MyPriority HMO Silver 3200 - Off-Marketplace - Bronson Healthcare Partners

MyPriority HMO Silver 3200 - Off-Marketplace (full or narrow network) plans are an affordable option for individuals who do not qualify for a federal subsidy, or chose not to use it. It offers a lower monthly premium because you purchase it directly from Priority Health and avoid fees associated with plans offered on the federally run Marketplace.

Highlights of what you get:

  • Free virtual care: 24/7 non-emergency care by phone or online
  • Prescription drugs: $20 copay for generics before deductible
  • Unlimited primary doctor visits: $30 primary care doctor visits before deductible
  • Urgent Care: $75 urgent care visits before deductible
  • Cost Estimator: Access to our tool to see prices for hundreds of services and procedures.
  • Active&Fit Direct™: Discounted prices for gym memberships and more!

Bronson Healthcare Partners: Narrow network option for individuals who live in some Southwest counties

These narrow network plans are available to individuals who live in Kalamazoo and Van Buren counties, and a portion of Calhoun County.

This network option is designed to appeal to price-sensitive individuals who are willing to accept a limited network of providers in exchange for a lower monthly premium while still getting access to quality care within the Bronson Healthcare system.

Members who choose one of these plans are required to receive care in the Bronson Healthcare system of doctors and hospitals and their affiliated clinics, outpatient facilities, labs, etc.

Network includes:

  • Bronson hospitals
    • Bronson Methodist
    • Bronson Battle Creek
    • Bronson Lakeview
  • Bronson Healthcare physicians
  • Bronson hospital-employed physicians
  • All physicians who denote Bronson Hospital (all campuses) as their primary affiliation
  • All in-network pharmacies

Details 

  • Care received outside of the Bronson Healthcare Partners network will not be covered, and members will be required to cover the full cost for out-of-network care.
  • Members who enroll in this plan will see the Bronson Healthcare Partners network on their ID cards.

Network

Bronson Healthcare Partners

You must receive care in the Bronson Healthcare system of doctors and hospitals and their affiliated clinics, outpatient facilities, labs, etc. Care received outside of the Bronson Healthcare Partners 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 Bronson Healthcare Partners network.

Metal level

Silver

The metal level determines how you and your plan share the costs of care. Silver means your health plan pays 70% (on average) and you pay about 30%.

Coinsurance

70%
Plan pays
30%
You pay

This is the amount you pay in-network, after deductible. Preventive health services are covered at 100%.

Out-of-pocket limit

$7,350
Individual
$14,700
Family

This is the most you pay during a policy period (usually a year) before Priority Health begins to pay 100% of the allowed amount. This includes your copayments, deductibles and coinsurance payments. This limit does not include your monthly premium.

Office visits

$30
Primary doctor, before deductible 
$45
Specialist, deductible applies
$75
Urgent care, before deductible

Virtual visits

$0 copayment
Before deductible

Free preventive care

$0 copayment

Routine care helps keep you and your family healthy. That's why we cover preventive care like well-child visits, flu shots and annual exams at no cost. See our Preventive Health Care Guidelines for a list of in-network covered preventive services.

Emergency services

$250 copayment
After deductible, waived if admitted
30%
Coinsurance

Diagnostic tests, X-rays, lab services and radiology services

30%
Coinsurance

Preferred generics and generic drugs

$20 copayment
Before deductible


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.