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• 4.1.2025 PA Criteria for Website

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• 2025 PrimeTime Health Plan Basic MA – Only (HMO-POS)

  Choosing PrimeTime Health Plan We believe that people choose PrimeTime Health Plan because of our person-to-person service, affordability, and clinical care coordination team. Our members are like our family. Whether they call or stop by our offices, the PrimeTime Team is always ready to talk with them and help them understand…

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• Provider Appeals

  Payment Appeal – A challenge or an ‘appeal’ related to benefit/payment denials by the Medicare health plan that results in zero payment being made to the non-contracted Medicare health plan provider. Examples include: Benefit Determinations Medical necessity issues Coverage issues related to nation and/or local coverage determination policies Claims Payment Dispute – Any decision…

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• learn

  Are you ready to learn more about Medicare? PrimeTime Health Plan offers Medicare Education webinars you can attend from the comfort of your home! Live Webinars: Select a date and time from the list below to attend a live webinar from your home. Once registered, you will receive an email with detailed information…

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• informed

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• Interoperability

  Currently available to PrimeTime Health Plan Medicare Advantage Members and AultCare Marketplace Members. You may find a mobile app or computer program that requests access to your health information to help you monitor your personal health goals. As your health plan, we need to provide a way for you to…

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• 2025 Medication Therapy Management (MTM)

  Medication Therapy Management is a distinct service or group of services provided by health care providers, including pharmacists, to ensure the best therapeutic outcomes for patients. It includes five core elements: medication therapy review, a personal medication record, a medication-related action plan, intervention or referral and documentation and follow-up. A Part…

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• National Resources

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• Telehealth Flyer

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• Veterans

  There's a plan for that! If you served, you deserve to have Medicare solutions that work for your needs. If you’re receiving prescriptions from the VA, or have no need for this kind of coverage, you can still explore PrimeTime plans without drug coverage. We have plans that offer valuable options, such…

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