Priority Made Simple HMO plans

The new Priority Made Simple plan addresses confusion about insurance and price transparency through a copay-only design with a $0 deductible. This plan includes no out-of-pocket payments for PCP, virtual or mental health visits. It provides both affordability and transparency.

Smart idea:

For employers, Priority Made Simple is a smart choice if youโ€™re looking for a plan that lets you and your employees avoid cost uncertainty.

Copayments for all in-network medical services โ€“ including inpatient care and durable medical equipment and prosthetics and orthotics

$0-dollar member cost for:

  • Primary care
  • Outpatient mental health and substance use
  • Allergy testing and treatment
  • Diabetic supplies purchased through a participating DME provide
  • $0 virtual care and telehealth services

Cash rewards โ€“ Our Cost Estimator tool lets members shop for high-quality care at lower-cost facilities. Best of all, when members receive care at a fair-price facility, weโ€™ll send them a Visaยฎ reward card

Hearing exams and discounts on high-quality hearing aids โ€“ Offered by our partner, TruHearing

Optional dental coverage โ€“ Two Delta Dental PPO/Premier plans to choose from, both include annual exams and cleanings. Learn more

No referral needed โ€“ Our plans don't require a referral to see a specialist

Plan notes

We want you to know exactly what you're looking at, so here are explanations of the notes used in the plan pricing information.

  • (E) "Embedded" means the plan contains an individual limit (stop) within the family total. The embedded stop occurs when an individual's deductible or out-of-pocket limit has been satisfied, but the family deductible or out of pocket limit hasn't.
  • (A) "Aggregate" means the total deductible or out-of-pocket limit does not contain an individual limit. An individual is covered when the family deductible or out-of-pocket limit has been met.
  • Deductibles and out-of-pocket limits are listed as individual/family amounts.
  • Priority Made Simple (Plus)

    Deductible: $0/$0 E
    Coinsurance: None
    Out-of-pocket-limit: $5000/$10000 E
    Primary/specialist/urgent care: $0/$100/$100
  • Priority Made Simple

    Deductible: $0/$0 E
    Coinsurance: None
    Out-of-pocket-limit: $8150/$16300 E
    Primary/specialist/urgent care: $0/$100/$100

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