MyPriority Standard Gold plan has a lower annual deductible and copays in exchange for a higher monthly premium. Plus you get extra benefits at low or no cost.

Plan information

The MyPriority® Standard Gold plan is ideal if you or your family expect to visit the doctor often during the year and want to manage prescription drug costs.

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

  • $15 copay for tier 1 prescriptions, before deductible
  • $30 copay for primary care visits, before deductible
  • $60 copay for specialist visits, 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.

Gold

Deductible

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

Individual

$1,500

Family

$3,000

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

75%

You pay

25%

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

$7,800

Family

$15,600

Tier 1a and Tier 1b drugs

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

Tier 1a

$15 copayment

Before deductible

Tier 1b

$15 copayment

Before deductible

Doctor visits, ER and Urgent Care

Primary care

$30 copayment

Before deductible | Evaluation only

Specialist

$60 copayment

Before deductible | Evaluation only

Mental health

$30 copayment

Before deductible

Urgent care

$45 copayment

Before deductible

Retail health clinic

$45 copayment

Before deductible

Emergency room

25% coinsurance

After deductible

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

Before deductible

Services

Diagnostic tests

25% coinsurance

After deductible

Labs

25% coinsurance

After deductible

X-rays

25% coinsurance

After deductible

Radiology services

25% coinsurance

After deductible

Chiropractic manipulation

$30 copayment

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

Outpatient physical & occupational therapy

$30 copayment

Before 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 25% 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.