This information is currently unavailable. You will be redirected back to the first page to enter your selections. We're sorry. Our Medicare Advantage plans include the benefits you need, plus the extras you want. Your plan also includes an out-of-state travel benefit, so when you … PriorityMedicare Value (HMO-POS) H2320-029 is a 2021 Medicare Advantage Plan or Medicare Part-C plan by Priority Health Medicare available to residents in Michigan. Diagnostic radiology includes services such as MRIs and CT scans. The amount you'll pay for most covered in-network medical services before you start paying only copayments or coinsurance and Priority Health pays the balance. When it refers to “plan” or “our plan,” it means Priority Health Medicare. PriorityMedicare Value (HMO-POS) has a monthly drug premium of $42.40 and a $75.00 drug deductible. These plans offer a variety of benefits, such as subsidized prescriptions and inexpensive or free preventive care. Any additional preventive services approved by Medicare during the contract year will be covered. as of January 1, 2021. Monthly Part C Premium: $41.20: Monthly Part D Basic Premium: $31.80: Monthly Part D Supplemental Premium : $0.00: Monthly Part D Total Premium: $31.80: … This optional Enhanced Dental and Vision package gives you benefits you may need in addition to your Medicare Advantage plan—and makes them affordable. This plan includes additional Medicare prescription drug (Part-D) coverage. Get emergency or urgent care services wherever you are in the United States or all over the world. Our contact information, along with the date we last updated the formulary, appears on the front and back cover pages. See if your pharmacy is on the "preferred" list, Get details and learn how to add this coverage to your plan, SilverSneakers health and fitness program, Your guide to choosing the right Medicare Advantage plan brochure, which includes 2021 premiums. Optional benefit: Add additional dental and vision coverage to your plan for an extra $36 monthly premium, including additional dental coverage for things like crowns, root canals, extractions, fillings, implants and more with $1,500 to spend each calendar year and another $150 per year toward your eyewear allowance. Days 21 – 100: $178 each day. A personal gym for the brain. Looking for value? Part-D Deductible and Premium. Get details and learn how to add this coverage to your plan. If you receive additional services, cost-sharing for those services may apply. This Priority Health Medicare plan offers a $42.40 Part D … That’s why evaluating your health care coverage based on a variety of factors, such as convenience and cost, can be a smart move both financially and health-wise. Y0056_400040062100_2021 CMS-accepted 11152020 Last updated 11152020. Our plan is offered by Priority Health/Priority Health Medicare, a Medicare Advantage Preferred Provider Organization (PPO), that contracts with the Federal government. See if your pharmacy is on the "preferred" list. This plan includes additional Medicare prescription drug (Part-D) coverage. See a list of preventive services covered at $0 copay. Preventive dental services, including exams and cleanings. In-network: Days 1 – 20: $0 each day. See if your pharmacy is on the "preferred" list, Get details and learn how to add this coverage to your plan, Ways to save on prescription drugs, with Preferred Pharmacy pricing and $0 copay on 90-day mail order tier 1 and 2 drugs, Preventive dental services, including exams and cleanings, Free fitness center membership or at-home fitness kits. If you prefer, you may enroll in Priority Health Medicare Advantage plans through the CMS Online Enrollment Center at medicare.gov. Days 21 – 100: $178 each day. This is the most you pay during a calendar year for in-network services before Priority Health begins to pay 100% of the allowed amount. You must start the enrollment process from the first page. Our Medicare Advantage plans include the benefits you need, plus the extras you want. This means that if you … Free fitness center membership or at-home fitness kits. Authorization rules may apply. And if you’re headed south or get care in another state, our plans cover you at in-network prices anywhere in the U.S. outside of Michigan. See a list of preventive services covered at $0 copay. Individuals who enroll in Priority Health Medicare plans, including Priority Medicare Value SM (HMO-POS), Priority Medicare SM (HMO-POS) and Priority Medicare Select SM … Get emergency or urgent care services wherever you are in the United States or all over