Member FAQs - Priority Partners MCO (2024)

What is HealthLINK@Hopkins?

HealthLINK@Hopkins is your member portal. In HealthLINK, you can: view your benefits, check claims and referral status, send secure messages to and receive them from Customer Service, request a new ID card, search for a doctor, and select a new primary care doctor (PCP).

How do I register for an account?

Click“Member Login” at the top of ppmco.org. Select “Member Register” under First Time Logging In? on the right side of the page. On the next page, enter your member ID, name, birthdate and gender. Then follow the steps to create a user ID and password. Your password must be nine characters and must contain at least one uppercase letter, one lowercase letter, one number, and one special character, such as #, * or @. Usernames and passwords are case-sensitive.

Remember: Your password is private. Do not write it down or keep it in a public space. Once the process is complete, you will be able to access your account.

How do I set up two-factor authentication?

When you try to log into HealthLINK, after entering your user name and password, you will be brought to this page:

Member FAQs - Priority Partners MCO (1)

You will be prompted to receive a security code either through text, (if you have a cell phone number listed in your account) or by email. If you don’t have a cell phone number listed in your account, you can add it later by scrolling down to the ‟Communication Preference” section of the Administration tab. (see the NOTE for instructions). If you request the code through email, and it does not appear in your inbox, check the spam/junk folder.

Enter the security code on the next screen:

Member FAQs - Priority Partners MCO (2)

NOTE: Changing Communication Preferences
After completing the two-factor authentication process using your email and successfully entering the HealthLINK portal, go to the Administration tab and scroll down to Communication Preferences.

  1. Go to “Edit Contact Details”
  2. Enter your mobile number and click “Save.”

Now that I’m logged in, how do I get started?

Once you’re logged in, you will see a welcome message on your homepage. This message will change to keep you up-to-date and informed on health issues. Start browsing the site by using the links located in the top navigation bar. They are organized by different sections including My Providers, My Health Plan, My Resources and My Preferences. You will also find a list of Quick Links in the left column of tasks most used by Priority Partners members.

What happens if I can’t remember my password?

When registering for a HealthLINK@Hopkins account, you will be asked two security questions. If you ever forget your password, you can reset your password by giving your username. You will have 24 hours to click on the link sent to your email. When you click on the link, you will be asked to answer the security questions. If you enter the wrong password three times, your account will be locked and you will have to call the HealthLink help desk at 877-814-9909.The help desk will ask you your security questions. If you do not answer correctly, you will be locked out of your account until Priority Partners is notified and can verify your membership. You will be contacted upon verification and you will then be able to reset your password and access your HealthLINK account.

How do I search for a provider?

Click “Search a Provider” in the left column under Quick Links or, under the My Health Plans tab in the top navigation bar.

How can I order a new member ID card?

You can easily request a new ID card by logging into HealthLINK. Under My Health Plan, click Member Information then click on Request ID Card. Select the box next to your name and press Submit. The request will be automatically sent to your Customer Service department who will process the request.

You can also download the Request an ID Card form, fill it in and fax it to 410-424-4991. Or, you can call our Customer Service department toll-free at 800-654-9728.

How can I change my Primary Care Provider (PCP)?

Under Quick Links, click “Change Your PCP” or, under My Health Plans, click “Change PCP.” If you know the name or practice of the doctor you’d like to choose, type it in. You can search for a new PCP in your area by selecting from the drop down and typing the city, county or zip code in the field to the right. You can also search by the hospital the physician is affiliated with, by the sex of the doctor or by the language the physician speaks. Once you press Submit, browse through the list of doctors and press Select when you find the physician you would like. This request will go directly to your Customer Service department who will process the request. Approved change requests will take effect on the date the request is submitted. You will also get a new ID card mailed to you within 7 to 10 days of the approval.

How can I update my address?

Address changes must be made through the Maryland Health Connection and cannot be done through HealthLINK. Follow these directions to change your address.

  1. Log into your account.
  2. Click onReport a Changeunder the Quick Links section on the right side of the page.
  3. ClickNext.
  4. Select theChange Home Addresscheckbox as it applies to you.
  5. ClickNext.
  6. If you have other changes to make to your account, check the boxes as they apply to you, then clickNext. If you do not need to make any other changes, keep clickingNextuntil you reach the summarypage.
  7. ClickConfirmafter reviewing your summary information.
  8. Answer questions aboutSpecial Enrollment.
  9. ReviewandConfirmall sections of application.
  10. Type your name in theSignaturebox exactly as it appears (or will appear) on your Maryland Health Connection account.

Maryland Health Connection phone number:855-642-8572

Important:After you have updated your address in your Maryland Health Connection account, remember also toupdate your addresswith Priority Partners. Keeping your address information current with Priority Partners is necessary so you may continue to receive member services and important announcements or updates to your benefits.

What is a secure message and how do I send one?

A HealthLINK@Hopkins secure message is similar to an email. As a member, you are able to send messages to and receive them from the Customer Service department and your Care Manager (if you are assigned one). To get started, click on “Message Center” in the top-right corner of your screen. From there, click “New,” and a new message box will open. Click on the Directory link for a list of possible recipient mailboxes. Type the mailbox name of the person or department you would like to message in the Search For field. The number of unread messages in your inbox will appear next to the envelope symbol in the top-right corner. You can view your sent, deleted and inbox mail by clicking Message Center and selecting the appropriate gray tab.

What is “View Audit”?

