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2026 Medicare HMO-POS plan benefits
| Service | In-network benefit |
|---|---|
Deductible This is the amount you pay for in-network covered health care services before Priority Health begins to pay. | $650 |
| Primary care visits | $0 copayment |
| Preventive annual exam | $0 copayment |
| Virtual care visits | $0 copayment |
| Specialist visits | $35 copayment |
Urgent care In or out-of-network | $45 copayment |
Emergency care In or out-of-network | $120 copayment |
| Labs/X-rays/Diagnostic tests and procedures | $10 copayment |
Priority Health Travel Pass
Coverage outside of the lower peninsula of Michigan
With Travel Pass, you'll pay in-network costs when you visit any Medicare-participating provider in the U.S. and its territories outside of the lower peninsula of Michigan. That means, when you travel out of the lower peninsula of Michigan, your coverage travels with you. Plus, your plan will include Assist America® for global emergency travel assistance when you're more than 100 miles from home or in a foreign country.
Save with mail-order prescriptions and preferred pharmacies
Sign up to get your medications mailed to you
Not only can you get a 100-day supply of your drugs for less than your normal copay - even paying $0 for tier 1 drugs - your prescriptions will be delivered right to your door. You can also save by filling your prescriptions at a preferred pharmacy, including Amazon Home Delivery and Express Scripts. Your costs will be less for your covered drugs when you use a pharmacy in our preferred network.
Medical and prescription coverage with one card
With a Priority Health Medicare Advantage Plan, you just need one card for both your medical and prescription coverage.
Know your prescription drug copays
Most of our prescription drugs have a copay, instead of coinsurance, so you'll know in advance what you're going to pay for your medication.
Get or stay fit
Stay active with a free One Pass® fitness membership when you become a Priority Health Medicare member. You'll have access to thousands of fitness locations nationwide.
Choose the plan that puts you first:
- Preventive care at no cost. Priority Health covers preventive health care at no cost. Get your annual wellness exam, flu shot, cancer screenings and more.
- No referrals. You don't need a referral from your primary care provider (PCP) to see an in-network specialist.
- Worldwide emergency and urgent care coverage. In addition to the out-of-state travel benefit in the U.S., you're also covered worldwide for emergency and urgent care services.
- Virtual doctor visits covered 100%. Virtual care is a fast, convenient and affordable way to see a board-certified doctor 24/7. You can see a health care professional over the phone, through email or using online video.
- Dedicated customer service with a local representative. When you call us with a question you'll be talking to a fellow Michigander, someone who is an expert in your plan. Better yet, you can reach us seven days a week and even over lunch.
Priority Health has HMO-POS and PPO plans with a Medicare contract. Enrollment in Priority Health Medicare depends on contract renewal. This information is not a complete description of benefits. Call 844.403.0847 (TTY users call 711) for more information.