MyPriority Telehealth PCP Bronze 8700 - Virtual First

Telehealth PCP: a plan option with access to virtual and in-person care

Three important things to know about a Telehealth PCP plan:

  1. Every visit starts with a virtual appointment; you will need a smartphone or computer: When you need care, you make a virtual appointment with your assigned Doctor On Demand provider and connect with them via the app or online portal.
  2. This plan offers all types of 'virtual first' care: The virtual PCP acts as a primary care doctor, urgent care, behavioral health, preventive health and chronic care provider.
  3. You'll need a referral to seek in-person care with a PCP or specialist: This is a 'virtual first' plan. Referrals from your assigned telehealth doctor are required to seek care in a traditional office setting. In-person claims that do not have a referral from a Doctor On Demand provider will be denied.

Members who choose a Priority Health Telehealth PCP plan will have a doctor from our virtual care partner, Doctor On Demand. You can have appointments and consultations with this doctor just like you would in person. If your Doctor On Demand physician refers you to an in-person facility for health care services, you have access to the Priority Health broad network.

Highlights of what members get:

  • Telehealth PCP: All visits with your doctor will take place virtually, all you need is a device with an internet connection
  • Doctor On Demand visits: $10 primary care doctor, urgent care & mental health visits before deductible
  • Prescription drugs: $5 Tier 1a and $20 Tier 1b drugs copay, before deductible
  • Chronic condition management: Services, supplies, and treatments for some of the most common chronic conditions, with cost-share, before deductible
  • Active&Fit Direct™: Discounted prices for gym memberships and more


  • A Telehealth PCP plan allows you to have appointments and consultations with your doctor from the comfort and safety of your home
  • If your virtual PCP from Doctor on Demand determines that you need in-person health care services, they will provide a referral within the broad Priority Health HMO network

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



With a Telehealth PCP plan, your primary care provider will be a Doctor on Demand provider and you will receive care virtually. When services cannot be provided virtually, Doctor on Demand will work to provide you with a referral within the broad Priority Health HMO Network.

Metal level


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.



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


Plan pays
You pay

After you’ve met your deductible, coinsurance is the percentage of the cost for medical services you have to pay. Preventive health services are covered at 100%.

Out-of-pocket limit


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

Virtual office visits

$10 copayment
Primary doctor, before deductible 
$10 copayment
Urgent care, before deductible 
$10 copayment
Mental health, before deductible

Office visits provided virtually by Doctor on Demand. Referral needed from Doctor on Demand to seek in person care from another provider.

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. Office visits provided virtually by Doctor on Demand. Referral needed from Doctor on Demand to seek care from another provider.

Emergency services

Covered in full
After deductible

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

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

Deductible applies

Referral needed from Doctor on Demand

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—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.