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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?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.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. 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. 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 inCOVERED 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.
OVER-THE-COUNTER (OTC) ALLOWANCE AND HEALTHY SAVINGS Over-the-counter health purchases can really add up over time. That's why we include a quarterly allowance on many of our plans so you can purchase thousands of health and wellness products to support yourhealth.
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.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. 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. 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 inCOVERED 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.
OVER-THE-COUNTER (OTC) ALLOWANCE AND HEALTHY SAVINGS Over-the-counter health purchases can really add up over time. That's why we include a quarterly allowance on many of our plans so you can purchase thousands of health and wellness products to support yourhealth.
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? 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. 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 Center: Medicare fee schedules. A list of standard fee schedules applying to services to Priority Health Medicare members. www.priorityhealth.com/provider SEARCH - PRIORITYHEALTH.COM Provider drug info: Granisetron. Authorizations forms for Granisetron. www.priorityhealth.com/drug-authorization-forms-list/granisetron. Provider drug info: Tetrabenazine 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 Provider drug info: Evenity® www.priorityhealth.com/drug-authorization-forms-list/evenity. Provider drug info: Ondansetron. Ondansetron authorization forms SEARCH - PRIORITYHEALTH.COM Provider drug info: Fluorouracil. Authorization forms for Fluorouracil0.5% cream.
www.priorityhealth.com/drug-authorization-forms-list/fluorouracil SEARCH - PRIORITYHEALTH.COM Provider drug info: Enbrel® Authorization information for Enbrel®. www.priorityhealth.com/drug-authorization-forms-list/enbrel. Provider drug info: Afinitor® SEARCH - PRIORITYHEALTH.COM Provider drug info: Rayaldee® Information on authorization for Rayaldee® (caldifediol) www.priorityhealth.com/drug-authorization-forms-list/rayaldee 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
Here's where health care providers can find out about joining our networks, request online accounts, get help without logging in, or log in to their online accounts.LOGIN REQUIRED
Priority Health members, please use the link to access the Member Center. Priority Health Member CenterMEMBER ACCOUNT
Do you have a MyHealth account? Your new Priority Health member account gives you access to everything regarding your health insurance plan, while MyHealth offers access to your Spectrum Health providers, appointments and other patient information.APPROVED DRUG LIST
Facts about your approved drugs. When a generic drug is listed for a brand copay or coinsurance, there will be little cost difference between the brand and its generic equivalent.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 -PAY YOUR PREMIUM
Find out how to pay your premium bill online, by phone or by mail AUTHORIZATIONS AND PSODS Priority Health requires pre-authorization for certain services and procedures. Providers must submit clinical documentation in writing that explains why the proposed procedure or TRANSPORTATION SERVICES You may only use our transportation to get to and from appointments or to pick up medicine and supplies covered by this plan. If you need a ride to services that are billed by a Community Mental Health Services Program, such as speech, language and occupational therapies for development disabilities, or behavioral and mental health help for depression or anxiety, the Community Mental Health 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
Here's where health care providers can find out about joining our networks, request online accounts, get help without logging in, or log in to their online accounts.LOGIN REQUIRED
Priority Health members, please use the link to access the Member Center. Priority Health Member CenterMEMBER ACCOUNT
Do you have a MyHealth account? Your new Priority Health member account gives you access to everything regarding your health insurance plan, while MyHealth offers access to your Spectrum Health providers, appointments and other patient information.APPROVED DRUG LIST
Facts about your approved drugs. When a generic drug is listed for a brand copay or coinsurance, there will be little cost difference between the brand and its generic equivalent.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 -PAY YOUR PREMIUM
Find out how to pay your premium bill online, by phone or by mail AUTHORIZATIONS AND PSODS Priority Health requires pre-authorization for certain services and procedures. Providers must submit clinical documentation in writing that explains why the proposed procedure or TRANSPORTATION SERVICES You may only use our transportation to get to and from appointments or to pick up medicine and supplies covered by this plan. If you need a ride to services that are billed by a Community Mental Health Services Program, such as speech, language and occupational therapies for development disabilities, or behavioral and mental health help for depression or anxiety, the Community Mental HealthFIND 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 - 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.APPROVED DRUG LIST
Find drugs covered under your plan through the Approved Drug List. The Approved Drug List, sometimes called a formulary, is a list of drugsyour plan includes.
SEARCH - PRIORITYHEALTH.COM Provider Manual services: Back & neck pain care. Authorization and billing information for musculoskeletal neck and spine services, including the use of Spine Centers of Excellence (SCOEs) SEARCH - PRIORITYHEALTH.COM Provider drug info: Symdeko® Authorization information for Symdeko® (Tezacaftor/ivacaftor) www.priorityhealth.com/drug-authorization-forms-list/symdeko SEARCH - PRIORITYHEALTH.COM Agent Center: Large group quoting. Get details on quoting for a large group and tips on how to use PriorityQuote. www.priorityhealth.com/agent/center/group/large/quoting SEARCH - PRIORITYHEALTH.COM PriorityMedicare 2019: Pharmacy chains. Here’s a list of a few of the chains that are in your PriorityMedicare 2019 pharmacy network. www.priorityhealth.com 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: Mavenclad® www.priorityhealth.com/drug-authorization-forms-list/mavenclad. Provider drug info: Octreotide. Octreotide authorization forms 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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