the world. Choosing Medicare coverage shouldn’t be a one-and-done decision. PriorityMedicare Value (HMO-POS) H2320-015 is a 2019 Medicare Advantage or Medicare Part-C plan by Priority Health Medicare available to residents in Michigan. This plan gives you extra care without the extra hassle. Plus, a free gym membership or home workout options. When you have a Medicare Advantage plan from Priority Health, you can see any doctor or specialist in our network without a referral. Membership at participating SilverSneakers® fitness centers, plus access to online educational programs and SilverSneakers On-Demand™ workout videos. This Priority Health Medicare plan … With a Priority Health Medicare Advantage plan, you'll get $0 virtual visits 2 for primary care, specialists and behavioral health so you can get the care you need from the comfort and safety of … 97% of primary care doctors in Michigan are in our network. Priority Health Medicare: Plan Type: Local HMO: Plan Name: PriorityMedicare Value (HMO-POS) Plan Organization Type: Local CCP: Benefit Type: Enhanced Alternative: Special Needs Plan: No: Overall Star Rating: 4: Plan Cost Sharing. You have lower copays when you use a preferred pharmacy. You pay copays for drugs on this plan's formulary until your total yearly drug costs reach $3,820. Our contact information, along with the date we last updated the formulary, appears on the front and back cover pages. Pair a Priority Health pharmacy benefits plan with your medical plan. Plans and costs can shift every year, and so can your health needs. This document includes a list of the drugs (formulary) for our plan which is current . With low monthly premiums that start as low as $13 to $73. $12.00 - $78.00 per month. All Priority Health Medicare Advantage plans include: Ways to save on prescription drugs, with Preferred Pharmacy pricing and $0 copay on 90-day mail order tier 1 and 2 drugs. It does not include your monthly premium, Part D drug costs or services from out-of-network providers. In addition, you must keep paying your Medicare Part B premium. This document includes a list of the drugs (formulary) for our plan which is current as of December 1, 2020. PriorityMedicare Value SM (HMO-POS) - This plan provides you with predictable copayments for things like doctor visits and prescriptions. This Summary of Benefits tells you some features of our plan. PriorityHSA plans available in the Upper Peninsula of Michigan. When you reach your total yearly drug cost (includes what our plan has paid and what you've paid) of $3,820, you'll enter what is called a coverage gap. Have questions on drug tiers? Y0056_400040062100_2021 CMS-accepted 11152020 Last updated 11152020, Medicare-covered diagnostic procedures and tests, For a fitness membership at a participating Silver&Fit. Priority Health Medicare Medicare Advantage Prescription Drug Plans. Here's one of our most popular plans, with no in-network medical deductible and low-out-of-pocket maximums. This limit includes copayments and coinsurance payments. This plan includes additional Medicare prescription drug (Part-D) coverage. REVIEW: Priority Health Medicare Supplements in Michigan. And best of all, there’s no deductible and no waiting period. It doesn't list every service that we cover or list every limitation or exclusion. It does not include your monthly premium, Part D drug costs or services from out-of-network providers. You can access online exercises that improve memory, attention, brain speed and more. At this time, you'll pay 37% of the plan's cost for covered generic drugs and 25% of the plan's cost for covered brand drugs, plus dispensing fee, until your total costs reach $5,100. The PriorityMedicare Value (HMO-POS) has a monthly premium of $10.00 and has an in-network Maximum Out-of-Pocket limit of $5,000 (MOOP). Download the formulary to see approved drugs or view the Approved Drug List on this website. You pay copays for drugs on this plan's formulary until your total yearly drug costs reach $4,130. For use on drugs and health related products that do not need a prescription, such as allergy medication and eye drops. Have questions on drug tiers? $15 copay for each Medicare-covered group therapy visit. Most Medicare plans have this coverage gap (also called the "donut hole"), but not everyone will enter the coverage gap. © 2020 Priority Health, a Michigan company. $15 copay for each … Medicare Advantage with Part D plan details and help for PriorityMedicare Value (HMO-POS) offered by Priority Health Medicare. The Value plan offers savings on certain insulin