Getting care

We make it easy to find and use all the services included in your PriorityMedicare D-SNP health plan.

Drug coverage

This plan has no deductible, so you'll pay these amounts for your drugs.

Tiers 1 - Generic Tier 1- Brand
$0 (preferred retail)
$1.30 (standard retail)
$3.60 (90-day mail order)
$0 (preferred retail)
$3.90 (standard retail)
$8.95 (90-day mail order)

Cost share will vary on your LIS status. Specialty drugs are available in a 30-day supply at a time.

What drugs are covered

Medication Therapy Management

Keep up to date on the medications you need with our Medication Therapy Management (MTM) program. We work with specially trained area pharmacists to help you get the best results from your medications while keeping your out-of-pocket costs down. These pharmacists do much more than dispense drugs: they review your current medications and go over any questions you may have.

Learn more

OTC Benefit allowance

You can purchase health and wellness products that don’t require a prescription and support your health. You’ll receive a quarterly allowance* to use on things such as:

  • Pain relievers
  • Cold medicine
  • Allergy medication
  • Cough drops
  • Vitamins
  • Toothpaste
  • Eye drops
  • Compression socks
  • And more

Your Priority Health Medicare OTC card and catalog, along with information on how and where you can use your card, will arrive in the mail following enrollment in your plan. You’ll be able to:

  • View products, check your account balance and order online anytime or by downloading the Healthy Benefits Plus mobile app.
  • Shop at participating store locations near you. Scan your OTC card or mobile app at checkout.
  • Call 888.862.8434 (TTY 711) to place an order for delivery, 8 a.m. – 8 p.m., seven days a week, October – March; Monday – Friday, April – September.

Healthy Savings Program

Included with your OTC benefit is access to the Healthy Savings Program. Save on fresh produce, lean meats, yogurt, eggs and more from over 200 healthy food brands. Find new offers through weekly emails, the website and the Healthy Benefits Plus mobile app. Scan the back of your OTC card at participating stores to save.

*Your unused OTC allowance does not roll over. Funds expire at the end of each quarter on March 31, June 30, September 30 and December 31.


Vision, dental and hearing coverage

Your plan includes routine vision from EyeedSM providers, hearing coverage from TruHearingTM providers and preventive dental services through Delta Dental®.

Vision

You won’t pay anything for a routine vision exam or retinal imaging and we include a $200 eyewear allowance each year for glasses or contacts.

To find an EyeMed “Select” provider near you, call EyeMed at 844.366.5127 (TTY users should call 711), Monday through Friday from 9 a.m. – 8 p.m. Or, use our Find a Doctor tool.

Dental

Our contract with Delta Dental provides a large network of dentists and includes preventive exams, cleanings and one set of bitewing X-rays covered at no cost.

You can find participating dentists in the Delta Dental Medicare Advantage Premier and Medicare Advantage PPO network by calling 800.330.2732 (TTY users should call 711), Monday through Friday 9 a.m. - 8 p.m. or search online at deltadentalmi.com/findadentist and select the Medicare Advantage PPO and Medicare Advantage Premier network.

Hearing

You’re also covered for a routine hearing exam and one advanced level hearing aid per year, per year. Call TruHearing at 833.714.5356, Monday through Friday from 8 a.m. to 8 p.m., TTY users should call 711. For assistance on Saturday or Sunday, call Priority Health Medicare at 888.389.6648 (TTY users should call 711), from 8 a.m. to 8 p.m.