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WELCOME PROVIDERS
Welcome, providers. Thanks for working with Priority Health to give our members the right care at the right time. Log in. COVID-19: Learn about billing, coverage, virtual care and more. Provider Manual. Find guidelines and forms without logging in. Need an account? COVID-19 | PRIORITY HEALTH COVID-19 vaccine update. Want to talk to someone now? We're here to help. Call us toll-free at 833.997.1344. We're available Monday – Friday 8:30 a.m. to 4:30 p.m.LOGIN REQUIRED
Priority Health members, please use the link to access the Member Center. Priority Health Member CenterMEMBER ACCOUNT
You can quickly and easily: Track spending balances to keep your budget in check. Search claims and see a detailed breakdown of care and prescription costs. Compare costs of medical procedures and prescriptions based on your plan so you can save money. Set up a video visit and get virtual care when and where you need it, includingprescriptions.
COVID-19 VACCINE
Is the COVID-19 vaccine covered? The vaccine is available at no cost to all Priority Health members. Note: You may receive a bill for administration of the vaccine if you use an out-of-network provider. See "Will I get a bill for the vaccine?" below for more information.APPROVED DRUG LIST
Discover how Priority Health establishes Group, MyPriority and Medicare Approved Drug Lists. Approving drugs is a process based on medically accepted guidelines to maintain safety and effectiveness. Drug utilization review is a program of quality assurance to determine the appropriate use of medications. PRIORITYMEDICARE KEY 2021 Healthy Benefits Plus Over-the-counter (OTC) allowance and healthy food savings. Use this allowance for health and wellness products that don't require a prescription. OVER-THE-COUNTER (OTC) ALLOWANCE AND HEALTH SAVINGS Look up the products you want to order in the catalog provided by mail or online and call 1.833.862.8434 (TTY 711) to have it delivered to your home. Free two-day shipping is available on all phone OTC orders. Also included is the Healthy Savings program. This program allows members to save on healthier foods with up to $1,500 a year in AUTHORIZATIONS AND PSODS How to submit an authorization request. As a provider outside of Michigan who is not contracted with us, you should submit Medicare authorization requests via fax, using the proper prior authorization form. All Medicare authorization requests can be submitted using our general authorization form. Fax the request form to 888.647.6152. AFFORDABLE MICHIGAN HEALTH INSURANCE Affordable, award-winning health insurance plans for Michigan individuals, families, employer groups, and Medicare and Medicaid members. Enroll today!WELCOME PROVIDERS
Welcome, providers. Thanks for working with Priority Health to give our members the right care at the right time. Log in. COVID-19: Learn about billing, coverage, virtual care and more. Provider Manual. Find guidelines and forms without logging in. Need an account? COVID-19 | PRIORITY HEALTH COVID-19 vaccine update. Want to talk to someone now? We're here to help. Call us toll-free at 833.997.1344. We're available Monday – Friday 8:30 a.m. to 4:30 p.m.LOGIN REQUIRED
Priority Health members, please use the link to access the Member Center. Priority Health Member CenterMEMBER ACCOUNT
You can quickly and easily: Track spending balances to keep your budget in check. Search claims and see a detailed breakdown of care and prescription costs. Compare costs of medical procedures and prescriptions based on your plan so you can save money. Set up a video visit and get virtual care when and where you need it, includingprescriptions.
COVID-19 VACCINE
Is the COVID-19 vaccine covered? The vaccine is available at no cost to all Priority Health members. Note: You may receive a bill for administration of the vaccine if you use an out-of-network provider. See "Will I get a bill for the vaccine?" below for more information.APPROVED DRUG LIST
Discover how Priority Health establishes Group, MyPriority and Medicare Approved Drug Lists. Approving drugs is a process based on medically accepted guidelines to maintain safety and effectiveness. Drug utilization review is a program of quality assurance to determine the appropriate use of medications. PRIORITYMEDICARE KEY 2021 Healthy Benefits Plus Over-the-counter (OTC) allowance and healthy food savings. Use this allowance for health and wellness products that don't require a prescription. OVER-THE-COUNTER (OTC) ALLOWANCE AND HEALTH SAVINGS Look up the products you want to order in the catalog provided by mail or online and call 1.833.862.8434 (TTY 711) to have it delivered to your home. Free two-day shipping is available on all phone OTC orders. Also included is the Healthy Savings program. This program allows members to save on healthier foods with up to $1,500 a year in AUTHORIZATIONS AND PSODS How to submit an authorization request. As a provider outside of Michigan who is not contracted with us, you should submit Medicare authorization requests via fax, using the proper prior authorization form. All Medicare authorization requests can be submitted using our general authorization form. Fax the request form to 888.647.6152.MEMBER ACCOUNT
You can quickly and easily: Track spending balances to keep your budget in check. Search claims and see a detailed breakdown of care and prescription costs. Compare costs of medical procedures and prescriptions based on your plan so you can save money. Set up a video visit and get virtual care when and where you need it, includingprescriptions.
