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Prime Greater Houston (HMO)

Here's everything you need to know about your benefits and how your plan works.


Getting the Most from Your Plan

Learn your plan basics and how to use your benefits.


Summary of Benefits

See an overview of your plan's benefits and costs.


Dental Guide

Learn about your dental coverage.


Over-the-Counter (OTC) Catalog

Browse the items you can buy with your OTC Credit.


Evidence of Coverage

Dig into the nitty gritty about how your plan works, what's covered, and what you'll have to pay.


Annual Notice of Change

Find out how your plan will change in the coming year.


Drug Costs with Extra Help

With Extra Help from Medicare, you'll pay less for prescription drug coverage. Extra Help is also known as the low-income subsidy or LIS. And the charts that show your costs with Extra Help are sometimes called LIS Premium Summary Charts.


Prior Authorization

Before you get some types of care, you need prior authorization. That means your provider has to check with us first to make sure we'll cover it. Find out when you need prior authorization.


Referrals

Find out when you need a referral to a specialist.


Durable Medical Equipment

We cover all the same DME as Original Medicare. If our DME partners don't carry a brand or manufacturer you need, you can ask them to special order it for you. Use our provider search tool to find a DME partner in your area.