MyPriority Balanced Silver Off Marketplace
Bronson Healthcare Partners
MyPriority® Balanced Silver plan is a smart balance between having coverage in case of a major health care need and the reassurance of access to routine and general care for just a copay before the annual deductible.
With extra benefits and resources at low or zero cost, we'll help you balance saving money and staying healthy.
What is an Off Marketplace plan? If you don't qualify for a federal subsidy–or would rather not use one–you can save money on your monthly premium by purchasing an Off Marketplace plan directly from Priority Health.
Helping you stay healthy and engaged is our priority.
- Prescription coverage: Low copays on Tier 1 drugs, before deductible.
- Virtual urgent care: Before your deductible is met, virtual urgent care visits are covered in full when scheduled through the Priority Health member app.
- On-demand mental health support: Get access to a digital solution that helps with stress, anxiety, chronic pain and more. It can be self-directed or used with coaching support, available at no cost.
- Chronic condition management: Before your deductible is met, certain services, supplies and prescriptions used to treat common long-term health conditions are covered with cost share or in full.
- Diabetes management: Before your deductible is met, certain supplies, treatments, prescriptions and tests are covered with cost share or in full.
- Global emergency assistance: If you become ill or injured while traveling more than 100 miles from home, our partner Assist America® will help you get care and arrange your safe travel home.
- Care for your hearing: Get discounts for you and your extended family for hearing exams and hearing aids through TruHearing.®
Bronson Healthcare Partners
This narrow network plan is offered to individuals who live in Kalamazoo and Van Buren counties and a portion of Calhoun County.*
To ensure coverage of your health care costs, you must receive care from doctors and hospitals within the Bronson Healthcare Partners network or their affiliated facilities. If you receive care from an out-of-network provider, you will be responsible for paying the full cost. Emergency services are covered at the in-network level.
Hospital networks
- Bronson Methodist Hospital
- Bronson Battle Creek Hospital
- Bronson Lakeview Hospital
- Bronson South Haven Hospital
Physician networks (primary care and specialist)
- Bronson Healthcare physicians
- Bronson Hospital employed physicians
- Physicians who denote Bronson Hospital (all campuses) as their primary affiliation
All in-network pharmacies
*ZIP codes in Calhoun County where the Bronson Healthcare Partners is offered: 49011, 49014, 49015, 49017, 49021, 49029, 49033, 49037, 49051, 49052, 49068, 49076, 49092, 49094
Network
In order for your health care costs to be covered, you must receive care from doctors and hospitals within the Bronson Healthcare Partners network or their affiliated facilities. If you receive care from an out-of-network provider, you will be responsible for paying the full cost. Emergency services are covered at the in-network level.
Use our online Find a Doctor directory to check if your doctor is in-network. Change the search parameters from All plans to Bronson Healthcare Partners.
Metal level
The metal level determines how you and your plan share the costs of care. Silver generally means moderate monthly premiums and moderate out-of-pocket costs when you receive care.
Deductible
Individual
Family
The deductible is the amount you pay for in-network covered health care services before Priority Health begins to pay.
Coinsurance
Plan pays
You pay
Coinsurance is the percentage of the cost of medical services you have to pay after you've met your deductible. Some services – like preventive care and chronic condition management – are accessible with low or no coinsurance before you meet your deductible.
Out-of-pocket limit
Individual
Family
This is the most you'll pay for covered health care expenses in one year. This amount includes deductibles, coinsurance and copayments for covered services.
Office visits
Primary care
Before deductible
Specialist
Before deductible
Mental health
Before deductible
Initial mental health visit is covered in full, before deductible.
Tier 1a and Tier 1b drugs
Tier 1a
Before deductible
Tier 1b
Before deductible
Tier 1 includes low-cost generic drugs, proven to be as safe as brand-name drugs.
Urgent care and Retail health clinics
Urgent care
Before deductible
Retail health clinic
Before deductible
Emergency room
Emergency room
After deductible
Emergency room copayment is waived if admitted.
Virtual urgent care
Virtual urgent care
Before deductible
See a provider through Corewell Health Virtual Urgent Care. This care is accessed through your Priority Health member account and is best for treating minor illnesses and injuries like ear infections, fevers, coughs, minor burns or bites.
Preventive care
Before deductible
Preventive services help you avoid potential health problems or find them early when they are most treatable before you feel sick or have symptoms. See our Preventive Health Care Guidelines for a list of covered preventive services.
Maternity
Routine prenatal and postnatal care
Before deductible
Delivery and nursery care are covered with 30% coinsurance, after deductible.
Diagnostic tests, X-rays, lab services and radiology services
After deductible
The features and benefits shown on this page are intended to give you an overview of what this plan covers. For more details, please refer to the Summary of Benefits and Coverage.
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Marketplace survey results* show our plans make your health our priority.