COVID-19 VACCINE
Is the COVID-19 vaccine covered? The vaccine is available at no cost to all Priority Health members. Note: You may receive a bill for administration of the vaccine if you use an out-of-network provider. See "Will I get a bill for the vaccine?" below for more information.BEHAVIORAL HEALTH
Did you know Priority Health benefits include free, 24/7 behavioral health assistance? With growing concern for employee burnout and a clear need for mental health in the workplace, we go above and beyond to help your employees manage things like: Emotional distress. Depression or sad thoughts. Substance-abuse-related issues.SUBMIT A CLAIM
How to: submit claims to Priority Health. We accept claims from out-of-state providers by mail or electronically. Paper claims should be mailed to: Priority Health Claims, P.O. Box 232, Grand Rapids, MI 49501. Electronic claims set up and payer ID information is availablehere.
AUTHORIZATIONS AND PSODS How to submit an authorization request. As a provider outside of Michigan who is not contracted with us, you should submit Medicare authorization requests via fax, using the proper prior authorization form. All Medicare authorization requests can be submitted using our general authorization form. Fax the request form to 888.647.6152.SEARCH
Provider drug info: Phenobarbital. Phenobarbital authorization forms. www.priorityhealth.com/drug-authorization-forms-list/phenobarbital. Provider drug info: PromethazineSEARCH
Agent Center: Small group Central East PriorityHRA. Get details and documents for small group HRA plans in the Central East region of Michigan. www.priorityhealth.comSEARCH
Provider drug info: Rayaldee® Information on authorization for Rayaldee® (caldifediol) www.priorityhealth.com/drug-authorization-forms-list/rayaldeeSEARCH
Provider drug info: Inflectra™ Authorizations forms forInflectra™.
www.priorityhealth.com/drug-authorization-forms-list/inflectra. Provider drug info: Kadcyla™SEARCH
Provider Center services: Percutaneous left atrial appendage closure. Coverage, authorization and billing information for percutaneous left atrial appendage closure AFFORDABLE MICHIGAN HEALTH INSURANCE Affordable, award-winning health insurance plans for Michigan individuals, families, employer groups, and Medicare and Medicaid members. Enroll today!WELCOME PROVIDERS
Welcome, providers. Thanks for working with Priority Health to give our members the right care at the right time. Log in. COVID-19: Learn about billing, coverage, virtual care and more. Provider Manual. Find guidelines and forms without logging in. Need an account?LOGIN REQUIRED
Priority Health members, please use the link to access the Member Center. Priority Health Member CenterMEMBER ACCOUNT
You can quickly and easily: Track spending balances to keep your budget in check. Search claims and see a detailed breakdown of care and prescription costs. Compare costs of medical procedures and prescriptions based on your plan so you can save money. Set up a video visit and get virtual care when and where you need it, includingprescriptions.
APPROVED DRUG LIST
Discover how Priority Health establishes Group, MyPriority and Medicare Approved Drug Lists. Approving drugs is a process based on medically accepted guidelines to maintain safety and effectiveness. Drug utilization review is a program of quality assurance to determine the appropriate use of medications.PAY YOUR PREMIUM
Wondering how to pay your premium bill? Making a payment is easy. Pick your plan to see specific instructions. My Priority. Pay for individual insurance. Medicare. Pay for Medicare Advantage or Medigap. Employers: log in for premium payment information.BEHAVIORAL HEALTH
Did you know Priority Health benefits include free, 24/7 behavioral health assistance? With growing concern for employee burnout and a clear need for mental health in the workplace, we go above and beyond to help your employees manage things like: Emotional distress. Depression or sad thoughts. Substance-abuse-related issues.COVERED DRUGS
The Approved Drug List, or "formulary," is a list of all drugs that Priority Health Medicare Advantage plans will pay for. Use the drug name search below to check if your drugs are listed, or you can open and save our 2021 Medicare Advantage Plan Formulary PDF.It's updatedmonthly.