This button allows you to see all of your account transactions. If you would like further information about any of the transactions, write down the complete transaction ID and contact Customer Service. The Customer Service numbers can be found below, or you can send a secure message by clicking “Message Center” in the top-right corner of the HealthLINK@Hopkins screen.

Why do I sometimes see “data unavailable?”

One reason may be that federal and state privacy regulations require us to protect certain information from being shared, or the data you anticipated has not been made available to us yet. For specific information about your record, please contact Customer Service.

Can I see my child’s or spouse’s information if they are under my plan?

If you are a Priority Partners member, this feature is unavailable because all members have individual HealthLINK accounts. Call Priority Partners Customer Service at800-654-9728with questions.

Why aren’t my claims appearing?

Claims status takes 2 to 5 business days to update. If you’d like to confirm receipt or check the status of a claim, you can also call Customer Service.

Customer Service800-654-9728

How do I get a new member ID card?

Log into your member portal, by clicking “Member Login” at the top of our website. You can also call Priority Partners at800-654-9728.

Member FAQs - Priority Partners MCO (2024)

FAQs

Is Priority Partners MD Medicaid? ›

Priority Partners is one of seven Managed Care Organizations authorized by the State of Maryland to provide health care services for over 200,000 Medicaid, Maryland Children's Health Program (MCHP), Medical Assistance for Families and Primary Adult Care (PAC) recipients.

Who owns Priority Partners Insurance? ›

Priority Partners is owned by Johns Hopkins Health Plans and the Maryland Community Health System.

What is the payer ID for Priority Partners MCO? ›

EDI Payor ID #52189.

Does Johns Hopkins accept priority partners? ›

Priority Partners members can use Johns Hopkins OnDemand Virtual Care. Using a mobile app, computer or tablet, you can have a video visit with a health care provider in minutes who can answer your call, review your symptoms and prescribe medications if needed, no appointment necessary.

What is a MCO in Medicaid? ›

Medicaid managed care provides for the delivery of Medicaid health benefits and additional services through contracted arrangements between state Medicaid agencies and managed care organizations (MCOs) that accept a set per member per month (capitation) payment for these services.

Does Priority Partners have OTC benefits? ›

In addition to prescription benefits, some over-the-counter (OTC) medications are covered. Please refer to the Over-The-Counter Drug Coverage list in the pharmacy formulary. Please note that only certain OTC drugs listed in the formulary are covered by the plan.

Is Priority Health part of Medicare? ›

Priority Health has HMO-POS and PPO plans with a Medicare contract.

Is Cigna owned by Priority Health? ›

Cigna and Priority Health have entered into a Strategic Alliance. This partnership enables us to leverage the best capabilities of both organizations, and deliver a health care experience in Michigan's Lower Peninsula that is more predictable and simplified for providers and customers.

Who did Priority Health merge with? ›

Total Health Care and Priority Health announce the completion of a merger, allowing the companies to work together to provide improved care and access for current and future members.

What is MCO name insurance? ›

A managed care organization (MCO) is a health care company or a health plan that is focused on managed care as a model to limit costs, while keeping quality of care high.

Is MD physicians care Medicaid? ›

MPC provides free, quality health care services to Maryland's HealthChoice enrollees by extending the full benefits of Medicaid. Our strong network of hospitals, doctors, clinics and pharmacies helps our Members live as healthy as possible through education, support, and quality programs.

What is the claims address for Johns Hopkins Priority Partners? ›

o If mailing in claims, please use separate envelopes and mail to the unique address for each health plan, new claims address for Priority Partners, EHP, Hopkins ElderPlus noted below: ▪ Priority Partners: P.O. Box 4228, Scranton, PA 18505 ▪ EHP: P.O. Box 4227, Scranton, PA 18505 ▪ Hopkins ElderPlus: P.O. Box 4077, ...

What is a priority partner? ›

- Being a priority to a partner means that they support your goals and dreams, and encourage you to pursue them. - Being a priority to a partner means that they respect your boundaries and preferences, and don't pressure you to do things you don't want to do.

What insurances does Johns Hopkins accept? ›

To confirm coverage of your specific physician or provider, please contact the insurer directly.
  • Aetna.
  • CareFirst BlueCross BlueShield.
  • Cigna Healthcare*
  • First Health.
  • Geisinger Health Plan.
  • Humana.
  • Johns Hopkins Health Plans.
  • Kaiser Permanente of the Mid-Atlantic States.

How elite is Johns Hopkins? ›

Johns Hopkins University's ranking in the 2024 edition of Best Colleges is National Universities, #9. Its tuition and fees are $63,340.

Who provides Medicaid in Maryland? ›

The Maryland Department of Health is the part of the state government that oversees public health. Medicaid is part of the Maryland Department of Health. Medicaid provides free or low-cost health insurance for those with limited income.

Is Maryland physicians care the same as Medicaid? ›

Holy Cross Health is an owner of Maryland Physicians Care, a Medicaid managed care organization. It is the third largest Medicaid managed care organization in the state and currently administers health care services to over 215,000 members.

Is CareFirst of Maryland Medicaid? ›

CareFirst BlueCross BlueShield Community Health Plan Maryland (CareFirst Community Health Plan Maryland or CareFirst CHPMD) is a Medicaid Managed Care Organization that participates in the Maryland HealthChoice Program. Carefirst CHPMD offers a health plan that combines personal attention with world-class healthcare.

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