PriorityExtras: HMO plans

Plan highlights

  • $20 office visits - Any combination of up to four specialist, family doctor or urgent care visits before deductible, including related non-surgical services (like X-rays, labs, etc.)
  • $30 acupuncture visits - 20 visits per year (medically necessary)
  • $30 medical massage - 20 visits per year (medically necessary)
  • $0 virtual visits - Unlimited 24/7 non-emergency care by phone or online "virtual" connection (with a Priority Health hosted provider).
  • Cash rewards - Our Cost Estimator lets you shop for high-quality care at lower-priced facilities. Best of all? When you receive care at a fair-price facility, we'll send you a Visa® reward card.
  • Cash incentives to be active - Earn money for being active with ExerciseRewardsTM.
  • $5 generic drugs - Preferred generics for a $5 copayment before deductible.
  • No referral needed - Our plans don't require a referral to see a specialist.
  • Optional dental coverage - Two plans to choose from, both include annual exams and cleanings (learn more)

Reasons to love our HMO

  • USA map

    Network includes 98% of doctors in Michigan

  • Specialist with patient

    No referral to see a specialist

  • Trophy icon

    PriorityRewards:  easy way to save & earn money for getting quality care at fair-priced facilities

  • Laptop

    Virtual visits - see a doctor 24/7 on the phone or online

  • Globe

    24/7 global emergency services with Assist America®

  • Retail building

    Retail health clinic coverage - new this year on all plans!

PriorityExtras HMO 1000

  • Metal level

    Gold

  • Deductible

    $1,000 individual
    $2,000 family

  • Coinsurance

    Employee pays 20%

  • Out-of-pocket limit

    $4,000 individual
    $8,000 family

  • Rx copayments

    Preferred generic: $5
    Generic: $15
    Preferred brand: $50
    Non-preferred specialty: $80
    Preferred & non-preferred specialty: 20%

  • Primary / specialist / urgent care

    $20 copayment for first 4 visits a year, then 20% coinsurance

  • Emergency room

    20% coinsurance

  • High-tech radiology

    20% coinsurance

PriorityExtras HMO 2500

  • Metal level

    Silver

  • Deductible

    $2,500 individual
    $5,000 family

  • Coinsurance

    Employee pays 30%

  • Out-of-pocket limit

    $4,500 individual
    $9,000 family

  • Rx copayments

    Preferred generic: $5
    Generic: $20
    Non-preferred brand: $60
    Preferred brand: $80
    Non-preferred & preferred specialty: 20%

  • Primary / specialist / urgent care

    $20 copayment for first 4 visits a year, then 30% coinsurance

  • Emergency room

    30% coinsurance

  • High-tech radiology

    30% coinsurance

PriorityExtras: West MI Partners

Is your small business is located in one of these West Michigan counties: Allegan (northern half), Lake, Kent, Mason, Mecosta, Newaygo, Osceola and Ottawa? If yes, then our affordable tiered network option is the best option for you.

PriorityExtras HMO is only available on the full HMO network for groups that live outside this area.