by Russell Noga | Updated October 2, 2024
Medicare supplement plans, known as “Medigap,” partially or fully cover the out-of-pocket costs associated with Original Medicare Parts A & B. Original Medicare is a federally funded program for seniors 65 and older. However, Medicare Parts A & B don’t fully cover medical and hospital costs.
A Medigap plan provides financial assistance for the remaining expenses. You can purchase Medigap plans from private healthcare insurers like Priority Health. The best time to sign up for a Medigap policy is during the “Open Enrollment” period in the six months after turning 65. During this time, Priority Health must accept your application to join its Medigap scheme, even if you have pre-existing health conditions.
This post examines the Medigap offering from Priority Health. We’ll look at the company’s Medigap offering, average monthly rates on premiums, Medigap benefits in each plan, and the perks the company offers with your policy.
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Priority Health Medigap Plans at a Glance
- Priority Health offers affordable premiums on Medigap plans but is not a cost leader in any market.
- The company focuses on providing the more popular Medigap plans, A, C, D, F, G, & N.
- Beneficiaries get discounts on vision and hearing services through their partner network.
- Priority Healthcare has one of the best household discounts, offering 12% for qualifying members.
Who Is Priority Health?
Founded in 1985 as Lakeshore HMO in 1985, the company rebranded to Priority Healthcare since 1992. It’s one of the largest players in the Michigan Medigap market.
What Medicare Supplement Plans Does Priority Health Offer?
Priority Health offers Medigap plans to Michigan residents, focusing on the more popular plans. You have options for Plans A, C, D, F, G, & N. Here is a breakdown of the coverage offered in each plan.
Plan A – Basic benefits for Medicare Part A, Coverage for Part B coinsurance and copayments, but no coverage for the Medicare Part A deductible.
Plan C – Near-comprehensive coverage. The plan includes a benefit for the Medicare Part B deductible but no coverage for Medicare Part B excess charges.
Plan D – Near-comprehensive coverage for Medicare Part A & B expenses, but no coverage for the Medicare Part B deductible or excess charges.
Plan F – The highest level of coverage of any Medigap plan. You get coverage for the Medigap Part B deductible.
Plan G – Near comprehensive coverage for Part A & B expenses. There’s no coverage for the Medicare Part B deductible.
Plan N – This policy comes with copayment responsibilities for doctor consultations and visits to the emergency room. There’s no coverage for the Medicare Part B deductible or excess charges.
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Priority Health Medigap Plans – Benefits & Coverage
Priority Health offers Medigap plans with benefits in every plan standardized to CMS requirements. As a result, you can expect the Medicare Part A & B benefits in Priority Health Medigap plans to be the same as any other Medigap provider.
All Medigap plans offer the following benefits for Original Medicare Parts A & B.
- Part A coinsurance and hospital costs for up to 365 days after using up Medicare benefits.
- Part A hospice care coinsurance or copayment.
- Part B coinsurance or copayment.
- Blood transfusion costs for the first three pints of blood.
Plans F*, G, and N offer additional Medicare Parts A & B benefits.
- Part A deductible.
- Part B excess charges (Plan N doesn’t cover these charges).
- Skilled nursing facility care coinsurance.
- 80% of emergency healthcare costs when traveling outside the US for 60 days. ($250 deductible and $50,000 maximum apply).
- Unlimited coverage for all out-of-pocket costs.
*Medigap Plans C & F are only available to seniors eligible for Original Medicare Parts A & B before January 1, 2020. If you’re eligible for Medicare before this date, you can sign up for Plan C or F with Priority Health. However, the company might require you to undergo a medical underwriting.
If you have pre-existing health conditions, the company can use this information to increase your monthly premiums over the average market rate or deny your application. You might qualify for a guaranteed issue right where you can avoid underwriting. Contact our team for more information.
What Priority Health Medigap Plans Don't Cover
Medigap plans only cover medical and hospital expenses relating to Original Medicare Parts A & B. Medigap policies don’t cover the costs of preventative treatments at the acupuncturist, podiatrist, physiotherapist, or chiropractor. In some cases, Medicare may cover these costs if your doctor deems them medically necessary.
Medigap doesn’t cover the cost of cosmetic procedures, and there’s no coverage for prescriptions or hearing, vision, and dental services. Medicare and Medigap don’t cover stays in unskilled nursing homes or private-duty nursing care services.
