Priority Health

It took me one month to change my provider. The first issue was the $70 spend card, which I could only use at CVS, Walgreens, or online. I ordered online since I don't drive. However, everything was triple the price and the selection of items was very limited. The second issue was that my prescriptions arrived with a $65 copay. I have Medicaid and have never paid a $55 copay for Albuterol. That was all it took for me to call and transfer my service.

They have made several things difficult over the last six or more years, but for the most part, they were great. If you have a mobility disability, don't expect to be able to use your OTC card. They took away the ability to use it at online stores about four years ago. You can only really purchase things from their website, which is insanely overpriced. Also, with the new changes, my caretaker is receiving a wage cut, even after the $3-plus increase here in 2025. They are really going downhill, and I'm reaching out to complain to everyone.

Worst health insurance ever, unfortunately, it's the only option my employer offers, or I would switch in a moment! I definitely say a change in health care reform needs to happen. Can we go back to when your provider thinks you need something for your health, you don't have to jump through hoops to get it? Why should someone or an entity decide what's best for my health other than myself and my doctor? I pay a lot of money for this insurance, yet when one needs to use it, you're denied. Shame on you, big insurance! But you can bet for those higher-ups, they get the care they need!

Horrible upfront premium rates: $3,000 for January 2026. The first year wasn't even close to this amount. No explanation and no itemized statement for the cost—red flag!

I’m not sure how I was supposed to know, at 2am while I was continuously vomiting and almost passing out from the pain of my first kidney stone, that 911 might send an ‘out of network’ ambulance service to get me to the hospital. Why is there even an out of network ambulance service anyway? Like you can’t contract with all the local services? So now, MORE THAN A YEAR AFTER THE INCIDENT, I get a $2200 bill from AMR??? That’s $1100/mile for the trip - I would have crawled to the hospital had I known that. What a deceitful and not at all client focused policy on the part of Priority Health - so disappointing and discouraging.

They are the absolute worst insurance company. They cover nothing; instead, they "negotiate a lower rate on our behalf." Their negotiation is the workaround to avoid paying anything, which is absolutely unacceptable. I'm left with hundreds of dollars in medical bills because, instead of them covering anything, they simply negotiate with doctors' offices and then pass the bill onto consumers. I cannot for the life of me figure out how this is legal.

This has got to be the worst insurance company that I have ever dealt with in my entire life. It is a complete nightmare. I kept asking for a supervisor or a manager and all I got was a runaround, with different phone numbers that I had already tried. Then they made a three-way call, and the representative, whose location I am unsure of, connected me to another agent and then said, "Okay, I've put you through, have a nice day, I'll let you talk." After the representative from Priority Health hung up, the associate on the phone explained to me that she does not handle transportation. She had already informed the agent at Priority Health that transportation was not within her purview, but because Priority Health did not want to connect me to a supervisor or a manager, that's how it was left. This is not the way to treat people, especially those covered under your Priority Health plans. I would caution anyone looking for insurance not to choose Priority Health. They are uncaring, to say the least. Even the agent that was mistakenly connected to me couldn't believe that she had been left on the call, as she made it clear that she doesn't handle transportation, only gas cards. Priority Health needs to evaluate their staff and perhaps implement intensive customer service training. If they cannot improve their service, they should not be in business. I plan on reporting this further, as no one should be treated the way I was treated today.

Too many chiefs, not enough Indians. Fact: one phone representative takes two-hour lunches when you are caller number one. Heck, I'm still waiting. Literally.

For the 2025 Priority Health Edge Medicare Advantage Plan, the affordability of GLP-1 inhibitors for the average person has been significantly reduced. They now place Ozempic in Tier 3, so you only have to pay about $250 out of pocket for your first pen. They have also eliminated access to other diabetic medications or adjusted the copay to be so expensive that they are unaffordable. I can't wait to drop this insurance. With high co-pays, deductibles, patient responsibility fees, almost no customer support, and a complicated process for appeals and grievances, this company exemplifies why there is a want and need for a single-payer system in the United States that treats its elderly citizens with respect. Currently, it seems like they view us as a source to be financially exploited.

My husband and I signed up for Priority Health for 2025. I tried to contact customer service and was put on hold for 54 minutes before I gave up. On my second attempt to call, I was on the phone for 15 minutes before I took their option for them to call me back. I never got a call back. My husband had an earache and called to see where we could go for medical care because we are snowbirds and were down in Florida for the winter. The agent told him he could not go to a med center as they would not pay for the service. Then we got disconnected, and the agent did not call him back. A friend told us we could go to an Urgent Care Unit. We went to the care unit in Daytona Beach, and Priority Health had the Urgent Care Unit secretary on hold for 35 minutes before they picked up to give an insurance approval. It is not acceptable to be unable to get a hold of your health insurance company in a reasonable time period.

I have had Priority Health for several years now. I have had several surgeries and follow-up care, including numerous and necessary physical therapy sessions, and have never been denied service. The Delta Dental plan is adequate, and the OTC benefit is generous for my needs. The hearing aid benefit is limited, but I can live with that since OTC aids are readily available at fairly reasonable rates. My plan also includes chiropractic care with a monthly visit included. If you don't need to see many specialists (I've had quite a few), this is a good plan. I will continue to use them as I trust my chosen medical providers to fight for my needs and care.

Just the worst company ever. Avoid at all costs; it's just a scam. The 5-star reviews are either from bots, paid individuals, or people with no experience with them yet.

Not one oral surgeon in Grand Rapids, Michigan, accepts Priority Health Medicare Advantage plans. Therefore, any oral surgery procedure is considered out-of-network. :-(

In my 45 years of being under a health insurance policy, Priority Health is the worst I have had to deal with. They are constantly overruling my doctor regarding the medication I need. Prior to Priority Health, I had been on medication for my diabetes that lowered my A1C by three points. However, after joining Priority Health, they have disallowed that medication, and over the last year, I have used what they approved, and my A1C has increased by a couple of points. It is a sad state of affairs today that insurance companies claim to know more than your medical doctor.

They are the worst at letting you get the medications you need, even if you have been on them for years. They automatically deny any prescription, then make you get multiple prior authorizations for one medication, which is basic, nothing fancy or dangerous. If you look at their Google reviews, this seems to be a common theme. I am switching due to this as it is negatively impacting my health, and they are no help in getting anything resolved.