Medicare Advantage Plans May Cost You Less
If you enroll in a Medicare Advantage plan, you must continue to pay your Medicare Part B premiums and you may pay an additional premium. The insurer determines the Medicare Advantage planâs premium, which can vary from one Medicare Advantage plan to another. Some Medicare Advantage plans may offer enrollees monthly premiums as low as $0.
Your cost sharing may also be less under Medicare Advantage. For, example, if an enrollee visits a primary care physician under Medicare Advantage, they may have a copayment of $10. However, if the enrollee visits a primary care physician under Original Medicare, they may have a coinsurance of 20%, which could be more than $10.
Also, a Medicare Advantage plan limits your maximum out-of-pocket expense. Once you have spent that maximum, you typically pay nothing for covered medical services for the remainder of the year. Original Medicare does not provide a maximum out-of-pocket cap, so potential expenses are limitless.
Often a Medicare Advantage plan can be less expensive than comparable coverage with Original Medicare. To get the most out of a Medicare Advantage plan with Original Medicare, you may also need to enroll in a stand-alone Medicare Part D Prescription Drug Plan as well as a Medicare Supplement Insurance plan.
Where Can I Use My Card
We are pleased to share that you have a variety of locations at which to use your Healthy Benefits Plus card:
- In NJ, you can use your card at ACME, CVS, Duane Reade, Stop & Shop, Walgreens, and Walmart locations. You cannot use your card at CVS locations located within Target stores.
- In GA and SC, you can use your card at CVS, Food Lion, Kroger, Walgreens, and Walmart locations. You cannot use your card at CVS locations that are located within Target stores.
New Kroger Medicare Plans Offer Whole
Kroger Health, the health care division of The Kroger Co., is rolling out two Medicare plans with the help of nationally recognized nonprofit health plan Priority Health. The two co-branded plans, which will be available in eight counties throughout Southeast Michigan beginning in January 2023, provide benefits and services that address an individuals whole-health needs and well-being.
The PriorityMedicare + Kroger and PriorityMedicare D-SNP + Kroger plans will offer eligible members benefit allowances that can be used at Kroger stores to buy nutritious food and health and wellness products. Both plans also come with a no-cost Boost membership that offers fuel points per $1 spent, digital coupons, online grocery ordering, next-day delivery and more.
Were excited to offer these co-branded plans with Kroger to our Medicare members in Southeast Michigan, said Samia Brown, director of senior markets and product development at Michigan-based Priority Health. We know nutrition impacts ones health and well-being, especially our senior population. At Priority Health, were always looking for ways to better serve our members and provide tangible resources and incentives that will help them live their healthiest lives possible.
According to Priority Health, eligible plan members will be able to reduce their monthly out-of-pocket costs and still achieve a balanced and nutritious diet.
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Priority Health And Kroger Health Announce Co
DETROIT—-Priority Health, a nationally recognized nonprofit health plan, and Kroger Health, the health care division of The Kroger Co., announced today the launch of two co-branded Medicare plans with benefits and services that address an individuals whole-health needs and well-being.
The two co-branded plans, PriorityMedicare + Kroger as well as PriorityMedicare D-SNP + Kroger , will be available in eight counties in Southeast Michigan beginning in January 2023. This includes the following counties: Genesee, Ingham, Livingston, Macomb, Oakland, Saginaw, Washtenaw and Wayne.
Eligible members enrolled in one of these plans will have benefit allowances that can be used at Kroger stores to buy nutritious food as well as health and wellness items. Both plans also offer a no-cost Boost membership which includes fuel points per $1 spent, digital coupons, the ability to order groceries online, next-day grocery delivery and more.
Were excited to offer these co-branded plans with Kroger to our Medicare members in Southeast Michigan, said Samia Brown, director of senior markets and product development at Priority Health. We know nutrition impacts ones health and well-being, especially our senior population. At Priority Health, were always looking for ways to better serve our members and provide tangible resources and incentives that will help them live their healthiest lives possible.
