Priority offers three Medicare Advantage plans. All three are Advantage policies that include prescription drug coverage. They cover parts a, b, c, and d in one consolidated plan where there is no Medigap coverage needed. PriorityMedicare, PriorityMedicare Value, and PriorityMedicare Plus are Medicare Advantage health maintenance organizations (HMOs) with point-of-service (POS) options. As an HMO, they save you money any time you use their network of health care providers. Because it also has a POS option, you can use providers outside the network but you may pay more. The plans vary in their copay amounts for the different services. Our Medicare specialists can help you find the plan that works best for you.
Medicare.gov: the official U.S. government site for Medicare
PriorityMedicare Value (HMO
The plan offers national in-network prescription coverage (i.e., this would include 50 states and the District of Columbia). This means that you will pay the same cost-sharing amount for your prescription drugs if you get them at an in-network pharmacy outside of the plan’s service area (for instance when you travel). Total yearly drug costs are the total drug costs paid by both you and a Part D plan. The plan may require you to first try one drug to treat your condition before it will cover another drug for that condition. Some drugs have quantity limits. Your provider must get prior authorization from PriorityMedicare Value (HMO-POS) for certain drugs. You must go to certain pharmacies for a very limited number of drugs, due to special handling, provider coordination, or patient education requirements that cannot be met by most pharmacies in your network. These drugs are listed on the plan’s website, formulary, printed materials, as well as on the Medicare Prescription Drug Plan Finder on Medicare.gov. If the actual cost of a drug is less than the normal cost-sharing amount for that drug, you will pay the actual cost, not the higher cost-sharing amount. You pay $0 the first time you fill a prescription for certain drugs. These drugs will be listed as "free first fill" on the plan’s website, formulary, printed materials, and on the Medicare Prescription Drug Plan Finder on Medicare.gov. If you request a formulary exception for a drug and PriorityMedicare Value (HMO-POS) approves the exception, you will pay Tier 3: Non-Preferred Brand cost sharing for that drug. In-Network $0 deductible. Initial Coverage You pay the following until total yearly drug costs reach $2,850: Retail Pharmacy Contact your plan if you have questions about cost-sharing or billing when less than a one-month supply is dispensed. You can get drugs the following way(s): Tier 1: Generic
Medicare Plans & Coverage: Part A, Part B, Part C, Part D
Medicare is a federal insurance program that covers hospitalization expenses as well as doctor and medical expenses. To be eligible for Medicare, one must be an American citizen 65 years or older, or younger with a qualifying disability.