Tiered copay plans—Upper Peninsula

Plan highlights

  • Range of deductibles – Choose from plans that have individual deductibles of $250, $500, $850, $1,000, $1,500, $2,000, $2,500, $2,750, $3,500 or $4,500 (family deductibles are double the individual amount)
  • Primary doctor visits – Comprehensive office visits before deductible, including related non-surgical services (like X-rays, labs, etc.)
  • Specialist visits – Copayment before deductible
  • Urgent care – Copayment before deductible
  • Generic drugs – Copayment before deductible
  • Cash rewards – Our Cost Estimator lets you shop for high-quality care at lower-priced facilities. Best of all? When you receive care at a fair-price facility, we'll send you a Visa® reward card.
  • No referral needed – Our plans don't require a referral to see a specialist
  • Optional dental coverage – Two Delta Dental PPO/Premier plans to choose from, both include annual exams and cleanings
  • Adult vision coverage  $15 copay for an annual eye exam, including a refraction test

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

  • 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