MyPriority HMO Silver 3200 - Off-Marketplace - Beaumont Health Network

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!

Beaumont Health Network: Narrow network option for residents of Wayne, Oakland and Macomb counties

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

The network includes:

Hospitals

  • Beaumont Health Hospitals – Dearborn, Farmington Hills, Grosse Pointe, Royal Oak, Taylor, Trenton, Troy, Wayne
  • Affiliated partners

Physician network

  • Beaumont Medical Group
  • Oakwood Hospital
  • Botsford Medical Group

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 Beaumont Health Network on their ID cards.
  • Care received outside of the Beaumont Health network will not be covered, and members will be required to cover the full cost for out-of-network care.

Network

Beaumont Health Network

You must receive care in the Beaumont Health Network system of doctors and hospitals and their affiliated clinics, outpatient facilities, labs, etc. Care received outside of the Beaumont Health 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 Beaumont Health 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%.

Deductible

$3,200
Individual
$6,400
Family

This is the amount you pay for in-network covered health care services before Priority Health begins to pay.

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.