AUTHORIZATIONS AND PSODS How to submit an authorization request. As a provider outside of Michigan who is not contracted with us, you should submit Medicare authorization requests via fax, using the proper prior authorization form. All Medicare authorization requests can be submitted using our general authorization form. Fax the request form to 888.647.6152. TOTAL HEALTH CARE AND PRIORITY HEALTH ANNOUNCE COMPLETION Total Health Care and Priority Health announce completion of merger. (Detroit – January 6, 2020): Priority Health, Michigan's second-largest health insurance plan, announced today that the company's merger with Total Health Care is now complete. Originally announced in summer 2019, the new partnership between two of Michigan's most-recognized AFFORDABLE MICHIGAN HEALTH INSURANCE Affordable, award-winning health insurance plans for Michigan individuals, families, employer groups, and Medicare and Medicaid members. Enroll today!WELCOME PROVIDERS
Welcome, providers. Thanks for working with Priority Health to give our members the right care at the right time. Log in. COVID-19: Learn about billing, coverage, virtual care and more. Provider Manual. Find guidelines and forms without logging in. Need an account?LOGIN REQUIRED
Priority Health members, please use the link to access the Member Center. Priority Health Member CenterMEMBER ACCOUNT
You can quickly and easily: Track spending balances to keep your budget in check. Search claims and see a detailed breakdown of care and prescription costs. Compare costs of medical procedures and prescriptions based on your plan so you can save money. Set up a video visit and get virtual care when and where you need it, includingprescriptions.
APPROVED DRUG LIST
Discover how Priority Health establishes Group, MyPriority and Medicare Approved Drug Lists. Approving drugs is a process based on medically accepted guidelines to maintain safety and effectiveness. Drug utilization review is a program of quality assurance to determine the appropriate use of medications.PAY YOUR PREMIUM
Wondering how to pay your premium bill? Making a payment is easy. Pick your plan to see specific instructions. My Priority. Pay for individual insurance. Medicare. Pay for Medicare Advantage or Medigap. Employers: log in for premium payment information.BEHAVIORAL HEALTH
Did you know Priority Health benefits include free, 24/7 behavioral health assistance? With growing concern for employee burnout and a clear need for mental health in the workplace, we go above and beyond to help your employees manage things like: Emotional distress. Depression or sad thoughts. Substance-abuse-related issues.COVERED DRUGS
The Approved Drug List, or "formulary," is a list of all drugs that Priority Health Medicare Advantage plans will pay for. Use the drug name search below to check if your drugs are listed, or you can open and save our 2021 Medicare Advantage Plan Formulary PDF.It's updatedmonthly.
AUTHORIZATIONS AND PSODS How to submit an authorization request. As a provider outside of Michigan who is not contracted with us, you should submit Medicare authorization requests via fax, using the proper prior authorization form. All Medicare authorization requests can be submitted using our general authorization form. Fax the request form to 888.647.6152. TOTAL HEALTH CARE AND PRIORITY HEALTH ANNOUNCE COMPLETION Total Health Care and Priority Health announce completion of merger. (Detroit – January 6, 2020): Priority Health, Michigan's second-largest health insurance plan, announced today that the company's merger with Total Health Care is now complete. Originally announced in summer 2019, the new partnership between two of Michigan's most-recognizedMEMBER ACCOUNT
You can quickly and easily: Track spending balances to keep your budget in check. Search claims and see a detailed breakdown of care and prescription costs. Compare costs of medical procedures and prescriptions based on your plan so you can save money. Set up a video visit and get virtual care when and where you need it, includingprescriptions.
PRIORITYMEDICARE EDGE 1 According to June 2020 monthly enrollment reports from the Centers for Medicare and Medicaid Services. 2 Excluding the Vital plan, which has 20% coinsurance for virtual visits. 3 Priority Health Medicare Advantage HMO-POS plans are the highest-rated HMO-POS plans in Michigan, with a rating of 4.5 out of 5 in NCQA’s Private Health Insurance Plan Ratings 2019–2020.CARE MANAGEMENT
Get started with care management today. To learn more or get started, fill out the below form or call the customer service number on the back of your member ID card to be connected to a care manager. For inquiries related specifically to behavioral health, contact 800.673.8043 or fill out the below form. Skip survey header. Contact anurse.
