MyPriority Enhanced Gold
Southeast Michigan Network
MyPriority® Enhanced Gold is an ideal plan for individuals and families who expect to require health care services regularly during the year.
In exchange for a higher monthly premium, you won't have to worry about meeting an annual deductible. This simplifies managing your health care expenses for any anticipated needs–and unexpected ones, too.
Helping you stay healthy and engaged is our priority.
- Prescription coverage: Low copays on Tier 1 drugs.
- Virtual urgent care: Virtual urgent care visits are covered in full when scheduled through the Priority Health member app.
- On-demand mental health support: Get access to a digital solution that helps with stress, anxiety, chronic pain and more. It can be self-directed or used with coaching support, available at no cost.
- Chronic condition management: Certain services, supplies and prescriptions used to treat common long-term health conditions are covered with cost share or in full.
- Diabetes management: Supplies, treatments, prescriptions and tests are covered with a low cost share or in full.
- Global emergency assistance: If you become ill or injured while traveling more than 100 miles from home, our partner Assist America® will help you get care and arrange your safe travel home.
- Care for your hearing: Get discounts for you and your extended family for hearing exams and hearing aids through TruHearing.®
Southeast Michigan Network
This narrow network plan is offered to individuals who live in Macomb, Oakland, and Wayne counties.
To ensure coverage of your health care costs, you must receive care from doctors and hospitals within the Southeast Michigan Network or their affiliated facilities. If you receive care from an out-of-network provider, you will be responsible for paying the full cost. Emergency services are covered at the in-network level.
Hospital networks
Corewell Health East hospitals
- Corewell Health Dearborn Hospital
- Corewell Health Farmington Hills Hospital
- Corewell Health Beaumont Grosse Pointe Hospital
- Corewell Health Taylor Hospital
- Corewell Health Trenton Hospital
- Corewell Health Beaumont Troy Hospital
- Corewell Health Wayne Hospital
- Corewell Health William Beaumont University Hospital
Trinity Health East hospitals
- Trinity Health Ann Arbor Hospital
- Trinity Health Chelsea Hospital
- Trinity Health Livingston Hospital
- Trinity Health Livonia Hospital
- Trinity Health Oakland Hospital
Physician networks (primary care and specialist)
Corewell Health East hospitals
- Physicians employed by Corewell Health in Southeast Michigan
- Any individual community physician with admitting privileges at Corewell Health who is in-network and listed in the Priority Health Southeast Michigan Network Find a Doctor directory.
Trinity Health East hospitals
- Any individual community physician with admitting privileges at Trinity Health who is in-network and listed in the Priority Health Trinity Health East Network Find a Doctor directory.
All in-network pharmacies
Your out-of-pocket costs may vary based on your subsidy level from the Federally-Facilitated Marketplace (FFM).
Network
In order for your health care costs to be covered, you must receive care from doctors and hospitals within the Southeast Michigan Network or their affiliated facilities. If you receive care from an out-of-network provider, you will be responsible for paying the full cost. Emergency services are covered at the in-network level.
Use our online Find a Doctor directory to check if your doctor is in-network. Change the search parameters from All plans to Southeast Michigan Network.
Metal level
The metal level determines how you and your plan share the costs of care. Gold generally means higher monthly premiums but lower out-of-pocket costs when you receive care.
Deductible
Individual
Family
The deductible is the amount you pay for in-network covered health care services before Priority Health begins to pay.
Coinsurance
Plan pays
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
Individual
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
Primary care
Specialist
Mental health
Tier 1a and Tier 1b drugs
Tier 1a
Tier 1b
Tier 1 includes low-cost generic drugs, proven to be as safe as brand-name drugs.
Urgent care and Retail health clinic
Urgent care
Retail health clinic
Emergency room
Emergency room
Emergency room copayment is waived if admitted.
Virtual urgent care
Virtual urgent care
Virtual urgent care is offered through Corewell Health Virtual Urgent Care. This care is accessed through your Priority Health member account and is best for treating minor illnesses and injuries like ear infections, fevers, coughs, minor burns or bites.
Preventive care
Preventive services help you avoid potential health problems or find them early when they are most treatable before you feel sick or have symptoms. See our Preventive Health Care Guidelines for a list of covered preventive services.
Maternity
Routine prenatal and postnatal care
Delivery and nursery care are covered with a $1,000 copayment per day (maximum 5 copayments.)
Diagnostic tests, X-rays, lab services and radiology services
The features and benefits shown on this page are intended to give you an overview of what this plan covers. For more details, please refer to the Summary of Benefits and Coverage.
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