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Priority - MyPriority HMO Federal Standard Silver 3500
Michigan, 2017
Plan Type
HMO
Metal Tier
Silver
Out of Pocket Maximum
$7,150
Deductible
$3,500
Emergency Room Care: $400 Copay after deductible
Cost Sharing Benefits (In Network)
Policyholders are generally responsible for 100% of costs until the deductible amount is met. After the deductible has been met the policyholder is responsible for the coinsurance / copay until the out of pocket maximum is reached at which point the insurance company assumes 100% of all costs.
| Deductible (Individual) | $3,500 |
|---|---|
| Deductible (Family) | $7,000 |
| Coinsurance | Not applicable |
| Out of Pocket Maximum (Individual) | $7,150 |
| Out of Pocket Maximum (Family) | $14,300 |
Doctor Visits
| Primary Care Visit | Data Not Available |
|---|---|
| Specialist Visit | Data Not Available |
| Inpatient Facility | 20% Coinsurance after deductible |
| Inpatient Physician | 20% Coinsurance after deductible |
| Emergency Room Services | $400 Copay after deductible |
Tests and Imaging
| Imaging (CT/PET Scans, MRIs) | 20% Coinsurance after deductible |
|---|---|
| Laboratory Outpatient and Professional Services | 20% Coinsurance after deductible |
| X-Ray and Diagnostic Imaging | 20% Coinsurance after deductible |
Health Management Programs
| Asthma | Available |
|---|---|
| Depression | Available |
| Diabetes | Available |
| Heart Disease | Available |
| High Blood Pressure / High Cholesterol | Available |
| Lower Back Pain | Available |
| Pain Management | Available |
| Pregnancy | Available |
| Weight Loss | Available |
Other
| Mental / Behavioral Health Inpatient | 20% Coinsurance after deductible |
|---|---|
| Mental / Behavioral Health Outpatient | Data Not Available |
| Rehabilitative Speech Therapy | 20% Coinsurance after deductible |
| Rehabilitative Occupational & Physical Therapy | 20% Coinsurance after deductible |
| Outpatient Facility | 20% Coinsurance after deductible |
| Outpatient Surgery | 20% Coinsurance after deductible |
Prescription Drugs
| Generic Rx | Data Not Available |
|---|---|
| Preferred Brand Rx | Data Not Available |
| Non Preferred Brand Rx | Data Not Available |
| Specialty Drugs |
73% Cost Sharing Benefits
Households with incomes between 200% to 250% of FPL qualify for the following cost sharing benefits for this silver plan. To understand how cost sharing reductions work and how they work for you see our article about Obamacare Cost Sharing Reduction Discounts
Deductibles and Cost Sharing
| Deductible (Individual) | $3,000 |
|---|---|
| Deductible (Family) | $6,000 |
| Out of Pocket Maximum (Individual) | $5,700 |
| Out of Pocket Maximum (Family) | $11,400 |
Doctor Visits
| Primary Care Physician | |
|---|---|
| Specialists | |
| Emergency Room | $300 Copay after deductible |
| Inpatient Facility | 20% Coinsurance after deductible |
| Inpatient Physician | 20% Coinsurance after deductible |
Prescription Drugs
| Generic Rx | |
|---|---|
| Preferred Brand Rx | |
| Non Preferred Brand Rx | |
| Specialty Drugs |
87% Cost Sharing Benefits
Households with incomes between 150% to 200% of FPL qualify for the following cost sharing benefits for this silver plan.
Deductibles and Cost Sharing
| Deductible (Individual) | $700 |
|---|---|
| Deductible (Family) | $1,400 |
| Out of Pocket Maximum (Individual) | $2,000 |
| Out of Pocket Maximum (Family) | $4,000 |
Doctor Visits
| Primary Care Physician | |
|---|---|
| Specialists | |
| Emergency Room | $150 Copay after deductible |
| Inpatient Facility | 20% Coinsurance after deductible |
| Inpatient Physician | 20% Coinsurance after deductible |
Prescription Drugs
| Generic Rx | |
|---|---|
| Preferred Brand Rx | |
| Non Preferred Brand Rx | |
| Specialty Drugs |
94% Cost Sharing Benefits
Households with incomes between 138% to 150% of FPL qualify for the following cost sharing benefits for this silver plan.
