devices specific to their illness, like a blood pressure cuff, scale or pulse oximeter. | Members who meet clinical criteria for telemonitoring (i.e. congestive heart failure, COPD, diabetes) | |
| Substance Use Disorder treatment and support | Boulder Care | Boulder Care is a virtual platform that offers holistic telehealth treatment and support for Substance Use Disorder (SUD), particularly for opioid addiction, alcohol addiction and any co-occurring conditions like nicotine dependence, depression, anxiety and insomnia. | Any commercial group member at least 18 years old* *Some self-funded employer groups may opt out of this core benefit. |
| Transportation | SafeRide | SafeRide covers up to 30 one-way trips per calendar year to take members to and from health-related locations such as network providers and pharmacies. Each one-way trip is limited to 100 miles. Members can also submit for mileage reimbursement if they'd prefer to utilize their trip allowance this way. | Members with Medicaid, D-SNP or Dual Premier plans |
| Travel coverage | Assist America | We offer global emergency medical services for members powered by Assist America. If someone becomes ill or injured while traveling more than 100 miles from home, Assist America provides support with medical referrals, monitoring, evacuation, repatriation and much more. | All commercial (group and individual) and Medicare members |
| Virtual pulmonary rehab | Kivo Health | Kivo Health is a 9-week, at-home Chronic Obstructive Pulmonary Disease (COPD) recovery program led by a clinician through virtual sessions. | All Medicare members |
| Virtual physical therapy | Sword Health | Sword Health provides members whose employer groups have purchased this rider with access to digital physical therapy (PT) from the comfort and privacy of their home. | Commercial members whose employer groups have purchased the virtual PT rider |
| Vision benefits (PriorityVision) | EyeMed | PriorityVision plans include a range of vision benefits and discounts, including exam-only plans, exam and material packages and more. | Available to all plan types (Employer groups and individuals who purchase their own insurance must opt in.) |
| Weight loss support | Virta | Virta is a digital solution that offers our employers two different programs, each including customized care plans with dedicated coaching based on biomarker data and on-demand access to clinician-led care teams:
Note that members will only have one of the two plans above. Members should check with their employer or their plan documents to see which, if either, they have. Virta solutions focuses on nutrition therapy and lifestyle changes, personalized to each member’s preferences, budget and unique metabolic needs. All enrollees have 24/7 access to the tools and resources on Virta’s platform. | Any commercial group member at least 18 years old meeting specific eligibility criteria for one of the following programs:
|