About Priority Health:
About Kroger Health:
Medicare Advantage Plans Have Specific Service Areas
Most Medicare Advantage plans have regional networks of participating providers. To enroll, you must reside in the Medicare Advantage planâs service area at least 6 months of the year. If you divide your time between homes located in different areas, this requirement may be difficult to meet.
The bottom line is that Medicare Advantage plans may provide more affordable coverage than you would receive otherwise. The trade-off is that you have to follow the Medicare Advantage planâs rules to receive payment for covered services.
Do you have other questions about Medicare Advantage? Call us and speak with a licensed insurance agent about finding Medicare Advantage plans in your area and your Medicare coverage options. Or just enter you zip code on this page.
Find an affordable Medicare plan with extra benefits. We can help you find an all-in-one Medicare plan that may include dental benefits, hearing aids, eyeglasses, and more. Start Now.
Medicare information is everywhere. What is hard is knowing which information to trust. Because eHealthâs Medicare related content is compliant with CMS regulations, you can rest assured youâre getting accurate information so you can make the right decisions for your coverage.Read more to learn about our Compliance Program.
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Are There Different Types Of Medicare Advantage Plans
There are a total of six Medicare Advantage plans to choose from. The four most commonly used are:
The first type of Medicare Advantage plan is a Health Maintenance Organization , you will receive your necessary coverage in-network, with the exceptions of: Emergency care Out-of-area urgent care Out-of-area dialysis. In some HMO cases, you will need a referral for specialist visits.
The next kind of Medicare Advantage plan is Preferred Provider Organization plan, you are medically covered through a private Medicare-approved insurance company. One of the advantages of PPO is that you can save money by seeing the plans in-network providers.
The third Medicare Advantage plan is Private Fee-for-Service Plan. These plans are also offered by private Medicare-approved insurance companies, and the plan determines how much enrollees will pay health care providers and other coverage. This information is provided in âAnnual Notices of Changeâ and âEvidence of Coverageâ documents that are sent to enrollees each year.
The last type of Medicare Advantage plan is the Special Needs Plan which is ideal for enrollees who have specific medical diseases or characteristics. With these plans, Medicare tailors coverage and benefits to meet the specific needs of the groups served.
Do I Qualify For The Grocery Benefit
To qualify for the Grocery Plus benefit, you must be in a plan that is offering the benefit and have at least one of the following health conditions:
- Autoimmune disorders
- Chronic alcohol and other drug dependence
- Certain chronic and disabling mental health conditions
- Certain neurologic disorders
- Chronic arthritis
- Chronic heart failure
- End-stage renal disease requiring dialysis
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Eligibility For Part D
Anyone with Medicare is eligible to enroll in a Part D plan. To enroll in a PDP, the individual must have Part A OR Part B. To enroll in an MA-PD, the individual must have Part A AND Part B.
Enrollees must live in their plans service area. In the case of homeless persons, the following may be used as a permanent residence: a Post Office box, the address of a shelter or clinic, or the address where the person receives mail such as Social Security checks.
PDPs are usually national plans, but MA-PDs have delineated regions, sometimes by state, sometimes by counties within states ). For this reason, MA-PDs may not be appropriate for those who travel a great deal or who maintain summer and winter residences in different areas of the country. NOTE: Some MA-PDs offer passport plans that allow members to obtain benefits outside their normal service areas.
Individuals who reside outside the United States* are not eligible to enroll, but may do so upon their return to the country. Incarcerated individuals may not enroll in Part D, but they may enroll upon release from prison. Prior to 2021, people with end-stage-renal-disease could not enroll in an MA-PD. Starting in 2021, people with ESRD can enroll in Medicare Advantage plans during the annual Open Enrollment Period.
There are no other eligibility restrictions or requirements for Part D.
Kroger Priority Health Announce Co
Detroit-based Priority Health, a nationally recognized nonprofit health plan, and Kroger Health, the health care division of The Kroger Co., announced the launch of two co-branded Medicare plans with benefits and services that address peoples whole-health needs and well-being.
