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Priority Health Medicare. The choice is easy. NCMS_6000_6014_A 05092013. Great reasons to choose us. 25+ years of health care experience in Michigan
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Priority Health Medicare The choice is easy. NCMS_6000_6014_A 05092013
Great reasons to choose us • 25+ years of health care experience in Michigan • Priority Health is a nationally recognized health benefits company. We consistently rank among the nation's top health plans for quality and service • #1 Medicare plan in the state • 19,000+ providers– including the University of Michigan Health System • 57,000 pharmacies nationwide. 98% of pharmacies in the U.S. are in our national network Priority Health is health plan with a Medicare contract.
Why choose a Priority Health Medicare plan? • Control rising health care costs with our growing portfolio of high quality, affordable Medicare plans. • Offer competitive benefits to both retired employees and those looking forward to retirement.
Three great reasons to choose Priority Health Medicare #1 Improve your bottom line • Save 10 – 15% by moving people 65 and older away from your group plan without sacrificing the quality of their benefits. • Drug plan administration handled by Priority Health now that Affordable Care Act removed your Retiree Drug Subsidy (RDS).
Three great reasons to choose Priority Health Medicare #2 Enhance your benefits Retain the best employees by adding an employer-sponsored Priority Health Medicare plan to your overall benefits package.
Three great reasons to choose Priority Health Medicare #3 Plans for employers of all sizes • Choose from two standard Medicare Advantage plans with enhanced hospitalization benefits, prescription drug coverage in the “donut hole” and worldwide coverage for urgent and emergency care. • No minimum employer contribution necessary for companies of 20 or more employees. • We can create custom plans for (companies with 100 or more employees).
Our members love us! • More individuals choose Priority Health Medicare Advantage plans over any other plan in Michigan* • Our individual PriorityMedicare ValueSM (HMO-POS) and PriorityMedicareSM (HMO-POS) plans were awarded 4.5 stars (out of 5) by the Centers for Medicare and Medicaid Services** • Our plans received the highest accreditation status of "Excellent" from the National Committee for Quality Assurance (NCQA). *According to January 2012 - April 2013 monthly enrollment reports from the Centers for Medicare and Medicaid Services. **Plan performance star ratings are assessed each year and may change from one year to the next.
Our group Medicare Advantage plans • Offer additional benefits beyond what you get with Original Medicare • Include prescription drug coverage with no “donut hole” and a home delivery option • Coverage in the United States and around the world • Have predictable out-of-pocket expenses • Include doctor visits and hospital coverage • Don’t require a referral to see a specialist • Local, exceptional customer service
Medicare Advantage eligibility • Individuals must have both Medicare Part A and Part Bto enroll • Must be a permanent Michigan resident and reside in our service area for at least six months of the year. May temporarily be outside the service area for 6 months or less
Enrollment periods & eligibility • Mid-year enrollment may lower your group’s average age and positively impact your renewal premium. • Enrollment changes (elections) made on the group’s renewal date thereafter.
Get started: • Simple 4 step process • MAPD Group Agreement • MAPD Eligibility Verification Form • 30-day Notification Letter • PriorityMedicare MAPD Group Enrollment Form • *Contact your account manager for MAPD quotes for Mid- and Large-size groups.
Employer-sponsored options: • Low • Employer involvement low – simply wants to assist Medicare-eligibles with transition into individual coverage
Our Individual Medicare Advantage plans • PriorityMedicare ValueSM(HMO-POS) • PriorityMedicareSM(HMO-POS) • PriorityMedicare MeritSM(PPO) • PriorityMedicare SelectSM(PPO)
2013 Individual Priority Health Medicare Advantage premiums • Premiums range from $0 to $154* • Vary by county and plan • Refer to the Summary of Benefits in your individual packet for premium information *You must continue to pay your Medicare Part B premium
Individual MAPD benefits The benefits information provided is a brief summary, not a complete description of benefits. For more information contact Priority Health Medicare.
Why choose a Priority Health Medigap plan? • Affordable - plans as low as $100 a month • Give you access to any Medicare provider in the U.S. • Generally have no copays at the time of service • Help pay some of the health care costs that Original Medicare doesn’t cover • Have low out-of-pocket expenses • Automatically process and pay claims to providers 2 Preferred rates apply for beneficiaries who are in their Open Enrollment Period or who have Guaranteed Issue Rights, or who may qualify if they meet certain medical criteria. Non-Standard rates apply for those not in their Open Enrollment Period or don’t have Guaranteed Issue Rights; also based on health status and tobacco use.
Medigap benefits • 4Lifetime maximum of $50,000 on care received outside the U.S.
Medigap Premium Example Plan F: 65 year old Female, Guaranteed Issue Kent, Ottawa $120 Grand Traverse, Livingston, Monroe $129 Genesee, Ingham, Macomb, Oakland, Saginaw, Washtenaw, Wayne $132 Kalamazoo, Muskegon, St. Clair $136
Eligibility requirements • Beneficiaries must be eligible for Medicare Part A and enrolled in Medicare Part B • Must be a permanent resident of Michigan and physically reside in the state for six months of the year • Can’t have more than one Medigap plan • Can’t have a Medigap and an MAPD plan at the same time Neither Priority Health Medigap plans nor agents authorized to sell Priority Health Medigap plans are connected with or endorsed by the United States government or the federal Medicare program.
