MyPriority® network changes effective Jan. 1
Effective January 1, 2018, the Priority Health MyPriority® individual commercial plans will see a variety of changes we want to alert you to.
U of M out of network
University of Michigan facilities and providers will be considered out-of-network for MyPriority HMO 2018 plans. This affects approximately 740 members who have a primary care physician affiliated with University of Michigan.
Why? Health insurance companies update their provider contracts regularly to ensure we can offer our members affordable products and high quality care. This change is the result of our regular evaluation and efforts to offer competitively priced plans in the individual market.
Member impact: Members received letters the third week in October notifying them of this change and the need to either choose an in-network PCP or shop for another plan so they can keep their PCP. The letter also provides instructions on finding an in-network doctor.
- Keeping their U of M PCP and renewing their current plan means that they'll be responsible for the full cost of their care because they're not seeing an in-network doctor.
- A member choosing to keep their Priority Health plan will need to choose a new PCP by Dec. 15, 2017, or we'll assign a new in-network PCP to them.
We will send additional communications to members of MyPriority plans who have claims from a U of M specialist in the coming weeks, alerting the members to this change and how to select/be referred to an in-network specialist.
Call to action: We need help from our provider partners to ensure that our MyPriority members are referred to in-network providers. To learn which providers are in-network, navigate to our online Find A Doctor directory.
2018 MyPriority Gold 1100 plan has its own network
Their network for 2018 includes the entire Priority Health network, excluding:
- Metro Health
- North Ottawa Community Hospital
- Covenant Health System
- Henry Ford Health System (except Allegiance Jackson)
- Ohio and Indiana providers