MyPriority HMO Bronze 8150 - St. John Providence Network
MyPriority® HMO Bronze 8150 (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. This plan is a smart option for individuals and families that don’t anticipate needing major health care services and want the reassurance of being covered for general care.
Highlights of what you get:
-
Virtual care: 24/7 non-emergency care by mobile device or online (i.e. Spectrum Health App)
- Prescription drugs: $5 copay for preferred generics, before deductible.
- Unlimited primary doctor visits: $30 primary care doctor visits, before deductible.
- Vision coverage: Embedded vision exam and discounts, available through EyeMed.
- Urgent care: $75 urgent care visits, 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!
St. John Providence Network: Narrow network option for residents of Wayne, Oakland and Macomb counties
Members who choose a St. John Providence Network plan are required to receive care in the St. John Providence system of doctors and hospitals and their affiliated clinics, outpatient facilities, labs, etc.
The network includes:
Hospitals
- Ascension St. John Hospital
- St. John Macomb-Oakland Hospital (Macomb Center)
- St. John Macomb-Oakland Hospital (Oakland Center)
- Ascension Providence Park Hospital (Southfield Campus)
- Crittenton Hospital Medical Center
- St. John River District Hospital
- Ascension Providence Park Hospital (Novi Campus)
- Affiliated partners
Physician network
Physicians who are affiliated with Ascension-St. John Providence groups listed below:
- St. John and St. John North Shore
- St. John River District
- St. John Oakland
- St. John Macomb
- St. John Cornerstone
- Providence Hospital
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. John Providence network on their ID cards.
- Care received outside of the St. John Providence network will not be covered, and members will be required to cover the full cost for out-of-network care.
Network
Members must receive care in the St. John Providence Network system of doctors and hospitals and their affiliated clinics, outpatient facilities, labs, etc. Care received outside of the St. John Providence 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. John Providence Network.
Metal level
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
Individual
Family
This is the amount you pay for in-network covered health care services before Priority Health begins to pay.
Coinsurance
Plan pays
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
Individual
Family
Your annual maximum cost. The most you'll pay for health care services including copays and prescription drugs in one year.
Vision exam
Before deductible
Office visits
Primary doctor, before deductible
Specialist, deductible
applies
Urgent care, before deductible
Virtual care
Before deductible
24/7 non-emergency care by mobile device or online.
Free preventive care
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.
Emergency services
An illness, injury, symptom or condition so serious that a reasonable person would seek care right away to avoid severe harm.
Diagnostic tests, X-rays, lab services and radiology services
Tier 1a and Tier 1b drugs
Tier 1a,
before deductible
Tier 1b,
before 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.
We're sorry. This information is currently unavailable.
Application not available
Get plan details
Other plans
Narrow network - HMO
- HMO Bronze 8150 - Beaumont Health Network
- HMO Bronze 8150 - Bronson Healthcare Partners
- HMO Bronze 8150 - Spectrum Health Partners
- HMO Bronze 8150 - St. John Providence Network
- HMO Bronze 8150 - St. Joseph Mercy Health System Network
- HMO Silver 3200 - Beaumont Health Network
- HMO Silver 3200 - Bronson Healthcare Partners
- HMO Silver 3200 - Spectrum Health Partners
- HMO Silver 3200 - St. John Providence Network
- HMO Silver 3200 - St. Joseph Mercy Health System Network
- HMO Silver 3200 - Off Marketplace - Beaumont Health Network
- HMO Silver 3200 - Off Marketplace - Bronson Healthcare Partners
- HMO Silver 3200 - Off Marketplace - Spectrum Health Partners
- HMO Silver 3200 - Off Marketplace - St. John Providence Network
- HMO Silver 3200 - Off Marketplace - St. Joseph Mercy Health System Network
- HMO Silver 2400 50+ - Beaumont Health Network
- HMO Silver 2400 50+ - Bronson Healthcare Partners
- HMO Silver 2400 50+ - Spectrum Health Partners
- HMO Silver 2400 50+ - St. John Providence Network
- HMO Silver 2400 50+ - St. Joseph Mercy Health System Network
- HMO Gold Copay+ - Beaumont Health Network
- HMO Gold Copay+ - Bronson Healthcare Partners
- HMO Gold Copay+ - Spectrum Health Partners
- HMO Gold Copay+ - St. John Providence Network
- HMO Gold Copay+ - St. Joseph Mercy Health System Network
Narrow network - HSA
- HMO HSA Bronze 6900 - Beaumont Health Network
- HMO HSA Bronze 6900 - Bronson Healthcare Partners
- HMO HSA Bronze 6900 - Spectrum Health Partners
- HMO HSA Bronze 6900 - St. John Providence Network
- HMO HSA Bronze 6900 - St. Joseph Mercy Health System Network
- HMO HSA Silver 3000 - Off Marketplace - Beaumont Health Network
- HMO HSA Silver 3000 - Off Marketplace - Bronson Healthcare Partners
- HMO HSA Silver 3000 - Off Marketplace - Spectrum Health Partners
- HMO HSA Silver 3000 - Off Marketplace - St. John Providence Network
- HMO HSA Silver 3000 - Off Marketplace - St. Joseph Mercy Health System Network