MyPriority Prime Silver HSA Off Marketplace
Southeast Michigan Network

MyPriority® Prime Silver HSA Off Marketplace is an affordable plan if you tend to be healthy and like to prioritize savings. You save money by enrolling directly with Priority Health, making it a smart option if you don't qualify for a federal subsidy or would rather not use one.

This plan offers you protection in case of a major health event and allows you to save for medical expenses with a Health Savings Account (HSA). With an HSA, you can take advantage of federal tax benefits and roll over any unused funds into the next year.

Certain services covered under chronic condition and diabetes management are covered with cost share or in full before the deductible is met, giving you the resources you need to take control of your health.

Keep in mind, with an HSA plan, you'll be responsible for 100% of the cost of your health care until you meet your deductible.

Helping you stay healthy and engaged is our priority.

  • Free HSA partners: HealthEquity® will set up your HSA banking account and help you manage it. Then use your HSA card in our online Priority Health storefront on Amazon to purchase HSA-eligible health care items.
  • 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 at no cost.
  • Chronic condition management: Before your deductible is met, certain services, supplies and prescriptions used to treat common long-term health conditions are covered with cost share or in full.
  • Diabetes management: Before your deductible is met, certain supplies, treatments, prescriptions and tests are covered with 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 or 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.®

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

All in-network pharmacies

Network

Southeast Michigan Network

In order for your health care costs to be covered, 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.

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

Silver

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.

Deductible

$3,200
Individual
$6,400
Family

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

Coinsurance

70%
Plan pays
30%
You pay

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.

Out-of-pocket limit

$7,200
Individual
$14,400
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

30% coinsurance
Primary care
After deductible
30% coinsurance
Specialist
After deductible
30% coinsurance
Mental health
After deductible

Initial mental health visit is covered in full, after deductible.

Tier 1a and Tier 1b drugs

30% coinsurance
Tier 1a
After deductible
30% coinsurance
Tier 1b
After deductible

Tier 1 includes low-cost generic drugs, proven to be as safe as brand-name drugs. Some drugs for chronic condition management are accessible at low or no cost before you meet your deductible.

Urgent care and Retail health clinics

30% coinsurance
Urgent care
After deductible
30% coinsurance
Retail health clinic
After deductible

Emergency room

30% coinsurance
Emergency room
After deductible

Virtual urgent care

Covered in full
After deductible

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.

Preventive care

Covered in full
Before deductible

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
Before deductible

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

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

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.