MyPriority HMO Bronze 6450

Our MyPriority® HMO health plans include free preventive care, while covering office visits before deductible among other benefits. It's a valuable option for those that don't anticipate needing major health care services and the reassurance of being covered for general care.

Highlights of what you get

  • $25 office visits - An unlimited amount of in-network visits to primary doctor for evaluation and management for a $25 copayment before deductible.
  • $75 urgent care visits - Unlimited in-network urgent care visits for $75 copayment before deductible.
  • Prescription drug coverage - $20 copayment for in-network generics after deductible is met.
  • Cash rewards - Our Cost Estimator lets you shop for high-quality care at lower-priced facilities. Best of all? When you shop and then 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 an in-network specialist
  • Optional dental coverage - Two plans to choose from, both include annual exams and cleanings

More about MyPriority HMO Bronze 6450

Network

HMO

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.

Metal level

Bronze

The metal level determines how you and your plan share the costs of care. Bronze means your plan pays 60% on average and you pay about 40%.

Deductible

$6,450
Individual
$12,900
Family

This is the amount you pay for in-network covered health care services before Priority Health begins to pay.

Coinsurance

60%
Plan pays
40%
You pay

This is the amount you pay in-network, after deductible. Preventive health services are covered at 100%.

Out-of-pocket limit

$6,850
Individual
$13,700
Family

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.

Office visits - primary

$25 copayment 

Office visits only. Deductible does not apply.

Office visits - specialist

$50 copayment

Office visits only. Deductible applies.

Office visits - urgent care

$75 copayment
Urgent care

Office visits only. Deductible does not apply.

Free preventive care

$0 copayment

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.

Emergency services

$250 copayment
Waived if admitted
40% coinsurance
After deductible

Diagnostic tests, X-rays, lab services and radiology services

40% coinsurance
After deductible

Virtual visits

$25 copayment
Before deductible

Get 24/7 access to a doctor via the phone or web.

Preferred generics and generic drugs

$25 copayment
After deductible


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.