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.
Your health is our top priority
Earning 4 out of 5 stars* on healthcare.gov, Priority Health gives you more for your money and does more to improve your health.
Highlights of what members get:
- Out-of-state coverage: Receive in-network benefits outside the state of Michigan, but within the United States, with a Cigna OAP provider.
- On-demand mental health support: myStrength, included at no added cost, is a 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 OAP provider is used for care, even outside of Michigan. Find Cigna OAP 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 met your deductible, coinsurance is the percentage of the cost for medical services you have to pay. 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, office visits (evaluation only), before deductible
Specialist, office visits (evaluation only), before deductible
Mental health, office visits only, before deductible
Tier 1a and Tier 1b drugs
Tier 1 includes low-cost generic drugs—proven to be as safe as brand-name drugs—and, on some formularies, select brand-name drugs.
Retail health, urgent care and emergency services
Retail health clinic, office visits (evaluation only), before deductible
Urgent care, office visits (evaluation only), before deductible
Emergency room (waived if admitted); 30% coinsurance, after deductible
When you seek treatment for an illness, injury, symptom or condition that needs immediate care.
Limited virtual care
24/7 access to a provider with a Spectrum Health On-Demand virtual urgent 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.
Routine prenatal and postnatal care, before deductible
Diagnostic tests, lab services, X-rays and radiology services
Diagnostic tests and lab services, before deductible
X-rays and radiology services, after deductible
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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