MyPriority Enhanced Gold
Bronson Healthcare Partners

MyPriority® Enhanced Gold is an ideal plan for individuals and families who expect to require health care services regularly during the year.

In exchange for a higher monthly premium, you won't have to worry about meeting an annual deductible. This simplifies managing your health care expenses for any anticipated needs–and unexpected ones, too.

Helping you stay healthy and engaged is our priority.

  • Prescription coverage: Low copays on Tier 1 drugs.
  • Virtual urgent care: Virtual urgent care visits are covered in full when scheduled through the Priority Health member app.
  • On-demand mental health support: Get access to a digital solution that helps with stress, anxiety, chronic pain and more. It can be self-directed or used with coaching support, available at no cost.
  • Chronic condition management: Certain services, supplies and prescriptions used to treat common long-term health conditions are covered with cost share or in full.
  • Diabetes management: Supplies, treatments, prescriptions and tests are covered with a low cost share or in full.
  • Global emergency assistance: If you become ill or injured while traveling more than 100 miles from home, our partner Assist America® will help you get care and arrange your safe travel home.
  • Care for your hearing: Get discounts for you and your extended family for hearing exams and hearing aids through TruHearing.®

Bronson Healthcare Partners

This narrow network plan is offered to individuals who live in Kalamazoo and Van Buren counties and a portion of Calhoun County.*

To ensure coverage of your health care costs, you must receive care from doctors and hospitals within the Bronson Healthcare Partners network or their affiliated facilities. If you receive care from an out-of-network provider, you will be responsible for paying the full cost. Emergency services are covered at the in-network level.

Hospital networks

  • Bronson Methodist Hospital
  • Bronson Battle Creek Hospital
  • Bronson Lakeview Hospital
  • Bronson South Haven Hospital

Physician networks (primary care and specialist)

  • Bronson Healthcare physicians
  • Bronson Hospital employed physicians
  • Physicians who denote Bronson Hospital (all campuses) as their primary affiliation

All in-network pharmacies

*ZIP codes in Calhoun County where the Bronson Healthcare Partners is offered: 49011, 49014, 49015, 49017, 49021, 49029, 49033, 49037, 49051, 49052, 49068, 49076, 49092, 49094

Your out-of-pocket costs may vary based on your subsidy level from the Federally-Facilitated Marketplace (FFM).

Network

Bronson Healthcare Partners

In order for your health care costs to be covered, you must receive care from doctors and hospitals within the Bronson Healthcare Partners network or their affiliated facilities. If you receive care from an out-of-network provider, you will be responsible for paying the full cost. Emergency services are covered at the in-network level.

Use our online Find a Doctor directory to check if your doctor is in-network. Change the search parameters from All plans to Bronson Healthcare Partners.

Metal level

Gold

The metal level determines how you and your plan share the costs of care. Gold generally means higher monthly premiums but lower out-of-pocket costs when you receive care.

Deductible

$0
Individual
$0
Family

The deductible is the amount you pay for in-network covered health care services before Priority Health begins to pay.

Coinsurance

100%
Plan pays
0%
You pay

Coinsurance is the percentage of the cost of medical services you have to pay after you've met your deductible.

Out-of-pocket limit

$9,400
Individual
$18,800
Family

This is the most you'll pay for covered health care expenses in one year. This amount includes deductibles, coinsurance and copayments for covered services.

Office visits

$20 copayment
Primary care
$45 copayment
Specialist
$20 copayment
Mental health

Tier 1a and Tier 1b drugs

$5 copayment
Tier 1a
$20 copayment
Tier 1b

Tier 1 includes low-cost generic drugs, proven to be as safe as brand-name drugs.

Urgent care and Retail health clinic

$75 copayment
Urgent care
$75 copayment
Retail health clinic

Emergency room

$250 copayment
Emergency room

Emergency room copayment is waived if admitted.

Virtual urgent care

Covered in full
Virtual urgent care

Virtual urgent care is offered through Corewell Health Virtual Urgent Care. This care is accessed through your Priority Health member account and is best for treating minor illnesses and injuries like ear infections, fevers, coughs, minor burns or bites.

Preventive care

Covered in full

Preventive services help you avoid potential health problems or find them early when they are most treatable before you feel sick or have symptoms. See our Preventive Health Care Guidelines for a list of covered preventive services.

Maternity

Covered in full
Routine prenatal and postnatal care

Delivery and nursery care are covered with a $1,000 copayment per day (maximum 5 copayments.)

Diagnostic tests, X-rays, lab services and radiology services

$45 copayment

The features and benefits shown on this page are intended to give you an overview of what this plan covers. For more details, please refer to the Summary of Benefits and Coverage.