St. John Providence Network: Narrow network option for residents of Wayne, Oakland and Macomb counties

Members who choose a St. John Providence Network plan are required to receive care in the St. John Providence system of doctors and hospitals and their affiliated clinics, outpatient facilities, labs, etc.

The network includes:

Hospitals

  • St. John Hospital and Medical Center
  • St. John Macomb-Oakland Hospital (Macomb Center)
  • St. John Macomb-Oakland Hospital-Oakland Center (Madison Heights campus)
  • St. John Macomb-Oakland Hospital (Warren Campus)
  • Providence Park Hospital (Southfield campus)
  • Crittenton Hospital and Medical Center
  • St. John River District Hospital
  • Providence Park Hospital (Novi campus)
  • Affiliated partners

Physician network

All physicians who are affiliated with Ascension-St. John Providence groups listed below:

  • St. John and St. John North Shore
  • St. John River District
  • St. John Oakland
  • St. John Macomb
  • St. John Cornerstone
  • Providence Hospital

All in-network pharmacies

Details

  • A narrow network allows members to enjoy a lower monthly premium while getting access to quality care
  • Members who enroll in this plan will see the St. John Providence network on their ID cards.
  • Care received outside of the St. John Providence network will not be covered, and members will be required to cover the full cost for out-of-network care.

Network

St. John Providence Network

Members must receive care in the St. John Providence Network system of doctors and hospitals and their affiliated clinics, outpatient facilities, labs, etc. Care received outside of the St. John Providence Network will not be covered and members will be required to cover the full cost of out-of-network care.

Emergency services are covered at the in-network level. Use our Find a Doctor online directory to see if your doctor is in the St. John Providence Network.

Metal level

Gold

The metal level determines how you and your plan share the costs of care. Gold means your plan pays 80% on average and you pay about 20%.

Coinsurance

100%
Plan pays
0%
You pay

After you've paid your deductible, coinsurance is your portion of the cost for medical services listed as benefits in your insurance plan or prescriptions listed in the approved drug list. For example, if your plan's fee for an office visit is $100 and you've met your deductible, your coinsurance payment of 20% would be $20. Priority Health would pay the rest of the fee, 80%. Preventive health services are covered at 100%.

Free preventive care

$0 copayment

Preventive care includes specific health care services that help you avoid potential health problems or find them early when they are most treatable, before you feel sick or have symptoms. Examples of preventive care include flu shots, physical exams, lab tests and some prescriptions. See our Preventive Health Care Guidelines for a list of covered preventive services.


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.