Doctors and hospitals

When you have a Medicare Advantage plan from Priority Health, you can see any doctor or specialist in our network without a referral. Plus, 97% of primary care doctors in Michigan and all major hospital systems in the lower peninsula are in our network. Your plan also includes our out-of-state travel benefit, made even easier with MultiPlan network access, so when you travel out of state, your coverage travels with you.

If you have a PriorityMedicare Vital or Priority Health Medigap plan, you can see any doctor who accepts Medicare. There is no network.

See if your doctor or hospital is in the Priority Health Medicare network.

Visit Medicare.gov to find a Medicare-participating provider outside of our network.

More about our network

There are advantages to using our network of doctors and hospitals

  • You'll save money
    We negotiate with physicians, hospitals and pharmacies to get a discount for members of Priority Health Medicare Advantage plans.
  • You'll see excellent doctors and hospitals
    We track the safety and quality ratings of hospitals and primary care physicians. You'll receive your care from some of the most respected physicians and medical facilities anywhere.
  • No referrals necessary
    Our plans don't require you to get a referral to see a specialist in our network. (However, some specialists independently require referrals from your primary care physician or other primary health care provider.)

It's easy to go to out-of-network health care providers

You can go to any health care providers (doctors, hospitals, medical supply companies) you like outside our Michigan network. Note: When you get your Priority Health Medicare plan through an employer, your costs may vary.

  • Emergency or urgent care is always considered "in network"
    Emergency or urgent care, post-stabilization care, or dialysis that you receive outside our network will be considered in-network.
  • You have a deductible for out-of-network services
    You'll pay 100% of the cost of Medicare-covered medical services received outside our network until you have met your out-of-network deductible.
  • Your copays may be slightly higher
    After you meet the out-of-network deductible, you'll pay a copay for covered medical services you receive from out-of-network health care providers.

It's easy to go to out-of-network health care providers in Michigan

You can go to any Medicare-participating health care providers (doctors, hospitals, medical supply companies) you like outside our network in Michigan if your plan has out-of-network coverage included. Note: When you get your Priority Health Medicare plan through an employer, your costs may vary.

  • Some plans have a deductible for out-of-network services
    You'll pay 100% of the cost of Medicare-covered medical services received outside our network until you have met your out-of-network deductible.
  • Your out-of-pocket costs may be slightly higher
    After you meet the out-of-network deductible, you'll pay a coinsurance for covered medical services you receive from out-of-network health care providers in Michigan.

 


*Excludes PriorityMedicare D-SNP and many employer group Medicare Advantage plans. Please check your Evidence of Coverage document for benefit details.
**Out-of-network deductibles vary by plan

Note: Out-of-network/non-contracted providers are under no obligation to treat Priority Health members, except in emergency situations. Call our customer service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.

According to the Michigan Department of Insurance and Financial Services 2019 Individual and Small Group network filing comparisons of primary care doctors who participate with insurance, excluding out-of-state and Upper Peninsula providers. Network varies by plan.