PriorityHMO tiered copay plans 

Plan highlights

  • Range of deductibles - Choose from plans that have individual deductibles of $250, $500, $1,000, $2,000 or $3,000. (Family deductibles are double the individual amount.)
  • Primary doctor visits - Comprehensive office visits before deductible, including related non-surgical services (like X-rays, labs, etc.)
  • Specialist visits - Covered before deductible
  • Urgent care - Covered before deductible
  • Generic drugs - Copayment before deductible
  • 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.
  • 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!

PriorityHMO 250 100% tiered copay

  • Metal level

    Platinum

  • Deductible

    $250 individual
    $500 family

  • Coinsurance

    Employee pays 0%

  • Out-of-pocket limit

    $1,400 individual
    $2,800 family

  • Rx copayments

    Generic: $10
    Preferred brand: $40
    Non-preferred brand: $80
    Preferred specialty: 20%
    Non-preferred specialty: 20%

  • Primary / specialist / urgent care

    $10 / $25 / $75 copayment

  • Emergency room

    $150 copayment

  • High-tech radiology

    $150 copayment

PriorityHMO 250 90% tiered copay

  • Metal level

    Platinum

  • Deductible

    $250 individual
    $500 family

  • Coinsurance

    Employee pays 10%

  • Out-of-pocket limit

    $1,500 individual
    $3,000 family

  • Rx copayments

    Generic: $10
    Preferred brand: $40
    Non-preferred brand: $80
    Preferred specialty: 20%
    Non-preferred specialty: 20%

  • Primary / specialist / urgent care

    $10 / $25 / $75 copayment

  • Emergency room

    $150 copayment

  • High-tech radiology

    $150 copayment

PriorityHMO 500 2-tier Rx tiered copay

  • Metal level

    Gold

  • Deductible

    $500 individual
    $1000 family

  • Coinsurance

    Employee pays 20%

  • Out-of-pocket limit

    $5,000 individual
    $10,000 family

  • Rx copayments

    Generic: $10
    Preferred brand: $40
    Non-preferred brand: $40
    Preferred specialty: $40
    Non-preferred specialty: $40

  • Primary / specialist / urgent care

    $20 / $35 / $75 copayment

  • Emergency room

    $150 copayment

  • High-tech radiology

    $150 copayment

PriorityHMO 500 5-tier Rx tiered copay

  • Metal level

    Gold

  • Deductible

    $500 individual
    $1,000 family

  • Coinsurance

    Employee pays 20%

  • Out-of-pocket limit

    $5,000 individual
    $10,000 family

  • Rx copayments

    Generic: $15
    Preferred brand: $50
    Non-preferred brand: $80
    Preferred specialty: 20%
    Non-preferred specialty: 20%

  • Primary / specialist / urgent care

    $20 / $35 / $75 copayment

  • Emergency room

    $150 copayment

  • High-tech radiology

    $150 copayment

PriorityHMO 1000 tiered copay

  • Metal level

    Gold

  • Deductible

    $1,000 individual
    $2,000 family

  • Coinsurance

    Employee pays 20%

  • Out-of-pocket limit

    $5,000 individual
    $10,000 family

  • Rx copayments

    Generic: $15
    Preferred brand: $50
    Non-preferred brand: $80
    Preferred specialty: 20%
    Non-preferred specialty: 20%

  • Primary / specialist / urgent care

    $20 / $35 / $75 copayment

  • Emergency room

    $150 copayment

  • High-tech radiology

    $150 copayment

PriorityHMO 2000 tiered copay

  • Metal level

    Silver

  • Deductible

    $2,000 individual
    $4,000 family

  • Coinsurance

    Employee pays 30%

  • Out-of-pocket limit

    $6,250 individual
    $12,500 family

  • Rx copayments

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

  • Primary / specialist / urgent care

    $30 / $45 / $75 copayment

  • Emergency room

    $250 copayment

  • High-tech radiology

    $150 copayment

PriorityHMO 3000 tiered copay

  • Metal level

    Silver

  • Deductible

    $3,000 individual
    $6,000 family

  • Coinsurance

    Employee pays 30%

  • Out-of-pocket limit

    $6,250 individual
    $12,500 family

  • Rx copayments

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

  • Primary / specialist / urgent care

    $30 / $45 / $75 copayment

  • Emergency room

    $250 copayment

  • High-tech radiology

    $150 copayment

PriorityHMO tiered copay plans: West MI Partners

If your small business is in West Michigan and most of your employees live in West Michigan, consider our affordable tiered network option.