MyPriority Bronze 8700
MyPriority® Bronze 8700 (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 members get:
- Limited virtual care: 24/7 access to a doctor with a Spectrum Health On-Demand Video Visit
- Primary doctor visits: $30 primary care doctor visits, before deductible
- Urgent care: $75 urgent care visits, before deductible
- Prescription drugs: $5 copayment for Tier 1a and $20 copayment for Tier 1b drugs, before deductible
- Chronic condition management: Services, supplies and treatments for some of the most common chronic conditions, 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®
Your out-of-pocket costs may vary based on your subsidy level from the Federally-Facilitated Marketplace (FFM).
With an HMO, you choose a primary doctor that coordinates your care. You need to see an in-network doctor unless it's an emergency or you get prior approval. Use our Find a Doctor online directory to see if your doctor is in-network.
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%.
This is the amount you pay for in-network covered health care services before Priority Health begins to 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%.
Your annual maximum cost. The most you’ll pay for health care services including copays and prescription drugs in one year.
Primary doctor, before deductible
Specialist, after deductible
Mental health, before deductible
Limited virtual care
24/7 access to a doctor with a Spectrum Health On-Demand Video Visit.
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
Retail health clinic, before deductible
Urgent care, before deductible
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
Tier 1a and Tier 1b drugs
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.
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