Understanding the essentials of Priority Health Medicare Advantage policies
Priority Health Offers Variety of Medicare Advantage Plans to Michigan Residents
Priority Health, a Michigan-based health insurance company with over 30 years of experience, offers a range of Medicare Advantage plans to Michigan residents. These plans provide coverage for hospitalization, doctor visits, lab tests, prescription drugs, telehealth, some dental, vision, and hearing benefits, and a membership to the SilverSneakers fitness program.
Three Types of Medicare Advantage Plans
Priority Health offers three distinct types of Medicare Advantage plans: HMO-POS, PPO, and D-SNP. Each plan type has its own unique features and benefits.
- HMO-POS (Health Maintenance Organization Point-of-Service): This plan typically requires members to use a network of doctors and facilities for the lowest costs. However, it also offers some flexibility to see providers out-of-network but usually at higher costs. Referrals from a primary care doctor may be required to see specialists.
- PPO (Preferred Provider Organization): PPO plans provide more flexibility in choosing healthcare providers. Members can see any doctor or specialist without a referral, including out-of-network providers, though costs are lower when using in-network services.
- D-SNP (Dual Eligible Special Needs Plan): This plan is specifically designed for individuals eligible for both Medicare and Medicaid (dual eligibles). It combines Medicare coverage with additional benefits tailored to this population, often including more coordinated care.
Costs and Out-of-Pocket Expenses
The cost of Priority Health's Medicare Advantage plans can vary. For example, the PriorityMedicare Merit premium is $72, while the PriorityMedicare ThrivePlus premium is $39. The amount a person may need to pay will depend on the individual plan. Annual out-of-pocket caps vary, with lower-premium plans having higher annual caps.
Enrollment Periods
The Open enrollment period (OEP) for Medicare Advantage and Medicare prescription drug plans lasts from October 15 to December 7 each year. During this period, individuals can enrol in, switch, or drop a Medicare Advantage plan. The Medicare Advantage open enrollment period runs from January 1 to March 31 of every year, allowing beneficiaries to make changes to their Medicare Advantage plans.
Availability and Eligibility
Priority Health's Medicare Advantage plans are available in all counties of Michigan's Lower Peninsula. Medigap plans are available throughout Michigan. It's important to note that although the company offers plans only to Michigan residents, Michigan residents still have healthcare coverage when traveling to other states through Medicare-participating providers.
Additional Benefits
Priority Health offers a free well-being hub that provides personalized medical information and helps manage conditions and develop positive lifestyle habits. Furthermore, in St. Clair, MI, PriorityMedicare Vintage, Key, Vital, Edge, and Thrive plans have $0 premiums.
Table of Plans
| Plan Type | Network Flexibility | Referrals Needed | Target Group | Notes | |----------------|-------------------------------------|------------------|--------------------------------|-------------------------------| | HMO-POS | Primarily in-network, some out-of-network allowed with higher cost | Usually yes | General Medicare Advantage members | Balance between HMO and POS features | | PPO | Greater freedom to see in- or out-of-network providers without referrals | No | General Medicare Advantage members | More flexible but may cost more | | D-SNP | Usually network-based, with care coordination | Often yes | Dual-eligible Medicare & Medicaid members | Focus on specialized care |
These distinctions reflect how Priority Health structures access, cost, and care coordination across their Medicare Advantage plans.
For more information or to see all the options in your area, use the Medicare search tool before enrolling in a Priority Health Medicare Advantage plan.
- Health organizations such as Priority Health, a Michigan-based company, collaborate with science to develop and offer Medicare Advantage plans that cater to the needs of Michigan residents.
- Priority Health's diverse Medicare Advantage plans, including HMO-POS, PPO, and D-SNP, come with unique features like coverage for hospitalization, doctor visits, and telehealth, among others, as well as associated costs and out-of-pocket expenses.
- In addition to offering Medicare Advantage plans, health organizations like Priority Health provide supplementary benefits like the SilverSneakers fitness program and a free well-being hub for health-and-wellness management.