The plans, PriorityMedicare + Kroger as well as PriorityMedicare D-SNP + Kroger, will be available in eight counties in Southeast Michigan beginning in January. This includes: Genesee, Ingham, Livingston, Macomb, Oakland, Saginaw, Washtenaw and Wayne.
Eligible members enrolled in one of these plans will have benefit allowances that can be used at Kroger stores to buy food, as well as health and wellness items. Both plans also offer a no-cost Boost membership which includes fuel points per $1 spent, digital coupons, the ability to order groceries online and next-day grocery delivery.
Were excited to offer these co-branded plans with Kroger to our Medicare members in Southeast Michigan, said Samia Brown, director of senior markets and product development at Priority Health.
We know nutrition impacts ones health and well-being, especially our senior population. At Priority Health, were always looking for ways to better serve our members and provide tangible resources and incentives that will help them live their healthiest lives possible.
Through these plans that provide financial support for groceries and health-related items, eligible members will reduce their monthly out-of-pocket costs.
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Competition: Priority Health Vs Unitedhealthcare
Michigan has among the highest penetration of Medicare Advantage enrollments among Medicare beneficiaries. Among Medicare Advantage plans with the most enrollments in Michigan, UnitedHealthcare is a large national carrier with similar offerings. UnitedHealthcare and Priority Health score comparably on CSM quality ratings, as well as AM Best ratings.
UnitedHealthcare offers more supplemental plans, but Priority Health provides in-network pricing for providers nationwide, so members who travel get benefits outside of Michigan. Priority Health offers robust extra benefits, at least on par with the national carriers. In its favor, Priority Health has local corporate roots and in-person customer service at their walk-in centers. For local support, Priority Health wins.
Easy Ways To Enjoy Your Benefits
- Onlinego to carepartnersct.com/order-OTC, log-in with your OTC Card number and your CarePartners of Connecticut member ID number, and select the items you want to purchase. You can also access the online ordering site through your secure online account.
- call MonFri, MonFri, 8 a.m.7 p.m. ET, and a Medline representative will take your order.
- fill out the mail order form included with the Medline catalog. You will receive a catalog by mail.
OTC items ordered online, by phone or by mail will be delivered approximately 2-5 business days after the order is received by Medline.
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Common Questions About The Over
Ive called and tried to order items, but they seem to be on backorder do you know when theyll be back in stock?
COVID-19 has created shortages on many popular items. Were working closely with our OTC vendor and theyve advised us that calling or viewing the catalog online will give you the most up to date items.
How long will it take to get my order?
We are pleased to offer 2 day shipping on most items.
Can I pay for extra items if I use my full dollar amount?
If you would like to order items that are above your benefit amount you may use a credit card on the online catalogs for Medicare Advantage members or HAP Medicare Complete Duals members. You may order as frequently as you like.
Can I purchase items for family members and friends?
No. OTC products are intended for member use only to help with a health or medical need.
Do you accept returns?
No. Due to the personal nature of these products, returns are not accepted.
Need Help?
For information about your OTC benefit, call 484 -7977 24 hours a day, 7 days a week, 365 days a year to speak with an OTC advocate. They can answer any questions you might have and even help you place an order by phone.
Browsing The Product Catalogs
Product catalogs are based on your plan type and the quarterly dollar amount assigned to that plan. Find your plan type below to see which items are available for purchase. You can also use our online store using the links above or by logging into our secure member portal and clicking Over-the-Counter Benefit Catalog in the Quick Links section.
Youll need to register to use the store. Have your member ID card handy as youll need it during the process.
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The #1 Individual Medicare Advantage Plan In Michigan**
1Only members eligible for Special Supplemental Benefits for the Chronically Ill can use their OTC Plus card to purchase food and produce. Limitations apply
2Savings based on Krogers next-day delivery Boost plan, assuming two deliveries per week vs. non-member fee
3Priority Healths pharmacy network includes limited lower cost pharmacies in Michigan. The lower costs advertised in our materials for these pharmacies may not be available atthe pharmacy you use. For up-to-date information about our network pharmacies, including whether there are any lower-cost preferred pharmacies in your area, please call888.389.6648, TTY users call 711, or consult the online pharmacy directory at prioritymedicare.com.