Deductibles and Cost Sharing
| Deductible (Individual) | $250 |
|---|---|
| Deductible (Family) | $500 |
| Out of Pocket Maximum (Individual) | $1,250 |
| Out of Pocket Maximum (Family) | $2,500 |
Doctor Visits
| Primary Care Physician | |
|---|---|
| Specialists | |
| Emergency Room | $100 Copay after deductible |
| Inpatient Facility | 5% Coinsurance after deductible |
| Inpatient Physician | 5% Coinsurance after deductible |
Prescription Drugs
| Generic Rx | |
|---|---|
| Preferred Brand Rx | |
| Non Preferred Brand Rx | |
| Specialty Drugs |
Other Plans in Michigan
| Plan | Deductible | Coinsurance | Out of Pocket |
|---|---|---|---|
| Plan MyPriority HMO HSA Bronze 6550 | Deductible $6,550 | Coinsurance Not applicable | Out of Pocket $6,550 |
| Plan MyPriority HMO Holistic Silver 2500 | Deductible $2,500 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan MyPriority POS RxPlus Silver 2500 | Deductible $2,500 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan MyPriority POS RxPlus Bronze 4500 | Deductible $4,500 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan MyPriority POS Bronze 6700 | Deductible $6,700 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan MyPriority HMO RxPlus Silver 1800 | Deductible $1,800 | Coinsurance Not applicable | Out of Pocket $6,600 |
| Plan MyPriority Holistic Bronze - Bronson Healthcare Partners | Deductible $5,550 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan MyPriority RxPlus - Spectrum Health Partners | Deductible $1,800 | Coinsurance Not applicable | Out of Pocket $6,600 |
| Plan MyPriority HMO RxPlus Silver 2500 | Deductible $2,500 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan MyPriority POS HSA Bronze 6550 | Deductible $6,550 | Coinsurance Not applicable | Out of Pocket $6,550 |
| Plan MyPriority HMO Silver 1400 | Deductible $1,400 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan MyPriority HMO Bronze 6700 | Deductible $6,700 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan MyPriority POS HSA Silver 1500 | Deductible $1,500 | Coinsurance Not applicable | Out of Pocket $5,250 |
| Plan MyPriority POS RxPlus Bronze 4500 | Deductible $4,500 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan MyPriority Holistic Silver - Bronson Healthcare Partners | Deductible $2,500 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan MyPriority POS Silver 1400 | Deductible $1,400 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan MyPriority POS Silver 2000 | Deductible $2,000 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan MyPriority POS HSA Bronze 6550 | Deductible $6,550 | Coinsurance Not applicable | Out of Pocket $6,550 |
| Plan MyPriority HSA - Spectrum Health Partners | Deductible $6,550 | Coinsurance Not applicable | Out of Pocket $6,550 |
| Plan MyPriority Holistic Silver - Spectrum Health Partners | Deductible $2,500 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan MyPriority POS RxPlus Silver 2500 | Deductible $2,500 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan MyPriority POS HSA Silver 1500 | Deductible $1,500 | Coinsurance Not applicable | Out of Pocket $5,250 |
| Plan MyPriority POS Holistic Silver 2500 | Deductible $2,500 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan MyPriority Holistic Bronze - Spectrum Health Partners | Deductible $5,550 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan MyPriority POS Holistic Bronze 5550 | Deductible $5,550 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan MyPriority HMO RxPlus Bronze 4500 | Deductible $4,500 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan MyPriority POS RxPlus Silver 1800 | Deductible $1,800 | Coinsurance Not applicable | Out of Pocket $6,600 |
| Plan MyPriority RxPlus - Bronson Healthcare Partners | Deductible $1,800 | Coinsurance Not applicable | Out of Pocket $6,600 |
| Plan MyPriority HMO HSA Silver 1500 | Deductible $1,500 | Coinsurance Not applicable | Out of Pocket $5,250 |
| Plan MyPriority POS Bronze 6700 | Deductible $6,700 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan MyPriority HMO Silver 2000 | Deductible $2,000 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan MyPriority POS Silver 1400 | Deductible $1,400 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan MyPriority POS Silver 2000 | Deductible $2,000 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan MyPriority HMO RxPlus Silver 1900 | Deductible $1,900 | Coinsurance Not applicable | Out of Pocket $6,600 |
| Plan MyPriority HSA - Bronson Healthcare Partners | Deductible $6,550 | Coinsurance Not applicable | Out of Pocket $6,550 |
| Plan MyPriority HMO Holistic Bronze 5550 | Deductible $5,550 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan MyPriority HMO RxPlus Gold 800 | Deductible $800 | Coinsurance Not applicable | Out of Pocket $7,000 |
| Plan MyPriority POS Holistic Bronze 5550 | Deductible $5,550 | Coinsurance Not applicable | Out of Pocket $7,150 |
| Plan MyPriority POS RxPlus Silver 1800 | Deductible $1,800 | Coinsurance Not applicable | Out of Pocket $6,600 |
| Plan MyPriority POS Holistic Silver 2500 | Deductible $2,500 | Coinsurance Not applicable | Out of Pocket $7,150 |