OVER-THE-COUNTER (OTC) ALLOWANCE AND HEALTH SAVINGS Look up the products you want to order in the catalog provided by mail or online and call 1.833.862.8434 (TTY 711) to have it delivered to your home. Free two-day shipping is available on all phone OTC orders. Also included is the Healthy Savings program. This program allows members to save on healthier foods with up to $1,500 a year in PRIORITYMEDICARE VALUE 2021 MAPD HEALTH PLAN Out-of-pocket maximum. $4,900. 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. This limit includes copayments and coinsurance payments. It does not include your monthly premium, Part D drug costs or services from out-of-network providers. AUTHORIZATIONS AND PSODS How to submit an authorization request. As a provider outside of Michigan who is not contracted with us, you should submit Medicare authorization requests via fax, using the proper prior authorization form. All Medicare authorization requests can be submitted using our general authorization form. Fax the request form to 888.647.6152. SEARCH - PRIORITYHEALTH.COM Provider drug info: Lemtrada® Lemtrada® authorization forms. www.priorityhealth.com/drug-authorization-forms-list/lemtrada. Provider drug info: Sylvant SEARCH - PRIORITYHEALTH.COM What's a referral? Definition of "referral" in health insurance plans. www.priorityhealth.com/glossary/whats-a-referral. What's a rider? Definition of "rider" in SEARCH - PRIORITYHEALTH.COM Provider drug info: Strensiq. Authorization forms for Strensiq®. www.priorityhealth.com/drug-authorization-forms-list/strensiq. Provider drug info: Reblozyl® SEARCH - PRIORITYHEALTH.COM Provider drug Info: Uplizna® Authorization information for Uplizna®(inebilizumab-cdon)
www.priorityhealth.com/drug-authorization-forms-list/uplizna AFFORDABLE MICHIGAN HEALTH INSURANCE Affordable, award-winning health insurance plans for Michigan individuals, families, employer groups, and Medicare and Medicaid members. Enroll today!WELCOME PROVIDERS
Welcome, providers. Thanks for working with Priority Health to give our members the right care at the right time. Log in. COVID-19: Learn about billing, coverage, virtual care and more. Provider Manual. Find guidelines and forms without logging in. Need an account?LOGIN REQUIRED
Priority Health members, please use the link to access the Member Center. Priority Health Member CenterMEMBER ACCOUNT
You can quickly and easily: Track spending balances to keep your budget in check. Search claims and see a detailed breakdown of care and prescription costs. Compare costs of medical procedures and prescriptions based on your plan so you can save money. Set up a video visit and get virtual care when and where you need it, includingprescriptions.
APPROVED DRUG LIST
Discover how Priority Health establishes Group, MyPriority and Medicare Approved Drug Lists. Approving drugs is a process based on medically accepted guidelines to maintain safety and effectiveness. Drug utilization review is a program of quality assurance to determine the appropriate use of medications.PAY YOUR PREMIUM
Wondering how to pay your premium bill? Making a payment is easy. Pick your plan to see specific instructions. My Priority. Pay for individual insurance. Medicare. Pay for Medicare Advantage or Medigap. Employers: log in for premium payment information.BEHAVIORAL HEALTH
Did you know Priority Health benefits include free, 24/7 behavioral health assistance? With growing concern for employee burnout and a clear need for mental health in the workplace, we go above and beyond to help your employees manage things like: Emotional distress. Depression or sad thoughts. Substance-abuse-related issues.COVERED DRUGS
The Approved Drug List, or "formulary," is a list of all drugs that Priority Health Medicare Advantage plans will pay for. Use the drug name search below to check if your drugs are listed, or you can open and save our 2021 Medicare Advantage Plan Formulary PDF.It's updatedmonthly.
