PriorityClassic HMO plans
Our PriorityClassic (formerly tiered copay) plans offer big benefits for your small business. You get a choice of three plan networks (HMO, POS, PPO). Best of all, your employees get great coverage before deductible for services like routine doctor visits, specialist visits, prescriptions and urgent care.
Smart idea:
Classic plans are ideal if you’re seeking competitively priced plans with richer benefits before the deductible is met.
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 benefits needed most – Primary care, specialist, urgent care, labs, standard radiology, and prescription drugs are covered with a copayment 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
- Adult vision coverage, powered by EyeMed – $15 annual eye exam and in-network discounts on frames, standard plastic lenses, lens options, select contact lenses, laser vision correction, and non-prescription sunglasses
- 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.
-
PriorityHMO 250 100%
Deductible:
$250/$500 E
Coinsurance:
100%
Out-of-pocket-limit:
$5000/$10000 E
Primary/specialist/urgent care:
$10/$35/$75 -
PriorityHMO 250 90%
Deductible:
$250/$500 E
Coinsurance:
90%
Out-of-pocket-limit:
$5000/$10000 E
Primary/specialist/urgent care:
$15/$35/$75 -
PriorityHMO 475
Deductible:
$475/$950 E
Coinsurance:
90%
Out-of-pocket-limit:
$1650/$3300 E
Primary/specialist/urgent care:
$15/$35/$75
-
PriorityHMO 500
Deductible:
$500/$1000 E
Coinsurance:
80%
Out-of-pocket-limit:
$7900/$15800 E
Primary/specialist/urgent care:
$20/$50/$85 -
PriorityHMO 850
Deductible:
$850/$1700 E
Coinsurance:
70%
Out-of-pocket-limit:
$8250/$16500 E
Primary/specialist/urgent care:
$15/$40/$85 -
PriorityHMO 1000
Deductible:
$1000/$2000 E
Coinsurance:
80%
Out-of-pocket-limit:
$7950/$15900 E
Primary/specialist/urgent care:
$20/$50/$85 -
PriorityHMO 1500
Deductible:
$1500/$3000 E
Coinsurance:
80%
Out-of-pocket-limit:
$7950/$15900 E
Primary/specialist/urgent care:
$20/$50/$85 -
PriorityHMO 2000
Deductible:
$2000/$4000 E
Coinsurance:
80%
Out-of-pocket-limit:
$7950/$15900 E
Primary/specialist/urgent care:
$20/$50/$85 -
PriorityHMO 2500
Deductible:
$2500/$5000 E
Coinsurance:
80%
Out-of-pocket-limit:
$8100/$16200 E
Primary/specialist/urgent care:
$25/$60/$85 -
PriorityHMO 2750
Deductible:
$2750/$5500 E
Coinsurance:
70%
Out-of-pocket-limit:
$8150/$16300 E
Primary/specialist/urgent care:
$45/$75/$85 -
PriorityHMO 3500
Deductible:
$3500/$7000 E
Coinsurance:
70%
Out-of-pocket-limit:
$8150/$16300 E
Primary/specialist/urgent care:
$35/$65/$85 -
PriorityHMO 4500
Deductible:
$4500/$9000 E
Coinsurance:
70%
Out-of-pocket-limit:
$8150/$16300 E
Primary/specialist/urgent care:
$35/$65/$85
Tiered networks
Learn more about West MI Partners and Southeast MI Partners.
-
PriorityHMO 1000 - West MI Partners
Tier 1
Deductible:
$1000/$2000 E
Coinsurance:
80%
Out-of-pocket-limit:
$7950/$15900 E
Primary/specialist/urgent care:
$20/$50/$85Tier 2
Deductible:
$4000/$8000 E
Coinsurance:
60%
Out-of-pocket-limit:
$7950/$15900 E
Primary/specialist/urgent care:
$40/$100/$170 -
PriorityHMO 2500 - West MI Partners
Tier 1
Deductible:
$2500/$5000 E
Coinsurance:
80%
Out-of-pocket-limit:
$8100/$16200 E
Primary/specialist/urgent care:
$25/$60/$85Tier 2
Deductible:
$6250/$12500 E
Coinsurance:
60%
Out-of-pocket-limit:
$8100/$16200 E
Primary/specialist/urgent care:$50/$120/$170 -
PriorityHMO 3500 - West MI Partners
Tier 1
Deductible:
$3500/$7000 E
Coinsurance:
70%
Out-of-pocket-limit:
$8150/$16300 E
Primary/specialist/urgent care:
$35/$65/$85Tier 2
Deductible:
$8000/$16000 E
Coinsurance:
50%
Out-of-pocket-limit:
$8150/$16300 E
Primary/specialist/urgent care:
$70/$130/$170 -
PriorityHMO 1000 - Southeast MI Partners
Tier 1
Deductible:
$1000/$2000 E
Coinsurance:
80%
Out-of-pocket-limit:
$7950/$15900 E
Primary/specialist/urgent care:
$20/$50/$85Tier 2
Deductible:
$4000/$8000 E
Coinsurance:
60%
Out-of-pocket-limit:
$7950/$15900 E
Primary/specialist/urgent care:
$40/$100/$170 -
PriorityHMO 2500 - Southeast MI Partners
Tier 1
Deductible:
$2500/$5000 E
Coinsurance:
80%
Out-of-pocket-limit:
$8100/$16200 E
Primary/specialist/urgent care:
$25/$60/$85Tier 2
Deductible:
$6250/$12500 E
Coinsurance:
60%
Out-of-pocket-limit:
$8100/$16200 E
Primary/specialist/urgent care:
$50/$120/$170 -
PriorityHMO 3500 - Southeast MI Partners
Tier 1
Deductible:
$3500/$7000 E
Coinsurance:
70%
Out-of-pocket-limit:
$8150/$16300 E
Primary/specialist/urgent care:
$35/$65/$85Tier 2
Deductible:
$8000/$16000 E
Coinsurance:
50%
Out-of-pocket-limit:
$8150/$16300 E
Primary/specialist/urgent care:
$70/$130/$170