MyPriority HSA Bronze 7050 - St. Joseph Mercy Health System Network

MyPriority® HSA Bronze 7050 (full or narrow network) plans are an affordable choice if you're generally healthy and savings-minded. This plan gives you the peace of mind knowing you're protected if something catastrophic happens. Your HSA will help pay for medical expenses, is eligible for federal tax advantages and any unused money automatically rolls over from year to year.

Keep in mind you pay 100% of the cost of your health care out of your pocket until you meet your deductible.

Highlights of what members get:

  • Free HSA banking partner: HealthEquity® sets up and helps you manage your HSA banking account
  • Limited virtual care: 24/7 access to a doctor with a Spectrum Health On-Demand Video Visit
  • Prescription drugs: Tier 1a and Tier 1b drugs covered in full, after deductible
  • Chronic condition management: Services, supplies and treatments for some of the most common chronic conditions covered in full or with cost-share, before deductible
  • Cost Estimator: Access to our tool to see prices for hundreds of services and procedures
  • Active&Fit Direct™: Discounted prices for gym memberships and more!
  • Global emergency assistance: If you 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®

St. Joseph Mercy Health System Network: Narrow network option for residents of Wayne, Oakland, Macomb, Washtenaw and Livingston counties

Members who choose a St. Joseph Mercy Health System Network plan are required to receive care in the St. Joseph Mercy Health System network of doctors and hospitals and their affiliated clinics, outpatient facilities, labs, etc.

The network includes:

Hospitals

  • St. Joseph Mercy Chelsea Hospital
  • St. Joseph Mercy Hospital
  • St. Joseph Mercy Livingston Hospital
  • St. Joseph Mercy Oakland Hospital
  • St. Mary Mercy Livonia Hospital
  • Affiliated partners

Physician network

Physicians who are affiliated with St. Joseph Mercy groups as listed below:

  • IHA
  • Huron Valley Physician Association
  • Oakland Physician Network Services – with St. Joseph Mercy Oakland designated as the primary hospital
  • Livingston Physician Organization
  • St. Mary Mercy Physician Practices

All in-network pharmacies

Details:

  • A narrow network allows members to enjoy a lower monthly premium while getting access to quality care.
  • Members who enroll in this plan will see the St. Joseph Mercy Health System network on their ID cards.
  • Care received outside of the St. Joseph Mercy Health System network will not be covered, and members will be required to cover the full cost for out-of-network care.

Your out-of-pocket costs may vary based on your subsidy level from the Federally-Funded Marketplace (FFM).

Network

St. Joseph Mercy Health System Network

Members must receive care in the St. Joseph Mercy Health System Network system of doctors and hospitals and their affiliated clinics, outpatient facilities, labs, etc. Care received outside of the St. Joseph Mercy Health System Network will not be covered and members will be required to cover the full cost of out-of-network care.

Emergency services are covered at the in-network level. Use our Find a Doctor online directory to see if your doctor is in the St. Joseph Mercy Health System Network.

Metal level

Bronze

The metal level determines how you and your plan share the costs of care. Bronze means your plan pays 60% on average and you pay about 40%.

Deductible

$7,050
Individual
$14,100
Family

This is the amount you pay for in-network covered health care services before Priority Health begins to pay.

Coinsurance

100%
Plan pays
0%
You pay

After you've paid your deductible, coinsurance is your portion of the cost for medical services listed as benefits in your insurance plan or prescriptions listed in the approved drug list. For example, if your plan's fee for an office visit is $100 and you've met your deductible, your coinsurance payment of 20% would be $20. Priority Health would pay the rest of the fee, 80%. Preventive health services are covered at 100%.

Out-of-pocket limit

$7,050
Individual
$14,100
Family

Your annual maximum cost. The most you'll pay for health care services including copays and prescription drugs in one year.

Office visits

Covered in full
Primary doctor, after deductible 
Covered in full

Specialist, after deductible  
Covered in full
Mental health, after deductible

Limited virtual care

Covered in full, after deductible

24/7 access to a doctor with a Spectrum Health On-Demand Video Visit.

Preventive care

Covered in full

Preventive care includes specific health care services that help you avoid potential health problems or find them early when they are most treatable, before you feel sick or have symptoms. Examples of preventive care include flu shots, physical exams, lab tests and some prescriptions. See our Preventive Health Care Guidelines for a list of covered preventive services.

Retail health, urgent care and emergency services

Covered in full
Retail health clinic, after deductible
Covered in full

Urgent care, after deductible
Covered in full
Emergency room, after deductible

An illness, injury, symptom or condition that needs immediate care to avoid the worsening of the condition.

Diagnostic tests, X-rays, lab services and radiology services

Covered in full
After deductible

Tier 1a and Tier 1b drugs

Covered in full
Tier 1a, after deductible
Covered in full
Tier 1b, after deductible

The least expensive prescription drugs available to you. This tier includes low-cost generic drugs—proven to be as safe as brand-name drugs—and, on some formularies, select brand-name drugs.


The features and benefits explained in this section are intended to give you an overview of your coverage and do not include or explain every detail of what is and is not covered. Please refer to the Summary of Benefits and Coverage.