MyPriority Standard Bronze
Southeast Michigan Network

MyPriority® Standard Bronze plan is an affordable option that gives you access to certain visits and services with a copay before you reach your annual deductible. Choosing a higher deductible can lower your monthly premium, making it a great choice for those who are generally healthy and budget-conscious.

This plan also includes chronic condition and diabetes management, extra benefits and resources at low or no cost, providing comprehensive care for your physical, mental and emotional health.

Helping you stay healthy and engaged is our priority.

  • Prescription coverage: Before you meet your deductible, get coverage on Tier 1 generic drugs.
  • Virtual urgent care: Before your deductible is met, virtual urgent care visits are covered in full when scheduled through the Priority Health member app.
  • 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, available 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, 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 and 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

Offered to individuals who live in Macomb, Oakland, and Wayne counties.

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.

Hospital networks

Beaumont Health hospitals

  • former Oakwood hospitals
  • Beaumont Hospital Dearborn
  • Beaumont Hospital Farmington Hills
  • Beaumont Hospital Grosse Pointe
  • Beaumont Hospital Oakwood
  • Beaumont Hospital Royal Oak
  • Beaumont Hospital Taylor
  • Beaumont Hospital Trenton
  • Beaumont Hospital Troy
  • Beaumont Hospital Wayne

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)

Beaumont hospitals

  • Physicians employed by Beaumont Health
  • Any individual community physician with admitting privileges at Beaumont Health listed as in-network in the Priority Health Beaumont Network Find a Doctor directory.

Trinity Health East hospitals

  • IHA
  • Huron Valley Physician Association
  • Livingston Physician Organization
  • Oakland Physician Network Services with Trinity Health Oakland designated as the primary hospital
  • Trinity Health Livonia Physician Practices

All in-network pharmacies

Your out-of-pocket costs may vary based on your subsidy level from the Federally-Facilitated Marketplace (FFM).

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 Find a Doctor online directory to see if your doctor is in the Southeast Michigan Network.

Metal level

Bronze

The metal level determines how you and your plan share the costs of care. Bronze means generally lower premium costs but higher out-of-pocket costs at time of service.

Deductible

$7,500
Individual
$15,000
Family

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

Coinsurance

50%
Plan pays
50%
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

$9,400
Individual
$18,800
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

$50 copayment
Primary care
Before deductible
$100 copayment
Specialist
Before deductible
$50 copayment
Mental health
Before deductible

Tier 1a and Tier 1b drugs

$25 copayment
Tier 1a
Before deductible
$25 copayment
Tier 1b
Before deductible

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

Urgent care and Retail health clinics

$75 copayment
Urgent care
Before deductible
$75 copayment
Retail health clinic
Before deductible

Emergency room

50% coinsurance
Emergency room
After deductible

Virtual urgent care

Covered in full
Virtual urgent care
Before deductible

See a provider through Virtual Urgent Care provided by Corewell Health. 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 50% coinsurance, after deductible.

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

50% 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.