Get low copays even before meeting your deductible, along with low or zero-cost additional benefits and resources, when you choose a MyPriority Premier Silver plan.
Plan information
The MyPriority® Premier Silver plan offers access to a wide range of health care services and routine care with a low copay before you meet your annual deductible. By opting for a higher deductible, you benefit from a lower monthly premium, making it a great choice for those who are generally healthy and value knowing their expected health expenses.
You get coverage that supports your physical, mental and financial health:
- Low Tier 1-3 prescription drug copays, before deductible
- $30 copay for primary care visits, before deductible
- $10 copay for labs, before deductible
- $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
An HMO provides care through a designated network of doctors, specialists and facilities that members must use in order to be covered by the plan. A primary care provider coordinates your care and you need to see an in-network doctor unless it's an emergency or you get prior approval.
Use our online Find a Doctor directory to check if your doctor is in-network. Change the search parameters from All plans to MyPriority HMO.
HMO
Metal level
The metal level determines how you and your plan share the costs of care. Silver generally means moderate monthly premiums and moderate out-of-pocket costs when you receive care.
Silver
Deductible
The deductible is the amount you pay for in-network covered health care services before Priority Health begins to pay.
Individual
$5,500
Family
$11,000
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
70%
You pay
30%
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
$30 copayment
Specialist
$65 copayment
Mental health
$30 copayment
Urgent care
$75 copayment
Retail health clinic
$75 copayment
Emergency room
$250 copay + 30% coinsurance
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.
Corewell Health's Virtual Primary Care Practice in West Michigan offers virtual primary care. You need to choose a Corewell Health Virtual Primary Care Practice provider as your designated primary care physician (PCP).
Virtual urgent care
Covered in full
Virtual primary care
$10 copayment
Services
Diagnostic tests
$10 copayment
Labs
$10 copayment
X-rays
30% coinsurance
Radiology services
30% coinsurance
Chiropractic manipulation
30% coinsurance
Outpatient physical & occupational therapy
30% coinsurance
Preventive care
Covered in full
Maternity | Routine prenatal and postnatal care
Covered in full
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.