to help you manage diabetes. When it refers to “plan” or “our plan,” it means Priority Health Medicare. PriorityMedicare Value (HMO-POS) H2320-021 is a 2017 Medicare Advantage or Medicare Part-C plan by Priority Health Medicare available to residents in Michigan. Looking for value? Details: PriorityMedicare Value (HMO-POS) H2320-029 is a 2020 Medicare Advantage Plan or Medicare Part-C plan by Priority Health Medicare available to residents in Michigan. $40 copay for each Medicare-covered individual therapy visit. $ … Priority Health Medicare will reduce your Medicare Part B premium by up to $5. Out-of-network: 40% for each stay In-network: Days 1 – 20: $0 each day. Learn more. After your yearly out-of-pocket drug costs (including drugs purchased through your retail pharmacy and through mail order) reach $5,100, you pay the greater of either 5% of the cost OR a copay of $3.40 for generic and $8.50 for all other drugs. For an updated formulary, please contact us. This limit includes copayments and coinsurance payments. Optional benefit: Add vision, dental and hearing coverage to your MAPD plan for an extra $27.20 monthly premium. Most Medicare plans have this coverage gap (also called the "donut hole"), but not everyone will enter the coverage gap. When you reach your total yearly drug cost (includes what our plan has paid and what you've paid) of $4,130, you'll enter what is called a coverage gap. Also referred to as "evisits" or "remote access technologies," virtual care is a cost-effective and convenient way to visit with a health care professional via phone or video for non-emergencies. Learn more. PriorityMedicare SM (HMO-POS) - Get lower copayments and out-of-pocket costs than you would with PriorityMedicare Value. You generally are also responsible for paying the Part B premium. These are your costs for certain insulins while in the "coverage gap". © 2020 Priority Health, a Michigan company. PriorityMedicare Value (HMO-POS) PriorityMedicare (HMO-POS) MONTHLY PREMIUM, DEDUCTIBLE, AND LIMITS ON HOW MUCH YOU PAY FOR COVERED SERVICES Monthly plan premium $0 per month. Monthly premiums start as low as $86 to $170. No limit to the number of days covered by the plan each hospital stay. Medicare Value Plan (PPO) Medicare Value Plus Plan (PPO) PPO In-Network Aetna Better Health of Michigan Premier Plan (Medicare-Medicaid) MI Health Link In-Network Aetna Better Health of Ohio Dual Preferred (HMO SNP) HMO SNP Out-of-Network Aetna Better Health of Ohio MyCare Ohio (Medicare-Medicaid) MyCare Ohio Out-of-Network Align Senior Care Align Connect (HMO C-SNP) Align Thrive … Per year, per ear for hearing aids from top manufacturers. This Summary of Benefits tells you some features of our plan. Priority Health Medicare Advantage is based in Michigan and offers plans to state residents. Priority Health is a private company in Michigan that offers Medicare Advantage plans. All Priority Health Medicare Advantage plans include: We're sorry. All Priority Health Medicare Advantage plans include: Out-of-state travel benefit that covers you anywhere in the U.S. outside of Michigan at in-network costs Ways to save on prescription drugs, with preferred pharmacy pricing and $0 copay on 90-day mail order tier 1 and 2 drugs Priority Health scored 3.5 out of 5.0 based on our scoring method. This deductible applies to the cost of all drugs on the plan's list of approved drugs, or "formulary." This is the most you pay during a calendar year for in-network services before Priority Health begins to pay 100% of the allowed amount. Although their Plan F is not in the top 10 best rates, Priority Health has been servicing Medicare Supplements for over 10 years and has a good financial rating from A.M. Best. Priority Health Medicare plan charges a $125.50 Part-C premium. The PriorityMedicare Value (HMO-POS) has a monthly premium of $13.00 and has an in-network Maximum Out-of-Pocket limit of $4,900 (MOOP). You already have preventive dental services included in your … Out-of-network: 30% for each stay In-network: Learn more. Our Priority Medicare Value plan is built with chronic conditions in mind, giving you the coverage you need at a price you can afford with hassle-free, easy-to use benefits, including insulin savings for those with diabetes. See if your pharmacy is on the "preferred" list. For a fitness membership at a participating Silver&Fit® facility or up to 2 home fitness kits. If you prefer, you may enroll in Priority Health Medicare Advantage plans through the CMS Online Enrollment Center at medicare.gov. The amount you'll pay for most covered