MyPriority HMO Gold 1100
Our MyPriority HMO Gold 1100 plan is designed for individuals and families who anticipate needing health care services throughout the year. Once the deductible is met, you share in the costs with the health plan.
Keep in mind you’ll pay 100% of the cost for your health care out-of-pocket until the deductible is met.
Highlights of what members get:
- Free virtual care: 24/7 non-emergency care by phone or online
- Cost Estimator: Access to our tool to see prices for hundreds of services and procedures
- Active&Fit Direct™: Discounted prices for gym memberships and more
This plan comes with our HMO network of doctors; however, there are some facilities that are not included. Please check our Find A Doctor tool to make sure your doctor is in network.
With an HMO, you choose a primary doctor that coordinates your care. You need to see an in-network doctor unless it's an emergency or you get prior approval. Use our Find a Doctor online directory to see if your doctor is in-network.
The metal level determines how you and your plan share the costs of care. Gold means your plan pays 80% on average and you pay about 20%.
This is the amount you pay for in-network covered health care services before Priority Health begins to pay.
This is the amount you pay in-network, after deductible. Preventive health services are covered at 100%.
This is the most you pay during a policy period (usually a year) before Priority Health begins to pay 100% of the allowed amount. This includes your copayments, deductibles and coinsurance payments. This limit does not include your monthly premium.
Primary doctor, specialist, urgent care
Free preventive care
Routine care helps keep you and your family healthy. That's why we cover preventive care like well-child visits, flu shots and annual exams at no cost. See our Preventive Health Care Guidelines for a list of covered preventive services.
Waived if admitted
Diagnostic tests, X-rays, lab services and radiology services
If the service provided is done during an office visit, 100% is covered. The deductible applies after the first four of any office visits.
Preferred generic and generic drugs
The features and benefits explained in this section are intended to give you an overview of your coverage and do not include or explain every detail of what is and is not covered. Please refer to the Summary of Benefits and Coverage.
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