The importance of staying in your HMO/EPO network

As a Priority Health member, you have access to thousands of health care providers. These are in-network doctors, specialists labs and hospitals that we’ve negotiated discounts with to provide you with high quality care at a lower price.

It’s important to know that when you stay in-network for any health service, you will pay less. If you choose to get care out of network, then you may pay more based on where you are and how much your out of network provider chooses to bill you.

With an HMO or EPO plan, your care is coordinated through your primary care physician (PCP). It means your health plan shares the cost of care with you when you get in-network care. If you go out of network, then you pay the full cost of care. Generally, you only have in-network providers in the state of Michigan, but your specific plan may have special guidelines, so be sure to review your plan documents in your member account to understand how we share the cost of your care for medical services and prescriptions.

If you have any questions about in-network care, call the Customer Service number on the back of your member ID card or log in to your member account to send us a message.