Tiered copay plans—Upper Peninsula
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
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).
Tiered copay PPO plans—Upper Peninsula
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PriorityPPO 250 100%
Deductible:
$250 individual, $500 family
Coinsurance:
Employee pays 0%
Out-of-pocket limit: $5,000 individual, $10,000 family
Primary / specialist / urgent care:
$10 / $35 / $75 -
PriorityPPO 250 90%
Deductible:
$250 individual, $500 family
Coinsurance:
Employee pays 10%
Out-of-pocket limit: $5,000 individual, $10,000 family
Primary / specialist / urgent care:
$10 / $35 / $75 -
PriorityPPO 500
Deductible:
$500 individual, $1,000 family
Coinsurance:
Employee pays 20%
Out-of-pocket limit: $7,350 individual, $14,700 family
Primary / specialist / urgent care:
$20 / $50 / $75 -
PriorityPPO 1000
Deductible:
$1,000 individual, $2,000 family
Coinsurance:
Employee pays 20%
Out-of-pocket limit: $7,350 individual, $14,700 family
Primary / specialist / urgent care:
$20 / $50 / $75 -
PriorityPPO 1500
Deductible:
$1,500 individual, $3,000 family
Coinsurance:
Employee pays 20%
Out-of-pocket limit: $7,350 individual, $14,700 family
Primary / specialist / urgent care:
$20 / $50 / $75 -
PriorityPPO 2000
Deductible:
$2,000 individual, $4,000 family
Coinsurance:
Employee pays 20%
Out-of-pocket limit: $7,350 individual, $14,700 family
Primary / specialist / urgent care:
$20 / $50 / $75 -
PriorityPPO 2750
Deductible:
$2,750 individual, $5,500 family
Coinsurance:
Employee pays 30%
Out-of-pocket limit: $7,260 individual, $14,520 family
Primary / specialist / urgent care:
$45 / $75 / $85 -
PriorityPPO 3500
Deductible:
$3,500 individual, $7,000 family
Coinsurance:
Employee pays 30%
Out-of-pocket limit: $7,350 individual, $14,700 family
Primary / specialist / urgent care:
$35 / $65 / $75 -
PriorityPPO 4500
Deductible:
$4,500 individual, $9,000 family
Coinsurance:
Employee pays 30%
Out-of-pocket limit: $7,350 individual, $14,700 family
Primary / specialist / urgent care:
$35 / $65 / $75
Want more info?
Ready for a quote?
- Contact Small Business Sales at 800.471.2504, option 4
- Contact an independent licensed Priority Health agent
- Send us your contact information, and we'll have an expert get back to you