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All Priority Health Medicare Advantage plans include:

• Medicare Part D prescription drug coverage, so they're called "MAPD" plans (Medicare Advantage + Prescription Drug)
• The same benefits as Original Medicare, plus more
• Emergency care wherever you travel, in and outside the U.S.
• Routine health screenings such as mammograms and prostate screenings
• Lab and radiology services
• Outpatient surgery and services
• Ambulance services
• Home health care
• Chiropractic care

Plan features	PriorityMedicare Value	PriorityMedicare	PriorityMedicare Plus	PriorityMedicare Choice
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The benefit information in this chart is a brief summary, not a complete description of plan benefits. You can get more information about this plan's benefits to help you make a decision about your coverage. Please check the Evidence of Coverage booklet (click "More details," above), or call a Priority Health Medicare Representative toll-free at 888 389-6676 from 8:30 a.m. – 5:00 p.m., Monday through Friday.
Monthly premium	Call for pricing and availability $0 $21.30 $45.20 $59.80 $82.40 N/A N/A	Call for pricing and availability $33.40 $56.20 $69.80 $89.90 $110.80 N/A N/A	Call for pricing and availability $61.50 $81.70 $96.70 $117.10 $139.90 N/A N/A	Call for pricing and availability $77.80 $110.30 $120.10 $152.60 $193.80 $110.30 N/A
In-network deductible	$0	$0	$0	$0
Out-of-network deductible	$500	$400	$300	$300
In-network doctor visit copay Primary care Specialists	$15 $40	$10 $30	$15 $30	$5 $5
Out-of-network doctor visit copay	$45	$35	$35	$15
Routine physical exam copay (limited to 1 exam per year) In-network doctor Out-of-network doctor	$15 $20	$10 $15	$15 $20	$5 $15
Hospitalization stay copays at hospitals in our network	$600 per admission	Days 1-5: $75 per day Days 6+: $0 per day	$250 per admission	Days 1-5: $25 per day Days 6+: $0 per day
Routine hearing & vision service copays In-network providers Out-of-network providers	Not covered	$30 $35	$30 $35	$5 $15
Hearing hardware purchases	Not covered	$350 allowance every 3 years	$350 allowance every 3 years	$350 allowance every 3 years
Prescription benefits	PriorityMedicare Value	PriorityMedicare	PriorityMedicare Plus	PriorityMedicare Choice
Prescription copays (initial coverage before you reach $2,830 in total drug costs) Copays shown are for a 31-day supply of any drug on the formulary, from an in-network pharmacy	$8 for generic drugs $30 for preferred brands $60 for non-preferred brands 25% coinsurance for specialty drugs	$8 for generic drugs $30 for preferred brands $60 for non-preferred brands 25% coinsurance for specialty drugs	$8 for generic drugs $30 for preferred brands $60 for non-preferred brands 25% coinsurance for specialty drugs	$8 for generic drugs $30 for preferred brands $60 for non-preferred brands 25% coinsurance for specialty drugs
Drug costs in the coverage gap	You pay 100% of the discounted cost for drugs	You pay 100% of the discounted cost for drugs	$8 generic 100% of the discounted cost for brand names	You pay 100% of the discounted cost for drugs
Catastrophic prescription coverage (after the coverage gap", when you reach $4,550 in out-of-pocket drug costs) For 31-day supplies of any drug on the formulary, from an in-network pharmacy	You pay the greater of: $2.50 copay for generic drugs and a few brand-name drugs $6.30 copay for all other drugs OR 5% coinsurance of the discounted cost	You pay the greater of: $2.50 copay for generic drugs and a few brand-name drugs $6.30 copay for all other drugs OR 5% coinsurance of the discounted cost	You pay the greater of: $2.50 copay for generic drugs and a few brand-name drugs $6.30 copay for all other drugs OR 5% coinsurance of the discounted cost	You pay the greater of: $2.50 copay for generic drugs and a few brand-name drugs $6.30 copay for all other drugs OR 5% coinsurance of the discounted cost
Plan features	PriorityMedicare Value	PriorityMedicare	PriorityMedicare Plus	PriorityMedicare Choice
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