Plan Benefits

Priority Partners offers programs and services to help members better manage their health.

Benefits Overview

As Priority Partners HealthChoice members, your patients can take advantage of no and low-cost services that include:

Service	Appointment Wait Time (not more than)
Initial Appointments	Members must be scheduled for an initial health appointment within ninety (90) days of enrollment unless one of the exceptions set forth in the HealthChoice Provider Manual applies.
Initial Prenatal Appointments	Initial prenatal appointments should occur (10) days from request, or from the date Priority Partners receives a Health Risk Assessment (HRA) for the new member, unless the member continues care with an established provider and the provider concludes that no initial appointment is necessary.
Family Planning Appointments	Ten (10) days from the date the member requests an appointment
High Risk Enrollee Appointments	Fifteen (15) days from receipt of the enrollee’s completed HRA form
Urgent Care Appointments	Forty-eight (48) hours from request
Routine, Preventive Care, or Specialty Care Appointments	Thirty (30) days from initial request, or, where applicable, from authorization from PCP
Initial Newborn Visits	Fourteen (14) days from date of discharge from hospital
Initial Newborn Visits if a Home Visit Has Been Provided	Thirty (30) days from date of discharge from hospital
Regular Optometry, Lab, or X-Ray Appointments	Thirty (30) days from date of request
Urgent Lab or X-Ray Appointments	Forty-eight (48) hours from date of request
Member Inquiry to Use Emergency Facility	Within Thirty (30) minutes
Office Visit	Waiting time to be seen may not exceed 1 hour after the scheduled appointment time