Tiered copay plans

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

Select the right network for your employees

Still not sure?

HMO plans

PriorityHMOSM is our most popular health coverage option. It focuses on what’s most important: health and wellness, managing medical costs and ensuring employees receive all the necessary services they need.

  • It provides lower costs, but with limited coverage outside the plans' network of participating providers.
  • While out-of-network care is not covered, in-network benefits are provided only if a member has chosen a primary care physician (PCP).
  • Under this plan, members can also visit any specialist in our plan without a referral.

POS plans

PriorityPOSSM plan benefits employers who are looking for the flexibility of a traditional health plan but need the cost savings of managed care.

  • A hybrid of HMO and PPO plans, our POS offering can designate an in-network primary care provider (PCP) while also covering outside services at a slightly higher out-of-pocket cost.
  • Similar to HMO, members are also required to have a PCP to receive in-network benefits.

PPO plans

PriorityPPOSM offers employees the greatest freedom of choice by providing in-network and out-of-network options.

  • Employers reap the benefits of a low-cost health care plan, while employees can choose to see Priority Health network providers and pay less or visit non-network doctors or hospitals and pay more.
  • It lets members receive in-network benefits without having a designated primary care provider (PCP).