MyPriority Premier Silver Off Marketplace
Our MyPriority® Premier Silver plan offers you affordable access to a wide range of health care services, labs and routine care with a low copay before you meet your annual deductible. By opting for a higher deductible, you benefit from a lower monthly premium, making it a great choice for those who are generally healthy and budget-conscious.
With extra benefits and resources at a low or zero cost, you'll get a health plan that takes care of your physical, mental and emotional health.
What is an Off Marketplace plan? If you don't qualify for a federal subsidy–or would rather not use one–you can save money on your monthly premium by purchasing an Off Marketplace plan directly from Priority Health.
Helping you stay healthy and engaged is our priority.
- Prescription coverage: Low copays on Tier 1 drugs, before deductible.
- Virtual urgent care: Before your deductible is met, 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: Before your deductible is met, certain services, supplies and prescriptions used to treat common long-term health conditions are covered with cost share or in full.
- Diabetes management: Before your deductible is met, certain supplies, treatments, prescriptions and tests are covered with 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.®
Network
An HMO provides care through a designated network of doctors, specialists and facilities that members must use in order to be covered by the plan. A primary care provider coordinates your care and you need to see an in-network doctor unless it's an emergency or you get prior approval.
Use our online Find a Doctor directory to check if your doctor is in-network. Change the search parameters from All plans to MyPriority HMO.
Metal level
The metal level determines how you and your plan share the costs of care. Silver generally means moderate monthly premiums and moderate out-of-pocket costs when you receive care.
Deductible
Individual
Family
The deductible is the amount you pay for 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. Some services – like preventive care and chronic condition management – are accessible with low or no coinsurance before you meet 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
(evaluation only)
Before deductible
Specialist
(evaluation only)
Before deductible
Mental health
Before deductible
Initial outpatient mental health visit is covered in full, before deductible.
Tier 1a and Tier 1b drugs
Tier 1a
Before deductible
Tier 1b
Before deductible
Tier 1 includes low-cost generic drugs, proven to be as safe as brand-name drugs.
Urgent care and Retail health clinics
Urgent care
Before deductible
Retail health clinic
Before deductible
Emergency room
Emergency room
After deductible
Emergency room copayment is waived if admitted.
Virtual care
Virtual urgent care
Before deductible
Virtual primary care
Before deductible
See a provider 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.
Virtual primary care is offered through Corewell Health's Virtual Primary Care Practice in West Michigan when you select a Corewell Health Virtual Primary Care Practice provider as your designated PCP.
Preventive care
Before deductible
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
Before deductible
Delivery and nursery care are covered with 30% coinsurance, after deductible.
Diagnostic tests, lab services, X-rays and radiology services
Diagnostic tests & lab services
Before deductible
X-rays & radiology services
After deductible
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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