You can set up an automatic monthly electronic fund transfer (EFT) to pay your monthly premiums by filling out a form, below. Here's how it works.
When your payment is transferred: On the 1st or 10th day of the month, we will automatically debit the checking or savings account that you name on the form. You will no longer get a bill by mail each month.
To set up EFT premium payments: Send us an EFT request form by the 25th day of the month. Automatic premium payments will start on the first of the upcoming month.
To cancel EFT premium payments: We need 30 days advance notice. Send your notice to: Priority Health, MS 1190, 1231 East Beltline NE, Grand Rapids, MI 49525.
Note: We charge $30.00 each time a transfer is not completed due to insufficient funds in your bank account.
Sign up now
Automatic Bill Payment Form - online
Type in your information, print for your records, and click Submit. It will automatically send to Priority Health.
Automatic Bill Payment Form (72KB PDF) - paper form
Type in your information, print and mail it to us.