A MyPriority Premier Silver Off Marketplace plan has extra benefits and low prescription copays. You can save money by enrolling directly with Priority Health.

Plan information

The MyPriority® Premier Silver Off Marketplace 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.

If you don't qualify for a federal subsidy – or would rather not use one – you can save money on your monthly premium by enrolling in the MyPriority Premier Silver Off Marketplace plan directly with Priority Health. This plan comes with the same coverage as the Marketplace plan but without the associated fees.

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

  • Low 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

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

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%

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

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

Before deductible

Tier 1b

$20 copayment

Before deductible

Doctor visits, ER and Urgent care

Primary care

$30 copayment

Before deductible | Evaluation only

Specialist

$65 copayment

Before deductible | Evaluation only

Mental health

$30 copayment

Before deductible

Urgent care

$75 copayment

Before deductible

Retail health clinic

$75 copayment

Before deductible

Emergency room

$250 copay + 30% coinsurance

After deductible | 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.

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

Before deductible

Virtual primary care

$10 copayment

Before deductible

Services

Diagnostic tests

$10 copayment

Before deductible

Labs

$10 copayment

Before deductible

X-rays

30% coinsurance

After deductible

Radiology services

30% coinsurance

After deductible

Chiropractic manipulation

30% coinsurance

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

Outpatient physical & occupational therapy

30% coinsurance

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

Preventive care

Covered in full

Before deductible

Maternity | Routine prenatal and postnatal care

Covered in full

Before deductible | Delivery and nursery care are covered with 30% coinsurance, after deductible.

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.