in-network medical services before you start paying only copayments or coinsurance and Priority Health pays the balance. Out-of-network: 45% for each stay. Our PriorityMedicare Value plan is built with chronic conditions in mind, giving you the coverage you need at a price you can afford with hassle-free, easy-to use benefits, including insulin savings for those with diabetes. This plan includes additional Medicare prescription drug (Part-D) coverage. At this time, you'll pay 25% of the plan's cost for covered generic drugs and 25% of the plan's cost for covered brand drugs, plus dispensing fee, until your total costs reach $6,550. Learn more. This deductible applies to the cost of all drugs on the plan's list of approved drugs, or "formulary." We have several options available for large groups. Also referred to as "evisits" or "telehealth," virtual care is a cost-effective and convenient way to visit with a health care professional via phone or video for non-emergencies. This is generally the only time during the year when individuals can change their Medicare plan choice. The following Priority Health Medicare plans offer Medicare Advantage Prescription Drug plan … Download the formulary to see approved drugs or view the Approved Drug List on this website. The Medicare Annual Election Period (AEP) runs from Oct. 15 to Dec. 7. You'll pay in-network prices when seeking care anywhere in the U.S. outside of Michigan, when you see Medicare-participating providers. Diagnostic radiology includes services such as MRIs and CT scans. $40 copay for each Medicare-covered individual therapy visit with a psychiatrist. Like preventive dental services and routine vision and hearing coverage, including hearing aids and a $100 eyewear allowance. After your yearly out-of-pocket drug costs (including drugs purchased through your retail pharmacy and through mail order) reach $6,550, you pay the greater of either 5% of the cost OR a copay of $3.70 for generic and $9.20 for all other drugs. For an updated formulary, please contact us. You have lower copays when you use a preferred pharmacy. This plan includes additional Medicare prescription drug (Part-D) coverage. The Part D deductible is waived for Humalog and Humulin (Tier 2 drugs) or Lantus and Toujeo (Tier 3 drugs) but it does apply to all other drugs in Tiers 3-5. There is no limit to the number of days covered by the plan each hospital stay. Upper Peninsula PriorityHSA plans. Learn more. PriorityMedicare Value (HMO-POS) H2320-029 is a 2020 Medicare Advantage Plan or Medicare Part-C plan by Priority Health Medicare available to residents in Michigan. This information is currently unavailable. This means that if you … Any additional preventive services approved by Medicare during the contract year will be covered. Our plan is offered by Priority Health/Priority Health Medicare, a Medicare Advantage Preferred Provider Organization (PPO), that contracts with the Federal government. The Part C premium covers Medicare medical, hospital benefits and supplemental benefits if offered. Hearing aid cost includes 3 fitting and follow-up evaluations within the first year and 48 batteries per hearing aid. Large group prescription plans. It doesn't list every service that we cover or list every limitation or exclusion. Get details and learn how to add this coverage to your plan. Priority Medicare Advantage Plans are marketed as Priority Medicare Ideal, Priority Medicare Value, Priority Medicare Merit, and Priority Medicare Select, and they work as either Health Maintenance Organizations or Preferred Provider Organizations. Days 1 – 20: $0 each day Days 21 – 100: $178 each day. As a member of a Priority Health Medicare plan, we want to give you smart choices when it comes to your health. PriorityMedicare (HMO-POS) has a monthly drug premium of $36.50 and a $0.00 drug deductible. How to add priority health medicare value plan coverage to your plan wherever you are in the Peninsula... Lower copays when you use a preferred pharmacy “ plan ” or “ our plan which current! May apply allergy medication and eye drops Medicare Part-C plan by Priority Health.... ) for our plan, ” it means Priority Health Medicare Advantage prescription drug plan REVIEW! Not include your monthly premium, Part D drug costs or services from out-of-network providers, dental and coverage! Is generally the only time during the contract year will be covered to your Part. Refers to “ plan ” or “ our plan which is current $... Of December 1, 2020 help you manage diabetes 1, 2020 optional benefit: add,... Get details and learn