Chronic condition coverage
Chronic conditions – like asthma, heart disease, high blood pressure, diabetes and others – are conditions that last more than a year and require ongoing medical care.
Priority Health is committed to helping members live a happy life while managing these conditions.
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Watch this video to see how it works.
Your MyPriority® plan gives you access to medical services, supplies and medications related to your chronic condition for just the cost of a copay or coinsurance, even before your deductible is met.
Asthma
Asthma management involves controlling and preventing symptoms as well as promoting overall well-being. With a MyPriority plan, members with asthma get supplies and prescriptions – including inhalers and peak flow meters – covered in full, before deductible, with just a low copay or coinsurance.
Diabetes
Managing diabetes requires a comprehensive approach that encompasses medical care, lifestyle adjustments and ongoing support. With a MyPriority health plan, there are several services, supplies and treatments to help manage diabetes that are covered in full, before deductible, when furnished by a participating durable medical equipment (DME) provider1.
Members will pay no cost for:
- Insulin pumps
- Blood glucose monitors1
- Syringes and needles
- Lancets
- Glucose test strips
Diabetes prescriptions and testing procedures are also covered before deductible, with a reliable, low cost share.
Depression/anxiety
With a MyPriority plan, members with depression or anxiety have access to free on-demand mental health resources that target stress, anxiety, depression and more through Teladoc Health Mental Health. The program can be self-directed or used with coaching support.
Common prescriptions for depression and anxiety medications are available for a low copay, even before your deductible is met. Members also have access to low-cost fitness options through Active&Fit to help keep body and mind healthy.
High blood pressure
Managing high blood pressure is a key component of overall cardiovascular health. With a MyPriority plan, members with high blood pressure can get the prescriptions they need at the lowest available price through PriceMyMeds.
Blood pressure monitors, angiotensin converting enzyme (ACE) inhibitors and beta-blockers are also covered, before deductible, with just a low copay or coinsurance.
Heart disease
With a MyPriority plan, members with heart disease can get the prescriptions they need at the lowest available price through PriceMyMeds. Preventive services such as cardiovascular screenings, cholesterol tests and blood pressure checks are covered before deductible, with just a low copay or coinsurance.
Well-being benefits
Managing a chronic condition involves prioritizing your overall health, staying physically active, handling stress and carving out time for self-care. Priority Health members have access to well-being benefits such as the Active&Fit Direct program and Teladoc Health's Mental Health program. Both these benefits – and more – are available any time for our members through your member account.
- Active&Fit allows you to exercise at the gym or at home with flexible fitness options. Find a fitness program that fits your lifestyle with no annual fees and no long-term contracts.
- Teladoc Health's Mental Health program is a free mental wellness resource. Members have access to a digital solution that helps with stress, anxiety, chronic pain and more. It can be self-directed or used with coaching support.
Special plan coverage for specific MyPriority Value Bronze plans
Certain 2025 MyPriority Value Bronze plans have additional pharmacy benefits for chronic obstructive pulmonary disease (COPD) and asthma.
COPD
The medicatons for COPD in Figure 1 will be offered before deductble at the corresponding tier for the following QHP IDs:
- 29698MI0541011 | MyPriority Value Bronze Corewell Health West Michigan Network
- 29698MI0541036 | MyPriority Value Bronze Corewell Health West Michigan Network (Allegan, Barry)
- 29698MI0541012 | MyPriority Value Bronze Bronson Healthcare Partners
- 29698MI0541013 | MyPriority Value Bronze Southeast Michigan Network
- 29698MI0541015 | MyPriority Value Bronze Trinity Health East Network
Figure 1
| COPD drug | Tier |
|---|---|
| Spiriva Respimat and Handihaler (brand inhalers, multiple strengths) | 2 |
| Anoro Ellipta (brand inhaler, 1 strength) | 2 |
| Stiolto Respimat (brand inhaler, one strength) | 2 |
| Trelegy Ellipta (brand inhaler, 2 strengths) | 2 |
| Albuterol HFA 90 mcg inhaler (generic) | 1 |
| Albuterol nebulizer 2.5 mg/3mL (generic) | 1 |
Asthma
The medications for asthma in Figure 2 will be offered before deductible at the corresponding tier for the following QHP IDs:
- 29698MI0541010 | MyPriority Value Bronze
Figure 2
| Asthma drug | Tier |
|---|---|
| Budesonide/formoterol (generic Symbicort inhaler, various strengths) | 1 |
| Dulera (mometasone/formoterol) – brand inhaler, multiple strengths | 2 |
| Arnuity Ellipta (fluticasone furoate) – brand inhaler, multiple strengths | 2 |
| Fluticasone HFA or Diskus (generic inhalers, various strengths) | 1 |
| Fluticasone/salmeterol HFA or (generic Advair inhalers, various strengths) | 1 |
| Fluticasone/salmeterol Diskus (generic Advair inhalers, various strengths) | 3 |
| Breo Ellipta (fluticasone / vilanterol) – brand inhaler, multiple strengths | 2 |
| Montelukast 10 mg tablet (generic Singulair) | 1 |
| Albuterol HFA 90 mcg inhaler (generic) | 1 |
| Albuterol nebulizer 2.5 mg/3mL (generic) | 1 |
See your costs now
You can view copayments and coinsurance in your member account using Cost Estimator. Our Cost Estimator and Coverage Check tools help you understand your out-of-pocket expenses before receiving care.
Log in to your Priority Health member account.
Still need help?
- Call the number on the back of your Priority Health membership ID card to reach an expert on your plan.
- Call our award-winning customer service2 team at 800.942.0954.
- Log in to member.priorityhealth.com and click Get help. In the mobile app, visit the Help center in your profile.