MyPriority Travel Silver 5500
MyPriority® Travel Silver 5500 plan is an affordable choice for individuals or families who want to travel–for both work and leisure–but still want health coverage when outside of Michigan. Many common health care services like primary care visits and urgent care are available with a copay before deductible. This added travel benefit allows you to receive covered services and care from any Cigna OAP provider outside of Michigan and within the United States.
Highlights of what members get:
- On-demand mental health support: myStrength is a free mental health and wellness online tool that helps you live your best life.
- Chronic condition management: Access to a variety of medications, supplies and services to help keep your chronic conditions under control–covered in full or with a low cost share, before deductible.
- Diabetes management: Our plans provide coverage for diabetes management services, supplies and treatments for no cost, before deductible when furnished by a participating durable medical equipment (DME) provider. Diabetes prescriptions and testing procedures are covered before deductible, with cost share.
- Global emergency assistance: If you or your dependents 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 plan deductible, cost share and maximum out-of-pocket amounts stay the same when a Cigna provider is used for care, even outside of Michigan. Find Cigna providers outside of Michigan by using the Priority Health Find a Doctor tool.
The metal level determines how you and your plan share the costs of care. Silver means your health plan pays 70% (on average) and you pay about 30%. Silver level plans offer a good balance of premium and out-of-pocket costs.
The amount you pay for 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, before deductible
Mental health, before deductible (initial visit covered in full)
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, 30% coinsurance after deductible
An illness, injury, symptom or condition that needs immediate care to avoid the worsening of the condition.
Diagnostic tests, lab services, X-rays and radiology services
Diagnostic tests and lab services, before deductible
X-rays and radiology services, after deductible
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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