Southeast MI Partners plans

An ideal network solution for people who work and live in Southeast Michigan

We’re committed to helping our members find the right care, at the right time in the right place, everywhere in Michigan. We know that over 70% of insured residents live in Southeast Michigan alone, so we’ve worked with our provider partners in seven counties in this region to bring a low cost solution to members who live and work in Southeast Michigan.

Southeast MI Partners is available to groups that reside in six counties:

Southeast MI Partners map
  • Wayne
  • Oakland
  • Macomb
  • Livingston
  • Washtenaw
  • St. Clair

What are the benefits of a tiered network?

A tiered network can help employers save on premiums and help employees save on deductibles, out-of-pocket limits and cost sharing—all by utilizing the selected Tier 1 provider network.

How does it work?

Providers are separated into two tiers: Tier 1 and Tier 2. We've partnered with our Tier 1 providers to lower member costs, so if employees choose care through a Tier 1 provider, they'll benefit from lower coinsurance, copays and deductibles.

In Tier 2, employees will have access to our entire PriorityHMO network. However, if they choose to receive care outside of the Tier 1 network of hospitals and providers, they will have a higher cost share for care.

Tier 1 and Tier 2 provider networks include:

Tier 1

  • Ascension St. John and Ascension Providence hospitals and select affiliated physicians
  • St. Joseph Mercy Health System hospitals and select affiliated physicians
  • Lake Huron Medical Center and all HMO affiliated physicians
  • Beaumont ACO Hospitals and select affiliated physicians
  • State-wide ancillary coverage: all Tier 1 providers and state-wide, free-standing, independent ancillary facilities such as: labs, physical therapy, Radiology and home health
  • Michigan Medicine (University of Michigan and health centers) for non-primary care (with referral only)
  • All in-network pharmacies
  • Emergency services

Tier 1 hospitals

Tier 1 Hospitals

  • Ascension St. John Hospital and Medical Center 
  • Ascension Macomb–Oakland Hospital–Madison Heights Campus 
  • Ascension Macomb–Oakland Hospital– Warren Campus 
  • Ascension River District Hospital 
  • Ascension Providence Hospital–Novi Campus 
  • Ascension Providence Hospital–Southfield Campus 
  • Ascension Providence Rochester Hospital 
  • Beaumont Hospital Dearborn
  • Beaumont Hospital Farmington Hills
  • Beaumont Hospital Grosse Pointe
  • Beaumont Hospital Royal Oak

 

  • Beaumont Hospital Taylor
  • Beaumont Hospital Troy
  • Beaumont Hospital Trenton
  • Beaumont Hospital Wayne
  • Beaumont Urgent Care Centers
  • Lake Huron Medical Center
  • Michigan Medicine (University of Michigan) for non-primary care with referral only
  • St. Joseph Mercy Chelsea
  • St. Joseph Mercy Hospital
  • St. Joseph Mercy Livingston Hospital
  • St. Joseph Mercy Oakland
  • St. Mary Mercy Hospital Livonia

Tier 2

All providers are currently covered under the Priority Health HMO network.

Plans that offer Tiered Networks:

  • Tiered Copay
  • PriorityHSA
  • PriorityValue
  • Traditional Copay
  • Copay Align

Southeast MI Partners plans

  • PriorityHMO 1000 - Southeast MI Partners

    Deductible
    Tier 1: $1,000 individual, $2,000 family
    Tier 2: $4,000 individual, $8,000 family

    Coinsurance
    Tier 1: Employee pays 20%
    Tier 2: Employee pays 40%

    Out-of-pocket limit
    Tier 1: $7,350 individual, $14,700 family
    Tier 2: $7,350 individual, $14,700 family

    Primary / specialist / urgent care
    Tier 1: $20 / $50 / $75
    Tier 2: $45 / $75 / $85

  • PriorityHSA HMO 1400 – Southeast MI Partners

    Deductible
    Tier 1: $1,400 individual, $2,800 family
    Tier 2: $4,500 individual, $9,000 family

    Coinsurance
    Tier 1: Employee pays 10%
    Tier 2: Employee pays 30%

    Out-of-pocket limit
    Tier 1: $3,500 individual, $7,000 family
    Tier 2: $6,650 individual, $13,300 family

    Primary / specialist / urgent care
    Tier 1: 10% coinsurance
    Tier 2: 30% coinsurance

  • PriorityHSA HMO 2000 – Southeast Partners

    Deductible
    Tier 1: $2,000 individual, $4,000 family
    Tier 2: $5,500 individual, $11,000 family

    Coinsurance
    Tier 1: Employee pays 30%
    Tier 2: Employee pays 50%

    Out-of-pocket limit
    Tier 1: $6,650 individual, $13,300 family
    Tier 2: $6,650 individual, $13,300 family

    Primary / specialist / urgent care
    Tier 1: 30% coinsurance
    Tier 2: 50% coinsurance