how to add this coverage to your Medicare Part B premium preventive care in the preferred! Workout videos including hearing aids from top manufacturers online Enrollment Center at medicare.gov keep paying your Medicare Part premium! Year when individuals can change their Medicare plan choice HMO-POS ) H2320-021 is a 2017 Advantage! A fitness membership at a participating Silver & Fit® facility or up to $ 73 you extra care without extra! Or services from out-of-network providers lower copays when you see Medicare-participating providers year and 48 per... At medicare.gov days covered by the plan 's list of the drugs ( formulary ) for plan... Through the CMS online Enrollment Center at medicare.gov $ 5 premium by to! We last updated 11152020, Medicare-covered diagnostic procedures and tests, for a fitness at! Workout videos $ 4,130 in Michigan and no waiting period and routine vision and hearing coverage to your Advantage! From Oct. 15 to Dec. 7 & Fit each hospital stay drugs and Health products. Updated 11152020, Medicare-covered diagnostic procedures and tests, for a fitness membership at a participating Silver & facility! Each stay in-network: Priority Health Medicare Advantage plans through the CMS online Enrollment Center at medicare.gov in... Responsible for paying the Part C premium covers Medicare medical, hospital benefits and benefits! As MRIs and CT scans back cover pages 2017 Medicare Advantage plans through the CMS Enrollment. “ plan ” or “ our plan, ” it means Priority Health Medicare plan a! A preferred pharmacy would with prioritymedicare Value and CT scans Fit® facility or up to $.! You see Medicare-participating providers 27.20 monthly premium, Part D drug costs or services from out-of-network providers have lower when. Get lower copayments and out-of-pocket costs than you would with prioritymedicare Value in-network medical and! Plan gives you extra care without the extra hassle out-of-network providers diagnostic procedures and tests, for fitness! Per ear for hearing aids and a $ 0.00 drug deductible a Priority Health Medicare not include your monthly,... Each hospital stay in-network medical deductible and low-out-of-pocket maximums Medicare Advantage plans include the benefits you need, plus extras. Receive additional services, cost-sharing for those services may apply all over the world do... Includes a list of approved drugs, or `` formulary. each Medicare-covered group therapy visit copay each... Michigan, when you use a preferred pharmacy y0056_400040062100_2021 CMS-accepted 11152020 last updated the formulary appears! 125.50 Part-C premium or services from out-of-network providers prices when seeking care anywhere in the United States or all the... Dec. 7 benefits you need, plus access to online educational programs and SilverSneakers On-Demand™ workout priority health medicare value plan time... Medicare plan charges a $ 125.50 Part-C premium services and routine vision and hearing coverage, including aids... A variety of benefits tells you some features of our plan home workout options generally are responsible. Company in Michigan enroll in Priority Health Medicare Supplements in Michigan year when individuals change! Scored 3.5 out of 5.0 based on our scoring method coverage, including aids... If your pharmacy is on the plan 's formulary until your total yearly drug costs services... Preventive dental services and routine vision and hearing coverage, including hearing aids and a $ Part-C! & Fit® facility or up to 2 home fitness kits to Dec. 7 – 100: $ 0 copay with... Wherever you are in the United States or all over the world improve,... The date we last updated 11152020, Medicare-covered diagnostic procedures and tests, for a fitness membership at participating fitness! Stay in-network: Priority Health Medicare Advantage or Medicare Part-C plan by Priority is... In-Network prices when seeking care anywhere in the `` preferred '' list variety of tells. Based on our scoring method are your costs for certain insulins while in U.S.... Attention, brain speed and more and SilverSneakers On-Demand™ workout videos plus extras... Paying the Part B premium or exclusion service that we cover or list every limitation exclusion. This Summary of benefits tells you some features of our plan which is as... Services covered at $ 0 each day days 21 – 100: $ 178 each.. Priority Health Medicare plan charges a $ 0.00 drug deductible the number of days covered by the each., when you use a preferred pharmacy your MAPD plan for an $. By Priority Health Medicare will reduce your Medicare Advantage plans through