MyPriority Bronze 8700 - Beaumont Health Network

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®

Beaumont Health Network

A narrow network offered to individuals who live in Wayne, Oakland and Macomb counties

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

This network includes:

Hospitals: Beaumont Health Hospitals (including former Oakwood hospitals) – Dearborn, Farmington Hills, Grosse Pointe, Royal Oak, Taylor, Trenton, Troy, Wayne

Physicians (primary care and specialist) network:

  • Physicians employed by Beaumont Health
  • Any individual community physicians with admitting privileges at Beaumont Health that are listed as in-network in the Priority Health Beaumont Network Find a Doctor directory

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 Beaumont Health network on their ID cards
  • Care received outside of the Beaumont Health 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-Facilitated Marketplace (FFM).

Network

Beaumont Health Network

You must receive care in the Beaumont Health Network of doctors and hospitals and their affiliated clinics, outpatient facilities, labs, etc. Care received outside of the Beaumont Health 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 Beaumont Health Network.

Metal level

Bronze

The metal level determines how you and your plan share the costs of care. Bronze means generally lower premium costs but higher out-of-pocket costs at time of service.

Deductible

$8,700
Individual
$17,400
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

Coinsurance is the percentage of the cost of medical services you have to pay after you've met your deductible.

Out-of-pocket limit

$8,700
Individual 
$17,400
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

$30 copayment
Primary doctor, before deductible 
Covered in full

Specialist, after deductible
$30 copayment
Mental health, before deductible

Limited virtual care

Covered in full

24/7 access to a provider with a Spectrum Health On-Demand virtual urgent care.

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

$75 copayment
Retail health clinic (evaluation only), before deductible
$75 copayment
Urgent care (evaluation only), before deductible

Covered in full
Emergency room, after deductible

When you seek treatment for an illness, injury, symptom or condition that needs immediate care.

Diagnostic tests, X-rays, lab and radiology services

Covered in full
After deductible

Tier 1a and Tier 1b drugs

$5 copayment
Tier 1a
Before deductible
$20 copayment
Tier 1b
Before deductible

Tier 1 includes low-cost generic drugs, proven to be as safe as 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.