**According to May 2022 monthly enrollment reports from the Centers for Medicare and Medicaid Services.
How To Access The Healthy Savings Program
New discount offers are available every Sunday. There are three ways you can view the weekly discounts:
- Email:Log in to Healthy Benefits Plus to sign up for the weekly emails. Select Account Settings by clicking your name in the upper right-hand corner of the Healthy Benefits Plus page. Choose Preferences and ensure you have checked the box next to each preferred method of notification. Each weekly email will promote specific discounts on pre-qualified healthy food items.
- Phone: Call Healthy Benefits Plus customer service at to hear the offers for each week.
- Online: Download the Healthy Benefits Plus app or log in to Healthy Benefits Plus and select Grocery Discounts to view eligible items.
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Priority Health Medicare Otc 2020 Catalog
Transcription
1 Priority Health Medicare OTC 2020 Catalog And other participating stores
2 Quarterly allowance to buy thousands of OTC health items Priority Health is providing you a Priority Health Medicare OTC card you can use to purchase over-the-counter health items online, in-store at Walmart and other participating stores and by phone. You will receive an allowance each quarter to purchase items. Your balance will not roll over and funds expire at the end of each calendar quarter on March 31st, June 30th, September 30th and December 31st. 1. Order online View products online anytime at HealthyBenefitsPlus.com/ PHMOTC. Once you choose the items you want to buy, you will be directed to Walmart.com to complete the purchase. 2. Shop in-store Convenient in-store shopping is available at Walmart and other participating store locations near you. Just shop for qualified items and scan your card or mobile app at checkout Call for delivery Look up the products you want to order in this catalog or online and call to have it delivered to your home.
5 Table of Contents Allergy and Sinus Bath Safety Braces, Supports and Heating Pads Cold, Cough, Flu and Sinus Diabetes OTC Digestive Health – Antacids Digestive Health – Laxatives and Hemorrhoid Relief Eye Care and Ear Care Feminine Hygiene First Aid Foot Care Health Monitors Incontinence Oral Care Pain Relievers Skin Care Sleeping and Snoring Smoking Cessation Vitamins and Supplements
26 Notes
Shopping With Your Healthy Savings Program
You must shop in-store with your OTC card to receive the Healthy Savings program discount benefit.
Once you are in a store, simply choose the products from the qualified discounted offers for that week. Then, go to the check out and have the store clerk scan the barcode printed on the back of your OTC card for immediate savings on all of the promoted items you purchased.
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How Do I Access My Benefit
Qualifying members will have the $20 grocery allowance added to their Healthy Benefits Plus card to spend on groceries. This is in addition to your regular over-the-counter benefit.
Please note: The $20 allowance can be used only on qualifying grocery items. You can still purchase OTC items using your OTC quarterly allowance.
When Will The Grocery Plus Benefit Be Available
Qualifying members in GA, NJ, and SC will receive a $20 allowance to use only on groceries between August 1st and September 30, 2021.
Qualifying members in AZ, GA, MS, NJ, PA, SC, TN, and TX will receive a Grocery Plus benefit beginning on October 1st, 2021. If you qualify, you will have the choice to use your Q4 quarterly allowance to purchase groceries and/or over-the-counter items with your Healthy Benefits Plus card. If you do not qualify for the Grocery Plus benefit, you may still use your allowance for OTC items.
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Medicare Supplement Insurance Plans
Medicare Supplement Insurance plans, also called Medigap, cover some out-of-pocket costs for consumers that Original Medicare doesnt. There are ten different types of Medigap plans, each with set benefits and coverage. The benefits are the same within each plan type no matter the insurer, but costs and extra benefits vary by insurance company.
Priority Health offers six Medigap plan types. They vary in how much they cover and what they cost, but all include emergency care while traveling, hearing and vision discounts, and a 12% discount on monthly premiums if another person in your household is also enrolled in a Priority Health Medigap plan.