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

$125
Member
$250
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

$2,000
Member
$4,000
Family

Preventive care

$0

Hospital care

100% coverage
After deductible

Office care

$20
Copayment

Virtual visits

$10*
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)

$200*
Copayment (waived if admitted)

*$65 copay for Medicare Advantage Retirees (waived if admitted within 3 days).

Urgent care

$20
Copayment

Ambulance

100% coverage
After deductible

Pharmacy

$10 copay
Ceneric
$30 copay
Preferred brand
$60 copay
Non-preferred brand

Mail order (90-day supply): 2 copayments