MyPriority Standard Silver 5800 - Spectrum Health Partners

MyPriority® Standard Silver 5800 is a standardized plan, offered by qualified health plans (QHPs) on the federal Marketplace. Standard plans have uniform plan designs with the same cost-sharing parameters from issuer to issuer, making plan choice and comparison simpler for enrollees. These standard plans allow consumers to more easily find the right form of quality, affordable health coverage for their circumstances.

Your health is our top priority

Earning 4 out of 5 stars* on healthcare.gov, Priority Health gives you more for your money and does more to improve your health.

Highlights of what members get:

  • On-demand mental health support: myStrength, included at no added cost, is a mental health and wellness online tool that helps you live your best life.
  • Chronic condition management: Access to a variety of medications, supplies and services to help keep your chronic conditions under control–covered in full or with a low cost share, before deductible.
  • Diabetes management: Our plans provide coverage for diabetes management services, supplies and treatments for no cost, before deductible when furnished by a participating durable medical equipment (DME) provider. Diabetes prescriptions and testing procedures are covered before deductible, with cost share.
  • Global emergency assistance: If you or your dependents become ill or injured while traveling more than 100 miles from home, our partner Assist America® can help you get care and even arrange your safe travel home.
  • Hearing exams and hearing aids: Discounts for you and your extended family with TruHearing®

Spectrum Health Partners

A narrow network offered to individuals who live in Kent, Barry, Mecosta, Newaygo, Ottawa counties and a portion of Allegan County.*

Members who choose a Spectrum Health Partners plan are required to receive care in the Spectrum Health system of doctors and hospitals and their affiliated clinics, outpatient facilities, labs, etc.

This network includes:

Hospitals: All Spectrum Health hospitals (with the exception of Spectrum Health Lakeland)

Physicians (primary care and specialist) network:

  • Spectrum Health Medical Group
  • Physicians who denote a Spectrum Health hospital as their primary hospital affiliation

Other facilities:

  • Orthopedic Associates of Michigan (OAM) physicians
  • All ancillary facilities in the Priority Health network will be available in the Spectrum Health network as well. Examples include Pine Rest Christian Mental Health Services and Forest View Hospital.

All in-network pharmacies

Details:

  • A narrow network allows members to enjoy a lower monthly premium while getting access to quality care
  • No referral needed to see an in-network specialist
  • Members who enroll in this plan will see the Spectrum Health Partners network on their ID cards
  • Care received outside of the Spectrum Health Partners network will not be covered and members will be required to cover the full cost for out-of-network care

*ZIP codes in Allegan County where the Spectrum Health Partners narrow network is offered: 49070, 49311, 49314, 49323, 49328, 49335, 49344, 49348, 49406, 49408, 49416, 49419, 49423, 49453

* CMS scores qualified health plans (QHPs) offered through the Exchanges using the Quality Rating System (QRS) based on third-party validated clinical measure data and QHP Enrollee Survey responses. CMS calculates ratings yearly on a 5 star scale. Ratings may change from year to year.