AUTHORIZATIONS AND PSODS How to submit an authorization request. As a provider outside of Michigan who is not contracted with us, you should submit Medicare authorization requests via fax, using the proper prior authorization form. All Medicare authorization requests can be submitted using our general authorization form. Fax the request form to 888.647.6152. TOTAL HEALTH CARE AND PRIORITY HEALTH ANNOUNCE COMPLETION Total Health Care and Priority Health announce completion of merger. (Detroit – January 6, 2020): Priority Health, Michigan's second-largest health insurance plan, announced today that the company's merger with Total Health Care is now complete. Originally announced in summer 2019, the new partnership between two of Michigan's most-recognized AFFORDABLE MICHIGAN HEALTH INSURANCE Affordable, award-winning health insurance plans for Michigan individuals, families, employer groups, and Medicare and Medicaid members. Enroll today!WELCOME PROVIDERS
Welcome, providers. Thanks for working with Priority Health to give our members the right care at the right time. Log in. COVID-19: Learn about billing, coverage, virtual care and more. Provider Manual. Find guidelines and forms without logging in. Need an account?LOGIN REQUIRED
Priority Health members, please use the link to access the Member Center. Priority Health Member CenterMEMBER ACCOUNT
You can quickly and easily: Track spending balances to keep your budget in check. Search claims and see a detailed breakdown of care and prescription costs. Compare costs of medical procedures and prescriptions based on your plan so you can save money. Set up a video visit and get virtual care when and where you need it, includingprescriptions.
APPROVED DRUG LIST
Discover how Priority Health establishes Group, MyPriority and Medicare Approved Drug Lists. Approving drugs is a process based on medically accepted guidelines to maintain safety and effectiveness. Drug utilization review is a program of quality assurance to determine the appropriate use of medications.PAY YOUR PREMIUM
Wondering how to pay your premium bill? Making a payment is easy. Pick your plan to see specific instructions. My Priority. Pay for individual insurance. Medicare. Pay for Medicare Advantage or Medigap. Employers: log in for premium payment information.BEHAVIORAL HEALTH
Did you know Priority Health benefits include free, 24/7 behavioral health assistance? With growing concern for employee burnout and a clear need for mental health in the workplace, we go above and beyond to help your employees manage things like: Emotional distress. Depression or sad thoughts. Substance-abuse-related issues.COVERED DRUGS
The Approved Drug List, or "formulary," is a list of all drugs that Priority Health Medicare Advantage plans will pay for. Use the drug name search below to check if your drugs are listed, or you can open and save our 2021 Medicare Advantage Plan Formulary PDF.It's updatedmonthly.
AUTHORIZATIONS AND PSODS How to submit an authorization request. As a provider outside of Michigan who is not contracted with us, you should submit Medicare authorization requests via fax, using the proper prior authorization form. All Medicare authorization requests can be submitted using our general authorization form. Fax the request form to 888.647.6152. TOTAL HEALTH CARE AND PRIORITY HEALTH ANNOUNCE COMPLETION Total Health Care and Priority Health announce completion of merger. (Detroit – January 6, 2020): Priority Health, Michigan's second-largest health insurance plan, announced today that the company's merger with Total Health Care is now complete. Originally announced in summer 2019, the new partnership between two of Michigan's most-recognizedMEMBER ACCOUNT
You can quickly and easily: Track spending balances to keep your budget in check. Search claims and see a detailed breakdown of care and prescription costs. Compare costs of medical procedures and prescriptions based on your plan so you can save money. Set up a video visit and get virtual care when and where you need it, includingprescriptions.
PRIORITYMEDICARE EDGE 1 According to June 2020 monthly enrollment reports from the Centers for Medicare and Medicaid Services. 2 Excluding the Vital plan, which has 20% coinsurance for virtual visits. 3 Priority Health Medicare Advantage HMO-POS plans are the highest-rated HMO-POS plans in Michigan, with a rating of 4.5 out of 5 in NCQA’s Private Health Insurance Plan Ratings 2019–2020.CARE MANAGEMENT
Get started with care management today. To learn more or get started, fill out the below form or call the customer service number on the back of your member ID card to be connected to a care manager. For inquiries related specifically to behavioral health, contact 800.673.8043 or fill out the below form. Skip survey header. Contact anurse.