Priority Health Medigap Plans – Premiums
Priority Health uses a risk assessment to set your premiums when joining its Medigap scheme. They look at factors like your gender, age, smoking status, and location to form your risk profile. Our research shows a 65-year-old nonsmoking female will pay the following average premiums for Medigap- plans with Priority Health in Michigan.
- Plan A: $97.20 to $91.37
- Plan C: $171.33 to $161.06
- Plan D: $126.13 to $118.56
- Plan F: $179.91 to $169.12
- Plan G: $139.48 to $131.12
- Plan N: $113.60 to $106.79
*Your premium rates may vary depending on your unique risk profile.
Priority Health Medigap Plans – Additional Benefits & Discounts
Priority Healthcare offers discounts on hearing services through TruHearing and discounts on vision services discounts through EyeMed. The company has one of the best household discounts in the industry, with a 12% discount if multiple household members buy plans.
Priority Health Medigap Plans – Third-Party Ratings & Reviews
Priority Healthcare has an A rating from AM Best and no accreditation from the Better Business Bureau.
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Frequently Asked Questions
What are Priority Health Medigap Plans?
Priority Health Medigap Plans, also known as Medicare Supplement plans, are private health insurance policies designed to fill the gaps in Original Medicare coverage. They help pay for out-of-pocket costs such as deductibles, copayments, and coinsurance.
Who is eligible for Priority Health Medigap Plans?
To be eligible for Priority Health Medigap Plans, you must be enrolled in Medicare Part A and Part B. Generally, you need to be 65 or older, although some states may allow younger individuals with disabilities to apply.
When can I enroll in Priority Health Medigap Plans?
The best time to enroll in a Priority Health Medigap Plan is during your Medigap Open Enrollment Period, which starts when you’re 65 and enrolled in Medicare Part B. During this six-month period, you have guaranteed issue rights, meaning insurers cannot deny you coverage or charge you higher premiums based on your health.
What are the benefits of Priority Health Medigap Plans?
Priority Health Medigap Plans offer a range of benefits, including coverage for Medicare Part A and Part B deductibles, coinsurance, and extended hospital stays. Some plans may also cover foreign travel emergency expenses.
What are the differences between Plan G and Plan N under Priority Health Medigap Plans?
Plan G offers comprehensive coverage, paying for all Medicare Part A and B deductibles, coinsurance, and excess charges. Plan N covers similar benefits but requires you to pay a copayment for some doctor’s office and emergency room visits.
Can I use any healthcare provider with Priority Health Medigap Plans?
Yes, Priority Health Medigap Plans are accepted by any healthcare provider that accepts Medicare, giving you the freedom to choose your preferred doctors and hospitals.
Can I switch from Priority Health Medigap Plans to another provider?
Yes, you can switch from Priority Health Medigap Plans to another insurance provider offering Medigap plans. However, if you switch outside your Medigap Open Enrollment Period, you may be subject to medical underwriting and could face higher premiums based on your health condition.
Do Priority Health Medigap Plans cover prescription drugs?
No, Priority Health Medigap Plans do not cover prescription drugs. To get prescription drug coverage, you need to enroll in a Medicare Part D prescription drug plan.
How do Priority Health Medigap Plans differ from Medicare Advantage plans?
Priority Health Medigap Plans work with Original Medicare and provide supplemental coverage, while Medicare Advantage plans are private health plans that replace Original Medicare and may offer additional benefits like prescription drug coverage and dental services.
How can I choose the right Priority Health Medigap Plan for me?
To choose the right Priority Health Medigap Plan, consider your healthcare needs, budget, and preferences. Compare the benefits, premiums, and reputation of different plans to find one that suits your unique situation in 2023.
Call Us for More Information on Priority Health Medigap Plans
Contact our team of fully licensed Medigap agents at 1-888-891-0229 for a free consultation. We’ll discuss your healthcare requirements and recommend the right Priority Health Medigap plan for your needs. Our agents secure you the best rates on monthly premiums with a free quote.
If you can’t call us right now, leave your details on our contact form, and we’ll get a Medigap agent to connect with you. Or you can use the tool on this site to get a free automated quote on any Priority Medigap plan.
Russell Noga is the CEO and Medicare editor of Medisupps.com. His 15 years of experience in the Medicare insurance market includes being a licensed Medicare insurance broker in all 50 states. He is frequently featured as a featured as a keynote Medicare event speaker, has authored hundreds of Medicare content pages, and hosts the very popular Medisupps.com Medicare Youtube channel. His expertise includes Medicare, Medigap insurance, Medicare Advantage plans, and Medicare Part D.