MyPriority HMO Silver 3200 - St. John Providence Health Network
MyPriority HMO Silver 3200 (full or narrow network) plans are a smart option for individuals and families that don’t anticipate needing major health care services and want the reassurance of being covered for general care. This plan can be purchased on the federal Marketplace or directly from Priority Health.
Highlights of what you get:
- $0 virtual care: 24/7 non-emergency care by phone or online
- Prescription drugs: $5 copay for preferred generics before deductible
- Unlimited primary doctor visits: $30 primary care doctor visits before deductible
- Urgent Care: $75 urgent care visits before deductible
- 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
St. John Providence Network: Narrow network option for residents of Wayne, Oakland and Macomb counties
Members who choose a St. John Providence Network plan are required to receive care in the St. John Providence system of doctors and hospitals and their affiliated clinics, outpatient facilities, labs, etc.
The network includes:
- St. John Hospital and Medical Center
- St. John Macomb-Oakland Hospital (Macomb Center)
- St. John Macomb-Oakland Hospital-Oakland Center (Madison Heights campus)
- St. John Macomb-Oakland Hospital (Warren Campus)
- Providence Park Hospital (Southfield campus)
- Crittenton Hospital and Medical Center
- St. John River District Hospital
- Providence Park Hospital (Novi campus)
- Affiliated partners
All physicians who are affiliated with Ascension-St. John Providence groups listed below:
- St. John and St. John North Shore
- St. John River District
- St. John Oakland
- St. John Macomb
- St. John Cornerstone
- Providence Hospital
All in-network pharmacies
- A narrow network allows members to enjoy a lower monthly premium while getting access to quality care
- Members who enroll in this plan will see the St. John Providence network on their ID cards.
- Care received outside of the St. John Providence network will not be covered, and members will be required to cover the full cost for out-of-network care.
Members must receive care in the St. John Providence Network system of doctors and hospitals and their affiliated clinics, outpatient facilities, labs, etc. Care received outside of the St. John Providence Network will not be covered and members will be required to cover the full cost of out-of-network care.
Emergency services are covered at the in-network level. Use our Find a Doctor online directory to see if your doctor is in the St. John Providence Network.
The metal level determines how you and your plan share the costs of care. Silver means your health plan pays 70% (on average) and you pay about 30%.
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, before deductible
Specialist, deductible applies
Urgent care, before deductible
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 in-network covered preventive services.
After deductible, waived if admitted
Diagnostic tests, X-rays, lab services and radiology services
Coinsurance after deductible
Preferred generics 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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