OVER-THE-COUNTER (OTC) ALLOWANCE AND HEALTH SAVINGS Look up the products you want to order in the catalog provided by mail or online and call 1.833.862.8434 (TTY 711) to have it delivered to your home. Free two-day shipping is available on all phone OTC orders. Also included is the Healthy Savings program. This program allows members to save on healthier foods with up to $1,500 a year in AUTHORIZATIONS AND PSODS How to submit an authorization request. As a provider outside of Michigan who is not contracted with us, you should submit Medicare authorization requests via fax, using the proper prior authorization form. All Medicare authorization requests can be submitted using our general authorization form. Fax the request form to 888.647.6152. PRIORITYMEDICARE VALUE 2021 MAPD HEALTH PLAN Out-of-pocket maximum. $4,900. 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. This limit includes copayments and coinsurance payments. It does not include your monthly premium, Part D drug costs or services from out-of-network providers. SEARCH - PRIORITYHEALTH.COM Provider drug info: Tecfidera. Authorization forms for Tecfidera®. www.priorityhealth.com/drug-authorization-forms-list/tecfidera. Provider drug info: Testopel SEARCH - PRIORITYHEALTH.COM Provider drug info: trientine (generic Syprine) Authorization forms for Syprine® (trientine) www.priorityhealth.com/drug-authorization-forms-list/trientine SEARCH - PRIORITYHEALTH.COM Provider drug info: Miglustat. Authorization information forMiglustat.
www.priorityhealth.com/drug-authorization-forms-list/miglustat. Provider drug info: Dronabinol SEARCH - PRIORITYHEALTH.COM Provider drug Info: Uplizna® Authorization information for Uplizna®(inebilizumab-cdon)
www.priorityhealth.com/drug-authorization-forms-list/uplizna AFFORDABLE MICHIGAN HEALTH INSURANCE Affordable, award-winning health insurance plans for Michigan individuals, families, employer groups, and Medicare and Medicaid members. Enroll today!WELCOME PROVIDERS
Welcome, providers. Thanks for working with Priority Health to give our members the right care at the right time. Log in. COVID-19: Learn about billing, coverage, virtual care and more. Provider Manual. Find guidelines and forms without logging in. Need an account?MEMBER ACCOUNT
You can quickly and easily: Track spending balances to keep your budget in check. Search claims and see a detailed breakdown of care and prescription costs. Compare costs of medical procedures and prescriptions based on your plan so you can save money. Set up a video visit and get virtual care when and where you need it, includingprescriptions.
LOGIN REQUIRED
Priority Health members, please use the link to access the Member Center. Priority Health Member CenterAPPROVED DRUG LIST
Discover how Priority Health establishes Group, MyPriority and Medicare Approved Drug Lists. Approving drugs is a process based on medically accepted guidelines to maintain safety and effectiveness. Drug utilization review is a program of quality assurance to determine the appropriate use of medications.PAY YOUR PREMIUM
Wondering how to pay your premium bill? Making a payment is easy. Pick your plan to see specific instructions. My Priority. Pay for individual insurance. Medicare. Pay for Medicare Advantage or Medigap. Employers: log in for premium payment information.COVERED DRUGS
The Approved Drug List, or "formulary," is a list of all drugs that Priority Health Medicare Advantage plans will pay for. Use the drug name search below to check if your drugs are listed, or you can open and save our 2021 Medicare Advantage Plan Formulary PDF.It's updatedmonthly.
FIND A DOCTOR
Our online Find a Doctor directory is the easiest way to find doctors, hospitals, pharmacies and other health care providers in the Priority Health network. Learn how to use it - AUTHORIZATIONS AND PSODS How to submit an authorization request. As a provider outside of Michigan who is not contracted with us, you should submit Medicare authorization requests via fax, using the proper prior authorization form. All Medicare authorization requests can be submitted using our general authorization form. Fax the request form to 888.647.6152. TRANSPORTATION SERVICES We can help with transportation services or mileage reimbursement. Call us at 888.975.8102 (TTY users call 711 ). We’ll help you get a ride to your medical appointments or to pick up medicine and supplies covered by this plan. We can help if you do not have a way to get to and from: Make your appointment first. Then call us to set up a ride. AFFORDABLE MICHIGAN HEALTH INSURANCE Affordable, award-winning health insurance plans for Michigan individuals, families, employer groups, and Medicare and Medicaid members. Enroll today!WELCOME PROVIDERS
Welcome, providers. Thanks for working with Priority Health to give our members the right care at the right time. Log in. COVID-19: Learn about billing, coverage, virtual care and more. Provider Manual. Find guidelines and forms without logging in. Need an account?MEMBER ACCOUNT
You can quickly and easily: Track spending balances to keep your budget in check. Search claims and see a detailed breakdown of care and prescription costs. Compare costs of medical procedures and prescriptions based on your plan so you can save money. Set up a video visit and get virtual care when and where you need it, includingprescriptions.
