PriorityAssure HMO plans

PriorityAssure® provides affordable access to services ahead of deductible such as PCP and urgent care visits, $0 virtual care and $5 preferred generics. It also provides coverage for more serious heath events.

Smart idea:

If you want to cover employees when they need it most, PriorityAssure is a smart choice. 

Plan highlights

  • $0 virtual care and telehealth services – Covered in full before deductible
  • Diabetic coverage – certain diabetic supplies purchased through a participating DME provider are covered at 100% before deductible and preferred insulins are covered at the Tier 1b prescription drug tier
  • Chiropractic care – Covers up to 30 acute and/or maintenance care visits per contract year
  • Standard copayments for the services needed most – primary care, urgent care, labs, and Tier 1a and Tier 1b prescription drugs covered before deductible
  • Cash rewards – 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, we’ll send them a Visa® reward card
  • Hearing exams and discounts on high-quality hearing aids – Offered by our partner, TruHearing
  • Optional dental coverage – Two Delta Dental PPO/Premier plans to choose from, both include annual exams and cleanings. Learn more
  • No referral needed – 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.

  • PriorityAssure HMO 1750

    Deductible: $1750/$3550 E
    Coinsurance: 90%
    Out-of-pocket-limit: $7350/$14700 E
    Primary/specialist/urgent care: $30/Coins/$85

  • PriorityAssure HMO 3685

    Deductible: $3685/$7370 E
    Coinsurance: 70%
    Out-of-pocket-limit: $7900/$15800 E
    Primary/specialist/urgent care: $35/Coins/$85

  • PriorityAssure HMO 5000

    Deductible: $5000/$10000 E
    Coinsurance: 70%
    Out-of-pocket-limit: $7900/$15800 E
    Primary/specialist/urgent care: $25/Coins/$85

  • PriorityAssure HMO 8300

    Deductible: $8300/$16600 E
    Coinsurance: 100%
    Out-of-pocket-limit: $8300/$16600 E
    Primary/specialist/urgent care: $35/Coins/$85

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