Explore your Priority Health plan benefits
Below provides an overview of plan benefits for early retirees, those who are not yet eligible for Medicare. See the Summary of Benefits and Coverage documents for more coverage details.
2020-21 benefits for early retirees
Deductible
Member
Family
This year, your deductible won't apply from Oct. 1, 2020 - Dec. 31, 2020. The deductible will then go back into effect Jan. 1, 2021 - Dec. 31, 2021.
Your deductible is the amount you pay for in-network covered health care services before Priority Health begins to pay.
Out-of-pocket maximum
Member
Family
Preventive care
Hospital care
After deductible
Office care
Copayment
Virtual visits
Copayment
Virtual care is great option when you have a non-life-threatening condition but can't wait for a doctor's appointment.
*$20 virtual visit copay applies to State Police Troopers and Sergeants who retired on or after October 1, 1987.
ER (emergency)
Copayment (waived if admitted)
*$65 copay for Medicare Advantage Retirees (waived if admitted within 3 days).
Urgent care
Copayment
Ambulance
After deductible
Pharmacy
Ceneric
Preferred brand
Non-preferred brand
Mail order (90-day supply): 2 copayments