PriorityHMO tiered copay plans 

Plan highlights

  • Range of deductibles - Choose from plans that have individual deductibles of $250, $500, $1,000, $2,000 or $3,000. (Family deductibles are double the individual amount.)
  • Primary doctor visits - Comprehensive office visits before deductible, including related non-surgical services (like X-rays, labs, etc.)
  • Specialist visits - Covered before deductible
  • Urgent care - Covered before deductible
  • Generic drugs - Copayment before deductible
  • Cash rewards - Our Cost Estimator lets you shop for high-quality care at lower-priced facilities. Best of all? When you receive care at a fair-price facility, we'll send you a Visa® reward card.
  • No referral needed - Our plans don't require a referral to see a specialist
  • Optional dental coverage - Two plans to choose from, both include annual exams and cleanings (learn more)

PriorityHMO 250 100% tiered copay

  • Metal level

    Platinum

  • Deductible

    $250 individual
    $500 family

  • Coinsurance

    Employee pays 0%

  • Out-of-pocket limit

    $1,400 individual
    $2,800 family

  • Rx copayments

    Generic: $10
    Preferred brand: $40
    Non-preferred brand: $80
    Preferred specialty: 20%
    Non-preferred specialty: 20%

  • Primary / specialist / urgent care

    $10 / $25 / $75 copayment

  • Emergency room

    $150 copayment

  • High-tech radiology

    $150 copayment

PriorityHMO 250 90% tiered copay

  • Metal level

    Platinum

  • Deductible

    $250 individual
    $500 family

  • Coinsurance

    Employee pays 10%

  • Out-of-pocket limit

    $1,500 individual
    $3,000 family

  • Rx copayments

    Generic: $10
    Preferred brand: $40
    Non-preferred brand: $80
    Preferred specialty: 20%
    Non-preferred specialty: 20%

  • Primary / specialist / urgent care

    $10 / $25 / $75 copayment

  • Emergency room

    $150 copayment

  • High-tech radiology

    $150 copayment

PriorityHMO 500 2-tier Rx tiered copay

  • Metal level

    Gold

  • Deductible

    $500 individual
    $1000 family

  • Coinsurance

    Employee pays 20%

  • Out-of-pocket limit

    $5,000 individual
    $10,000 family

  • Rx copayments

    Generic: $10
    Preferred brand: $40
    Non-preferred brand: $40
    Preferred specialty: $40
    Non-preferred specialty: $40

  • Primary / specialist / urgent care

    $20 / $35 / $75 copayment

  • Emergency room

    $150 copayment

  • High-tech radiology

    $150 copayment

PriorityHMO 500 5-tier Rx tiered copay

  • Metal level

    Gold

  • Deductible

    $500 individual
    $1,000 family

  • Coinsurance

    Employee pays 20%

  • Out-of-pocket limit

    $5,000 individual
    $10,000 family

  • Rx copayments

    Generic: $15
    Preferred brand: $50
    Non-preferred brand: $80
    Preferred specialty: 20%
    Non-preferred specialty: 20%

  • Primary / specialist / urgent care

    $20 / $35 / $75 copayment

  • Emergency room

    $150 copayment

  • High-tech radiology

    $150 copayment

PriorityHMO 1000 tiered copay

  • Metal level

    Gold

  • Deductible

    $1,000 individual
    $2,000 family

  • Coinsurance

    Employee pays 20%

  • Out-of-pocket limit

    $5,000 individual
    $10,000 family

  • Rx copayments

    Generic: $15
    Preferred brand: $50
    Non-preferred brand: $80
    Preferred specialty: 20%
    Non-preferred specialty: 20%

  • Primary / specialist / urgent care

    $20 / $35 / $75 copayment

  • Emergency room

    $150 copayment

  • High-tech radiology

    $150 copayment

PriorityHMO 2000 tiered copay

  • Metal level

    Silver

  • Deductible

    $2,000 individual
    $4,000 family

  • Coinsurance

    Employee pays 30%

  • Out-of-pocket limit

    $6,250 individual
    $12,500 family

  • Rx copayments

    Generic: $20
    Preferred brand: $60
    Non-preferred brand: $80
    Preferred specialty: 20%
    Non-preferred specialty: 20%

  • Primary / specialist / urgent care

    $30 / $45 / $75 copayment

  • Emergency room

    $250 copayment

  • High-tech radiology

    $150 copayment

PriorityHMO 3000 tiered copay

  • Metal level

    Silver

  • Deductible

    $3,000 individual
    $6,000 family

  • Coinsurance

    Employee pays 30%

  • Out-of-pocket limit

    $6,250 individual
    $12,500 family

  • Rx copayments

    Generic: $20
    Preferred brand: $60
    Non-preferred brand: $80
    Preferred specialty: 20%
    Non-preferred specialty: 20%

  • Primary / specialist / urgent care

    $30 / $45 / $75 copayment

  • Emergency room

    $250 copayment

  • High-tech radiology

    $150 copayment

PriorityHMO tiered copay plans: West MI Partners

If your small business is in West Michigan and most of your employees live in West Michigan, consider our affordable tiered network option.

Reasons to love our HMO

  • USA map

    Broad state-wide network of doctors

  • Specialist with patient

    No referral to see a specialist

  • Trophy icon

    PriorityRewards:  easy way to save & earn money for getting quality care at fair-priced facilities

  • Laptop

    Virtual visits - see a doctor 24/7 on the phone or online

  • Globe

    24/7 global emergency services with Assist America®

  • Retail building

    Retail health clinic coverage - new this year on all plans!