PriorityHMO tiered copay: West MI Partners

Plan highlights

  • 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 Delta Dental PPO / Premier plans to choose from, both include annual exams and cleanings (learn more)

West MI Partners network

Our tiered network HMO plan is available to small employers within a 13 county* area and includes "tier 1" care providers who have privileges at Spectrum Health, Holland Hospital and Metro Health.

In a tiered network, members pay less out-of-pocket for care from hospitals and primary care providers that are high-quality and lower cost.

Emergency services outside of this plan's limited network are covered. Use our Find a Doctor online directory to find providers in the West MI Partners network.

Ideal solution if:

You're a price-sensitive employer with employees that are geographically located within The "tier 1" service area includes the northern half of Allegan1, Barry, Lake, Kent, Mason, Mecosta, Montcalm, Newaygo, Osceola, Ottawa, majority of Calhoun2, and the majority of Van Buren counties3.

Small group west mi partners service map

1Allegan County ZIP codes included in Tier 1: 49311, 49315, 49314, 49316, 49323, 49328, 49335, 49348, 49406, 49408, 49419, 49423, 49426, 49453, 49464.
1Allegan County ZIP codes NOT included in Tier 1: 49010, 49026, 49055, 49056, 49070, 49078, 49080, 49090, 49344, 49416, 49450.

2Calhoun County ZIP codes included in Tier 1: 49014, 49015, 49017, 49021, 49029, 49033, 49037, 49051, 49052, 49068, 49076, 49092, 49094.
2Calhoun County ZIP codes NOT included in Tier 1: 49034, 49224, 49237, 49045, 49252, 49284

3Van Buren County ZIP codes included in Tier 1: 49013, 49022, 49026, 49027, 49045, 49047, 49055, 49056, 49057, 49064, 49065, 49067, 49071, 49078, 49079, 49087, 49098.
3Van Buren County ZIP codes NOT included in Tier 1: 49038, 49043, 49090

Not included in tiered network: 49344, 49070, 49078, 49080, 49010, 49026, 49055, 49056, 49090, 49450, 49416.

**The full-network PriorityExtras HMO product is only available where the tiered network PriorityExtras HMO product is not.

PriorityHMO 1000 tiered copay West MI Partners plan

  • PriorityHMO West MI Partners 1000

    Deductible
    Tier 1: $1,000 individual, $2,000 family
    Tier 2: $4,000 individual, $8,000 family

    Coinsurance
    Tier 1: Employee pays 20%
    Tier 2: Employee pays 40%

    Out-of-pocket limit
    Tier 1: $7,150 individual, $14,300 family
    Tier 2: $7,150 individual, $14,300 family

    Primary / specialist / urgent care
    Tier 1: $15 / $30 / $75
    Tier 2: $45 / $60 / $75