Priority HMO/EPO Health Insurance Plans

Our Michigan Health Maintenance Organization (HMO) plan is our most popular health insurance option. PriorityHMOSM and PriorityEPOSM , which is the very similar employer-funded health insurance plan, combine excellent medical benefits with cost savings by ensuring that employees get all the health care and medical services they need, but none that are unnecessary. Go to any specialist in our network without a referral. Employees don't need a referral from their primary care physician or other primary health care provider (PCP) to see a specialist. However, PCPs coordinate medical care to help keep out-of-pocket medical costs low. Also, some specialists do require a referral from the PCP.

PriorityHMO Insurance Coverage Features
There are no claim forms to file. We take care of all the paperwork.
Copays are low. Some plans may also include a deductible.
No need to pay doctor bills up front and then wait for reimbursement.
Choose from a network of 18,000 doctors and other health care providers.
The network includes 109 hospitals.
You're covered for emergency care no matter where you travel around the world.
Each family member can choose his or her own PCP. (Many women prefer an OB/GYN who participates as a PCP, for example, and you can choose a pediatrician as a PCP for children.)
You can change your PCP once during any calendar month. The change is effective the first of the following month.
Routine physicals, immunizations, prenatal care and mammograms are 100% covered, less the office visit copay.
Any pharmacy in our nationwide network will fill your prescriptions for the normal copay, if your plan includes prescription coverage.
Some services, such as surgeries, will require prior approval from Priority Health beforehand.

See a comparison of PriorityHMO to PriorityPOS and PriorityPPO

View the PriorityHMO/PriorityEPO service area

PriorityHMO plan documents

• Read the PriorityHMO member  handbook (175KB PDF)

Plans run for 12 months, so if your plan starts in March, your coverage document is in effect until March of the following year.

• Read the 2010 PriorityHMO Certificate of Coverage (311KB PDF)  complete plan details for plans that started in 2010.
  
• Read the 2009 PriorityHMO Certificate of Coverage (215KB PDF) complete plan details for plans that started in 2009.
  

PriorityEPO plan documents

• Read the PriorityEPO member handbook (179KB PDF)
• Read the 2010 PriorityEPO policy (226KB PDF) which contains complete plan details.
  Note: Plan details may be altered by employer additions or deletions.
  
• Read the 2009 PriorityEPO policy (199KB PDF) which contains plan details.
  Note: Plan details may be altered by employer additions or deletions.