MyPriority PPO RxPlus Silver 1900

Our MyPriority® RxPlus plans are designed for people who want the best coverage for their money or may be transitioning from employer-provided insurance to buying direct. You get immediate, affordable access to office visits, including specialists and generic drugs, before you meet your annual deductible.

Highlights of what you get

  • $20 office visits – Any combination of up to four specialist, family doctor or urgent care visits before deductible, including related non-surgical services (like X-rays, labs, etc.)
  • Prescription drugs - $5 preferred generics or $10 generics before deductible
  • 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 coverageTwo plans to choose from, both include annual exams and cleanings.

More about MyPriority PPO RxPlus Silver 1900

Network

PPO

With a PPO, you can choose to see either in-network or out-of-network doctors. You'll pay less if you stay in-network and more if you see out-of-network doctors. Use our Find a Doctor online directory to see if your doctor is in our PPO network.

Metal level

Silver

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%.

Deductible (medical)

$1,900
Individual
$3,800
Family

This is the amount you pay for in-network covered health care services before Priority Health begins to pay. This amount does not include prescriptions. 

Separate prescription deductible

$500
Individual
$1,000
Family

This plan comes with a separate deductible for your prescription costs. You must pay this amount before Priority Health begins to pay for prescriptions.

Coinsurance

70%
Plan pays
30%
You pay

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

Out-of-pocket limit

$6,600
Individual
$13,200
Family

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

$20 copayment
Primary doctor, specialist, urgent care

$20 copayment first 4 visits a year including onsite labs and imaging. Deductible applies after first four any office visits, then coinsurance.

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
After deductible, waived if admitted
30%
Coinsurance

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

30%
Coinsurance

If the service provided is done during an office visit, 100% is covered. Deductible applies after the first four of any office visits.

Virtual visits

30% coinsurance
After deductible

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

Preferred generics and generic drugs

$5 or $10 copayment
Before 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.