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Priority - MyPriority Silver 3200
Michigan, 2018
Plan Type
HMO
Metal Tier
Silver
Out of Pocket Maximum
$7,350
Deductible
$3,200
Emergency Room Care: $250 Copay after deductible + 30% Coinsurance 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) | $3,200 |
|---|---|
| Deductible (Family) | $6,400 |
| Coinsurance | Not applicable |
| Out of Pocket Maximum (Individual) | $7,350 |
| Out of Pocket Maximum (Family) | $14,700 |
Doctor Visits
| Primary Care Visit | Data Not Available |
|---|---|
| Specialist Visit | $45 Copay after deductible |
| Inpatient Facility | $500 Copay per day after deductible + 30% Coinsurance after deductible |
| Inpatient Physician | 30% Coinsurance after deductible |
| Emergency Room Services | $250 Copay after deductible + 30% Coinsurance after deductible |
Tests and Imaging
| Imaging (CT/PET Scans, MRIs) | $150 Copay after deductible + 30% Coinsurance after deductible |
|---|---|
| Laboratory Outpatient and Professional Services | 30% Coinsurance after deductible |
| X-Ray and Diagnostic Imaging | 30% 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 | $500 Copay per day after deductible + 30% Coinsurance after deductible |
|---|---|
| Mental / Behavioral Health Outpatient | Data Not Available |
| Rehabilitative Speech Therapy | 30% Coinsurance after deductible |
| Rehabilitative Occupational & Physical Therapy | 30% Coinsurance after deductible |
| Outpatient Facility | $1000 Copay after deductible + 30% Coinsurance after deductible |
| Outpatient Surgery | $1000 Copay after deductible + 30% Coinsurance after deductible |
Prescription Drugs
| Generic Rx | Data Not Available |
|---|---|
| Preferred Brand Rx | $75 Copay after deductible |
| Non Preferred Brand Rx | $100 Copay after deductible |
| Specialty Drugs | 50% Coinsurance after deductible |
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) | $4,900 |
| Out of Pocket Maximum (Family) | $9,800 |
Doctor Visits
| Primary Care Physician | |
|---|---|
| Specialists | $25 Copay after deductible |
| Emergency Room | 30% Coinsurance after deductible |
| Inpatient Facility | 30% Coinsurance after deductible |
| Inpatient Physician | 30% Coinsurance after deductible |
Prescription Drugs
| Generic Rx | |
|---|---|
| Preferred Brand Rx | $40 Copay after deductible |
| Non Preferred Brand Rx | $50 Copay after deductible |
| Specialty Drugs | 20% Coinsurance after deductible |
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) | $1,200 |
|---|---|
| Deductible (Family) | $2,400 |
| Out of Pocket Maximum (Individual) | $1,550 |
| Out of Pocket Maximum (Family) | $3,100 |
Doctor Visits
| Primary Care Physician | |
|---|---|
| Specialists | $25 Copay after deductible |
| Emergency Room | 20% Coinsurance after deductible |
| Inpatient Facility | 20% Coinsurance after deductible |
| Inpatient Physician | 20% Coinsurance after deductible |
Prescription Drugs
| Generic Rx | |
|---|---|
| Preferred Brand Rx | $25 Copay after deductible |
| Non Preferred Brand Rx | $50 Copay after deductible |
| Specialty Drugs | 20% Coinsurance after deductible |
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) | $500 |
|---|---|
| Deductible (Family) | $1,000 |
| Out of Pocket Maximum (Individual) | $675 |
| Out of Pocket Maximum (Family) | $1,350 |
Doctor Visits
| Primary Care Physician | |
|---|---|
| Specialists | $10 Copay after deductible |
| Emergency Room | 20% Coinsurance after deductible |
| Inpatient Facility | 20% Coinsurance after deductible |
| Inpatient Physician | 20% Coinsurance after deductible |
Prescription Drugs
| Generic Rx | |
|---|---|
| Preferred Brand Rx | $15 Copay after deductible |
| Non Preferred Brand Rx | $25 Copay after deductible |
| Specialty Drugs | 20% Coinsurance after deductible |
Other Plans in Michigan
| Plan | Deductible | Coinsurance | Out of Pocket |
|---|---|---|---|
| Plan MyPriority HSA Bronze 6650 - Bronson Healthcare Partners | Deductible $6,650 | Coinsurance Not applicable | Out of Pocket $6,650 |
| Plan MyPriority HSA Bronze 6650 - St. John Providence Network | Deductible $6,650 | Coinsurance Not applicable | Out of Pocket $6,650 |
| Plan MyPriority Gold 1100 | Deductible $1,100 | Coinsurance Not applicable | Out of Pocket $7,350 |
| Plan MyPriority Silver 3200 - Spectrum Health Partners | Deductible $3,200 | Coinsurance Not applicable | Out of Pocket $7,350 |
| Plan MyPriority HSA Bronze 6650 - St. Joseph Mercy Health System Network | Deductible $6,650 | Coinsurance Not applicable | Out of Pocket $6,650 |
| Plan MyPriority HSA Bronze 6650 - Beaumont Health Network | Deductible $6,650 | Coinsurance Not applicable | Out of Pocket $6,650 |
| Plan MyPriority HSA Bronze 6650 - Spectrum Health Partners | Deductible $6,650 | Coinsurance Not applicable | Out of Pocket $6,650 |
| Plan MyPriority Silver 3200 - St. John Providence Network | Deductible $3,200 | Coinsurance Not applicable | Out of Pocket $7,350 |
| Plan MyPriority Silver 3200 - Bronson Healthcare Partners | Deductible $3,200 | Coinsurance Not applicable | Out of Pocket $7,350 |
| Plan MyPriority Silver 3200 - Beaumont Health Network | Deductible $3,200 | Coinsurance Not applicable | Out of Pocket $7,350 |
| Plan MyPriority Silver 3200 - St. Joseph Mercy Health System Network | Deductible $3,200 | Coinsurance Not applicable | Out of Pocket $7,350 |
| Plan MyPriority HSA Bronze 6650 | Deductible $6,650 | Coinsurance Not applicable | Out of Pocket $6,650 |