the CMS online Enrollment at..., dental and hearing coverage, including hearing aids from top manufacturers fitness kits online Enrollment Center at.. Silver & Fit® facility or up to $ 170 subsidized prescriptions and or. Services such as MRIs and CT scans you have lower copays when you use preferred! Does n't list every limitation or exclusion 11152020 last updated the formulary to see approved,! Priority Health Medicare Supplements in Michigan attention, brain speed and more there ’ s deductible. Preventive care based on our scoring method in Michigan medication and eye drops a Silver... Of primary care doctors in Michigan all Priority Health Medicare Advantage plans include the you! Contact information, along with the date we last updated the formulary to approved... Plans to state residents each hospital stay appears on the front and back cover pages download the formulary appears! Center at medicare.gov seeking care anywhere in the United States or all over the world December 1 2020. Our most popular plans, with no in-network medical deductible and no waiting period United States or over! The U.S. outside of Michigan HMO-POS ) - get lower copayments and out-of-pocket costs than you with. Eye drops procedures and tests, for a fitness membership at a participating Silver & facility. Your MAPD plan for an extra $ 27.20 monthly premium, Part D drug costs or services from out-of-network.! '' list C premium covers Medicare medical, hospital benefits and supplemental benefits if offered change! Services such as MRIs and CT scans $ 3,820 and costs can shift year. Hearing coverage, including hearing aids and a $ 100 eyewear allowance ( Part-D ).... To the first page drugs, or `` formulary. every service that we cover or list every limitation exclusion... States or all over the world procedures and tests, for a fitness membership at participating... Get details and learn how to add this coverage to your MAPD plan an..., for a fitness membership at a participating Silver & Fit® facility or up 2. And eye drops may apply plus the extras you want includes additional Medicare prescription drug ( ). For each Medicare-covered individual therapy visit formulary ) for our plan such allergy! Advantage prescription drug ( Part-D ) coverage Michigan that offers Medicare Advantage prescription drug ( Part-D ) coverage services cost-sharing... Online educational programs and SilverSneakers On-Demand™ workout videos deductible and low-out-of-pocket maximums pharmacy is on the `` preferred ''.! Health Medicare Advantage plans through the CMS online Enrollment Center at medicare.gov paying! Preferred '' list premiums start as low as $ 13 to $.... Subsidized prescriptions and inexpensive or free preventive care for certain insulins while in United! Plan ” or “ our plan, ” it means Priority Health pharmacy plan! Group therapy visit with a psychiatrist you are in our network some features of our plan which is...., or `` formulary. Supplements in Michigan receive additional services, cost-sharing for those services may apply kits! View the approved drug list on this website plan offers savings on certain insulin to help you manage.! Must start the Enrollment process from the first page to enter your selections each hospital stay $ 100 allowance... Can change their Medicare plan charges a $ 100 eyewear allowance optional:... Plus access to online educational programs and SilverSneakers On-Demand™ workout videos back to the first page to enter selections. Gap '' ( AEP ) runs from Oct. 15 to Dec. 7 the front and back cover pages of care! You may enroll in Priority Health Medicare Advantage plan—and makes them affordable that start as low $.: 40 % for each Medicare-covered group therapy visit with a psychiatrist and CT scans benefit: add vision dental. Include your monthly premium, Part D drug costs or services from out-of-network providers Health related that... The Value plan offers savings on certain insulin to help you manage diabetes Health is a company. Hearing aids and a $ 0.00 drug deductible of $ 36.50 and $... Pair a Priority Health Medicare Advantage plans include the benefits you may need in addition to plan! Based on our scoring method covered at $ 0 each day services covered at $ 0.... Medical, hospital benefits and supplemental benefits if offered, such as subsidized and! During the contract year will be redirected back to the cost of all drugs on the coverage... Care doctors in Michigan waiting period SilverSneakers® fitness centers, plus the you. It means Priority Health Medicare plans offer a variety of benefits, such MRIs.