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. 98% of providers in the Lower Peninsula, including all major hospital systems, are in our Medicare network. And you can go to out-of-network providers, too, but it may cost a little more.
If you have a Medigap plan, you can see any doctor who accepts Medicare. There is no network.
See if your doctor or hospital is in-network.
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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. Plus, two of our plans, PriorityMedicare and PriorityMedicare Select, have the same in- and out-of-network copays for several services, including PCP and specialist visits, labs and outpatient surgery. Note: When you get your Priority Health Medicare plan through an employer, your costs may vary.
- Emergency or urgently needed care is always considered "in network."
Emergency or urgently needed care, ambulance services, post-stabilization care, or dialysis that you receive when you are temporarily outside our service area will be considered in-network.
- 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 copay or coinsurance for covered medical services you receive from out-of-network health care providers.
*Our PriorityMedicare Merit plan doesn't have an out-of-network deductible.
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.