Keeping your patients healthy beyond their standard benefits

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 and discounts available to the patients you serve.

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Health and condition management benefits

Program Eligible plans Criteria About the program Cost to member How is the member informed?
Behavioral health self care: myStrength  
  • Commercial
  • D-SNP
  • Individual
  • Medicaid
  • Medicare
  An online behavioral health tool that offers coping tools, inspirational resources, community support and one-on-one coaching for depression, anxiety, substance abuse, stress and chronic pain.  $0 Members sign up on their own or their care manager may refer them
Care after inpatient admission: Transitions of Care
  • Commercial
  • D-SNP
  • Individual
  • Medicaid
  • Medicare
 Members with a risk of 8-10%+ of having a 30-day unplanned readmission A 30-day program aimed at preventing readmission by connecting members to PCPs for follow-up and providing education on condition and medication.  $0 Outreach by Priority Health care manager
Care management  
  • Commercial
  • D-SNP
  • Individual
  • Medicaid
  • Medicare
 

Members are proactively targeted using Johns Hopkins ACG model

Children with special needs who need extra support

Care managers connect patients with medical and behavioral health care to reduce avoidable hospital admissions and emergency department visits.   $0 Outreach by Priority Health care manager
Chronic disease self care: Better Choices, Better Health  
  • Commercial
  • D-SNP
  • Medicaid
  • Medicare
 Members 18+ years old with any chronic condition.  An online chronic disease self-management program.  $0 Priority Health care manager
Companion care with Papa  
  • D-SNP
  • Medicare
  Papa connects college students (Papa Pals) to Medicare members with chronic conditions who need assistance with transportation, house chores, technology, companionship and other services.  $0 Priority Health care manager
Diabetes Prevention Program
 
  • Commercial
  • Individual
  • Medicare

Members diagnosed with pre-diabetes, or are age 45+ with BMI >27 without a diagnosis of diabetes A one year virtual program that helps patients with healthy lifestyle changes like eating healthy, exercising and managing stress. The program provides a scale, coach and access to a peer support group.    $0 Referral email, Priority Health care manager
In-home chronic disease care: Tandem365  
  • Commercial
  • D-SNP
  • Individual
  • Medicaid
  • Medicare
Members in advanced stages of chronic disease In-home care management and care coordination to help patients in advanced stages of chronic disease remain in their home for as long as safely possible.   $0 Priority Health care management or Tandem365 care team
In-home health assessments
 
  • Individual
  • Medicaid
  • Medicare
  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.  $0 Member information or outreach from Signify Health to schedule a visit
Over-the-counter allowance
 
  • D-SNP
  • Some Medicare members (not all Medicare plans offer OTC benefits)
   

DSNP members get $145 per quarter to spend on over-the-counter items.

Some Medicare members get $25-$75 per quarter, depending on their plan.

The program also provides coupons for healthy foods. 

$0

Palliative Care
  • Commercial
  • D-SNP
  • Individual
  • Medicaid
  • Medicare
Members in advanced stages of chronic disease A team of care givers and services, including behavioral and pastoral care, available to patients in-home or over the phone through Aspire. 

$0

 

Priority Health care manager or Aspire care team

 
Pathways Community Connections
 
  • D-SNP
  • Medicaid
  • Medicare

Community health workers connect high risk patients to medical, social and behavioral health services to reduce risk factors. 
$0
Priority Health care manager
Personal emergency response for falls
 
  • D-SNP
  • Commercial
  • Individual
  • Medicare
Members with high risk for falls or a history of falling.
Members who are at high risk of falling receive a device that detects if and when they fall, and alerts an emergency contact of their choice, or 911. $0
Priority Health care manager
Pregnancy support: PriorityMOM™
 
  • Fully-funded groups
Pregnant members
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.
$0
 
Remote health condition monitoring
 
  • Commercial
  • D-SNP
  • Individual
  • Medicare
Members who meet clinical criteria for telemonitoring (i.e. congestive heart failure, COPD, diabetes).
Members who need close clinical monitoring are provided devices specific to their illness, like a blood pressure cuff, scale or pulse oximeter.
$0
Priority Health care manager
Social Determinants of Health: Priority Health Connect  
  • Commercial
  • D-SNP
  • Individual
  • Medicare
  Connects members with free and reduced-cost programs and social services. Members can search for resources like housing support, legal assistance, access to healthy foods and childcare, within their zip code. This online platform is powered by Aunt Bertha.  $0 Priority Health Connect
Travel coverage: Assist America®
  • Commercial
  • Individual
  • Medicare

Global emergency medical services for members. 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. $0

Member account or customer service.

Members will need a referral code.

Wellness, healthy habits and fitness-based benefits

Program Eligible plans Criteria About the program Cost to member How is the member informed?
Brain games: BrainHQ®
  • D-SNP
  • Medicare

  An online brain exercise tool that helps improve memory, attention, brain speed and more.
$0
Member information
Chronic condition management: Wellth
 
  • Medicare
Members who have disorders of lipid metabolism, diabetes, hypertension and 8+ chronic conditions
A digital tool that motivates medication adherence using reminders and rewards for chronic condition management. 
$0 (Members can earn up to $30/mo. in rewards)

The Wellth team reaches out to eligible members (list provided by Priority Health) to invite them to join the program and help guide them through set up.

Multi-channel approach: direct mail, email and phone outreach

Fitness center discount: Active&Fit Direct®
  • Commercial
  • Individual
  Members can choose from 11,000+ participating fitness centers nationwide for $25 a month (plus a $25 enrollment fee and taxes). $25/mo. for gym membership if they opt-in Member account
Fitness discount: SilverSneakers®
  • D-SNP
  • Medicare
  • Some commercial plans

Provides memberships to thousands of participating SilverSneakers fitness locations, including local gyms. $0 Priority Health care manager or member information
Rewards for healthy behaviors: Smart Rewards
  • Medicare

Members are rewarded for staying on track with preventive care and other milestones, like annual screening, flu shot and colon cancer screening. $0 (Members can earn up to $160 in rewards) Member information

Member discounts

Program Eligible plans About the program Cost to member How is the member informed?

Perks and discounts: BenefitHub

  • Commercial
  • Individual
  • Medicaid
Members can enjoy discounts, rewards, and other perks on thousands of brands from apparel to entertainment.  $0

Member account

Members need a referral code.

TruHearing discount program
  • Commercial
  • D-SNP
  • Individual
Provides members and their extended family access to a $75 hearing examination with a TruHearing hearing provider and a 30 - 60% discount on hearing aids.

$75 out-of-pocket cost for hearing exam with TruHearing provider (not a medical benefit) plus cost of hearing aids after the discount is applied

No cost for D-SNP members.

Sell sheet (found in HighSpot), member information