LOGIN REQUIRED
Priority Health members, please use the link to access the Member Center. Priority Health Member CenterAPPROVED DRUG LIST
Discover how Priority Health establishes Group, MyPriority and Medicare Approved Drug Lists. Approving drugs is a process based on medically accepted guidelines to maintain safety and effectiveness. Drug utilization review is a program of quality assurance to determine the appropriate use of medications.PAY YOUR PREMIUM
Wondering how to pay your premium bill? Making a payment is easy. Pick your plan to see specific instructions. My Priority. Pay for individual insurance. Medicare. Pay for Medicare Advantage or Medigap. Employers: log in for premium payment information.COVERED DRUGS
The Approved Drug List, or "formulary," is a list of all drugs that Priority Health Medicare Advantage plans will pay for. Use the drug name search below to check if your drugs are listed, or you can open and save our 2021 Medicare Advantage Plan Formulary PDF.It's updatedmonthly.
FIND A DOCTOR
Our online Find a Doctor directory is the easiest way to find doctors, hospitals, pharmacies and other health care providers in the Priority Health network. Learn how to use it - AUTHORIZATIONS AND PSODS How to submit an authorization request. As a provider outside of Michigan who is not contracted with us, you should submit Medicare authorization requests via fax, using the proper prior authorization form. All Medicare authorization requests can be submitted using our general authorization form. Fax the request form to 888.647.6152. TRANSPORTATION SERVICES We can help with transportation services or mileage reimbursement. Call us at 888.975.8102 (TTY users call 711 ). We’ll help you get a ride to your medical appointments or to pick up medicine and supplies covered by this plan. We can help if you do not have a way to get to and from: Make your appointment first. Then call us to set up a ride. MICHIGAN MEDICARE PLANS 1 According to June 2020 monthly enrollment reports from the Centers for Medicare and Medicaid Services. 2 Excluding the Vital plan, which has 20% coinsurance for virtual visits. 3 Priority Health Medicare Advantage HMO-POS plans are the highest-rated HMO-POS plans in Michigan, with a rating of 4.5 out of 5 in NCQA’s Private Health Insurance Plan Ratings 2019–2020.FIND A DOCTOR
Our online Find a Doctor directory is the easiest way to find doctors, hospitals, pharmacies and other health care providers in the Priority Health network. Learn how to use it - PREVENTIVE CARE: TESTS, SCREENINGS, ETC Cervical (Pap test) and vaginal (pelvic) cancer screening. Who is covered: All female Medicare members. When: Pap test & pelvic screenings: Every 2 years. Pap test annually if at high risk of cervical cancer or if you've had an abnormal Pap test within the past3 years and are
SEARCH - PRIORITYHEALTH.COM Provider services: Radiology, advanced diagnostic. How to get authorizations and bill for radiology services, including high-tech CT/CTA, MRI and ultrasound diagnostic imaging and low-tech X-rays SEARCH - PRIORITYHEALTH.COM Provider Manual: Vision care services. Routine vision care and medical vision services for all plans. www.priorityhealth.com/provider/manual/services/vision SEARCH - PRIORITYHEALTH.COM Provider drug info: Symdeko® Authorization information for Symdeko® (Tezacaftor/ivacaftor) www.priorityhealth.com/drug-authorization-forms-list/symdeko SEARCH - PRIORITYHEALTH.COM Provider drug info: Ranolazine. Authorization forms for Ranexa® www.priorityhealth.com/drug-authorization-forms-list/ranolazine. Provider drug info: Vigabatrin SEARCH - PRIORITYHEALTH.COM Provider drug info: Mavenclad® www.priorityhealth.com/drug-authorization-forms-list/mavenclad. Provider drug info: Octreotide. Octreotide authorization forms SEARCH - PRIORITYHEALTH.COM Provider drug info: Kyprolis. www.priorityhealth.com/drug-authorization-forms-list/kyprolis. Provider drug info: Spiriva. www.priorityhealth.com/drug-authorization SEARCH - PRIORITYHEALTH.COM Provider drug info: Topical testosterone. Authorization forms for topical testosterone. www.priorityhealth.com/drug-authorization-forms-list/topical-testosterone Questions? Call us at 877.436.7748 (TTY 711) 8 a.m. to 8 p.m.LOG IN
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