Summary of Benefits & Coverage

The Priority Partners HealthChoice plan includes coverage for the Medical Assistance For Families/Maryland Children’s Health Program (MCHP), a program for pregnant women and children.

As a Priority Partners HealthChoice member, your benefits include:

  • Medical visits with a primary care physician (PCP)

  • Dental services

    • Oral exam and cleaning twice per year
    • Limited x-rays
    • Simple and surgical extractions
  • Vision services

    • 1 eye exam per year
    • 1 pair of glasses or contact lenses every 2 years
  • Pharmacy coverage

  • Outreach services

    • Help with transportation or scheduling doctor appointments
    • Call 1-888-500-8786
  • Mental health and substance abuse services

    • Call 1-800-888-1965
  • Care Management services

    • For diabetics, pregnant women, and those with various other illnesses

Pregnant women receive all of the benefits above, plus:

  • No- or low-cost childbirth classes

    • You will get reimbursed in part or in whole once the classes are over.
  • Access to the program “Partners with Mom”

    • For members with a high-risk pregnancy
  • Outreach assistance

    • Locating OB physicians and keeping OB appointments

See our pregnancy page for more information on tips and services.

For details on the benefits above, download a PDF of our summary of coverage and benefits . You can also download a PDF of the Members Handbook.

*NOTE: Some procedures and services require a prior authorization. To see information details on prior authorization and other explanation of benefits, review our Outpatient Referral and Pre-Authorization Guidelines.

All documents are available in paper form without charge. To request a paper copy, please call Customer Service at 1-800-654-9728 (TTY for the hearing impaired: 1-888-232-0488).
 

Health Services Needs Information

Do you have health goals you want to achieve?

Are there challenges keeping you from your best health?

Priority Partners can help you. You can partner with a health coach to lose weight or quit smoking. You can work with a care manager to help improve a health condition. You may even be able to get free rides to and from your doctor visits.

Find out how we can help you! Fill out a Health Services Needs Information form. Tell us about your health, and we’ll see what services may be able to help.