MyPriority Enhanced Gold Southeast Michigan Network plan simplifies managing health care expenses without worrying about an annual deductible.

Plan information

You won't have to worry about meeting an annual deductible with a MyPriority® Enhanced Gold plan, in exchange for a higher monthly premium. This simplifies managing your health care expenses for any anticipated needs–and unexpected ones, too.

You get coverage that supports your physical, mental and financial health:

  • $0 deductible
  • $5 copay for tier 1a prescriptions
  • $20 copay for primary care visits
  • $45 copay for specialist visits
  • $0 limited virtual urgent care visits through Corewell Health Virtual Urgent Care, before deductible
  • On-demand mental health support through Teladoc Health Mental Health
  • Access to a large network of high-quality primary care providers across Michigan
  • Award-winning customer service

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

Network

Southeast Michigan Network

This narrow network plan is offered to individuals who live in Macomb, Oakland, and Wayne counties.

To ensure coverage of your health care costs, you must receive care from doctors and hospitals within the Southeast Michigan 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

Corewell Health East hospitals

  • Corewell Health Dearborn Hospital
  • Corewell Health Farmington Hills Hospital
  • Corewell Health Beaumont Grosse Pointe Hospital
  • Corewell Health Taylor Hospital
  • Corewell Health Trenton Hospital
  • Corewell Health Beaumont Troy Hospital
  • Corewell Health Wayne Hospital
  • Corewell Health William Beaumont University Hospital

Trinity Health East hospitals

  • Trinity Health Ann Arbor Hospital
  • Trinity Health Chelsea Hospital
  • Trinity Health Livingston Hospital
  • Trinity Health Livonia Hospital
  • Trinity Health Oakland Hospital

Physician networks (primary care and specialist)

Corewell Health East hospitals

  • Physicians employed by Corewell Health in Southeast Michigan
  • Any individual community physician with admitting privileges at Corewell Health who is in-network and listed in the Priority Health Southeast Michigan Network Find a Doctor directory.

Trinity Health East hospitals

Any individual community physician with admitting privileges at Trinity Health, including:

  • McAuley Health Partners
  • IHA OOMA
  • Oakland Physicians Network Services (OPNS)
  • Oakland Southfield Physicians
  • Huron Valley Physician Association (HVPA), also known as Village MD
  • Livingston Physician Organization (LPO)
  • Olympia

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

Metal level

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.

Gold

Deductible

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

Individual

$0

Family

$0

Coinsurance

Coinsurance is the percentage of the cost of medical services you have to pay after you've met your deductible. Some services–like preventive care and chronic condition management–are accessible with low or no coinsurance before you meet your deductible.

Plan pays

100%

You pay

0%

Out-of-pocket limit

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.

Individual

$9,200

Family

$18,400

Tier 1a and Tier 1b drugs

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

Tier 1a

$5 copayment

Tier 1b

$20 copayment

Doctor visits, ER and Urgent care

Primary care

$20 copayment

Specialist

$45 copayment

Mental health

$20 copayment

Urgent care

$75 copayment

Retail health clinic

$75 copayment

Emergency room

$250 copayment

Emergency room copayment is waived if admitted.

Virtual care

See a provider 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.

Virtual urgent care

Covered in full

Services

Diagnostic tests

$45 copayment

Labs

$45 copayment

X-rays

$45 copayment

Radiology services

$45 copayment

Chiropractic manipulation

$45 Copayment

Chiropractic manipulation benefits cover 30 visits per year, including maintenance visits.

Outpatient physical & occupational therapy

$45 Copayment

Physical therapy and occupational therapy have a combined limit of 30 visits per year.

Preventive care

Covered in full

Maternity | Routine prenatal and postnatal care

Covered in full

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

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.

Attention: This website is operated by Priority Health and is not the Health Insurance Marketplace® website at HealthCare.gov. This website does not display all Qualified Health Plans (QHPs) available through HealthCare.gov. To see all available QHP options, go to the Health Insurance Marketplace website at HealthCare.gov.

Also, you should visit the Health Insurance Marketplace website at HealthCare.gov if:

  • You want to select a catastrophic health plan

1CMS scores qualified health plans (QHPs) offered through the Exchanges using the Quality Rating System (QRS) based on third-party validated clinical measure data and QHP Enrollee Survey responses. CMS calculates QRS ratings yearly on a 5-star scale. QHP issuers work with HHS-approved survey vendors that independently conduct the survey each year. QRS ratings and QHP Enrollee Survey results may change from year to year.