Choosing the right health insurance can feel overwhelming, but Priority Health insurance simplifies the process with affordable, flexible plans.
Based in Michigan, this nonprofit offers coverage for individuals, families, and businesses.
This article explores Priority Health’s plans, costs, benefits, and tips for picking the best option in 2025.
What Is Priority Health Insurance?
Priority Health insurance is provided by Priority Health, a Michigan-based nonprofit serving over 600,000 members.
It offers plans for individuals, employers, Medicare, and Medicaid beneficiaries. Known for high customer satisfaction, it’s a top choice in Michigan’s Lower Peninsula.
The company emphasizes innovative solutions, like telehealth and cost-saving tools, to enhance care. Its plans are designed to balance affordability and comprehensive coverage.
Types of Plans Offered
Priority Health provides a variety of plans to suit different needs. MyPriority plans cater to individuals and families, available through the ACA Marketplace. Medicare Advantage and Medigap plans serve seniors, while Medicaid plans support low-income residents.
Employer-sponsored plans are tailored for businesses of all sizes. Specialized options, like HMO-POS and PPO plans, offer flexibility in provider choice.
MyPriority Individual and Family Plans
MyPriority plans are popular for their value and ACA compliance. They come in Bronze, Silver, and Gold tiers, with varying premiums and out-of-pocket costs. Bronze plans have lower premiums but higher deductibles, while Gold plans offer more coverage.
Subsidies can lower costs, with 80% of enrollees paying less than $10 monthly. These plans include preventive care and chronic condition management at low or no cost.
Medicare Advantage and Medigap
Priority Health’s Medicare Advantage plans are highly rated, earning a 4.5-star rating in 2024. Options include HMO-POS, PPO, and D-SNP plans, all with prescription drug coverage. Plans start at $0 monthly and include dental, vision, and gym memberships.
Medigap plans help cover Original Medicare gaps, like deductibles and coinsurance. They’re ideal for those wanting predictable costs and foreign travel benefits.
Medicaid and MIChild Plans
Priority Health offers Medicaid plans, including Healthy Michigan Plan and MIChild, for low-income individuals and families. These plans provide comprehensive care, including free transportation to appointments. Children’s Special Health Care Services support kids with specific needs.
Eligibility depends on income and family size. Enrollment is open year-round, ensuring access for qualifying residents.
Employer-Sponsored Plans
Priority Health insurance excels in group plans for businesses, from small startups to large corporations. Plans like PriorityIntegra offer narrow networks for cost savings, while optional riders add benefits like fertility support. These plans focus on managing chronic conditions and employee wellness.
Small businesses may qualify for tax credits, making coverage affordable. Employees benefit from large networks and low-cost care options.
Costs of Priority Health Plans
Costs vary by plan type, tier, and location. MyPriority premiums range from $300 to $700 monthly for individuals in 2025. Medicare Advantage plans often have $0 premiums, but copays and coinsurance apply.
Deductibles and out-of-pocket maximums affect expenses. Subsidies or employer contributions can significantly reduce costs.
Here’s a table comparing MyPriority plan tiers for a single adult:
| Plan Tier | Monthly Premium | Deductible | Out-of-Pocket Max |
|---|---|---|---|
| Bronze | $300–$400 | $7,500 | $9,200 |
| Silver | $400–$500 | $4,000 | $8,700 |
| Gold | $500–$700 | $1,500 | $7,000 |
Note: Costs are approximate for 2025 and vary by county.
Enrollment Periods
Marketplace open enrollment runs from November 1 to January 15, with coverage starting January 1 if enrolled by December 15. Special Enrollment Periods (SEPs) apply for life events like marriage or job loss. Medicare enrollment occurs from October 15 to December 7.
Medicaid and MIChild allow year-round enrollment. Employer plans typically enroll during annual open enrollment or upon hiring.
Key Features of Priority Health
Priority Health insurance offers benefits that enhance care and save money. Here are some highlights:
- Wide Network: Includes every major hospital in Michigan’s Lower Peninsula.
- No Referrals: See in-network specialists without prior approval.
- Telehealth: Access Teladoc for mental health and virtual care.
- Cost Tools: PriceMyMeds and Cost Estimator help plan expenses.
These features make Priority Health user-friendly and cost-effective.
Provider Networks
Priority Health’s network covers all major Michigan hospitals and thousands of providers. HMO-POS plans require in-network care but allow out-of-network visits at higher costs. PPO plans offer more flexibility, ideal for those who travel or prefer specific doctors.
Use the online Find a Doctor tool to check in-network status. Narrow network options, like PriorityIntegra, lower costs but limit provider choices.
Special Considerations
Priority Health caters to diverse groups. Young adults can stay on a parent’s plan until age 26. Self-employed individuals benefit from Marketplace subsidies and tax deductions. Retirees, like MPSERS members, get tailored Medicare plans with extra benefits.
Travelers enjoy out-of-state coverage with PPO plans. Those with chronic conditions access low-cost care before meeting deductibles.
Tips for Choosing a Plan
Start by assessing your healthcare needs. Healthy individuals may prefer Bronze plans for lower premiums. Families or those with frequent doctor visits might choose Silver or Gold plans for lower copays.
Compare networks to ensure your doctors are included. Use Priority Health’s Cost Estimator to predict expenses and apply for subsidies on Healthcare.gov.
Claims and Billing
In-network providers often file claims directly, so you only pay copays or deductibles. Out-of-network claims may require you to submit paperwork. The Priority Health app lets you track claims, view costs, and share ID cards with providers.
Keep receipts for out-of-network care. Your Explanation of Benefits (EOB) details what’s covered and what you owe.
Wellness and Preventive Care
Priority Health emphasizes prevention with $0 preventive care, like screenings and vaccines. Programs like PriorityMOM support pregnant members with gifts and cost guidance. The Wellbeing Hub offers personalized health tips and rewards.
Chronic condition management includes low-cost drugs and visits before deductibles. These tools help you stay healthy and save money.
Future of Priority Health Insurance
Priority Health is adapting to 2025 with new offerings, like HMA for employer groups and enhanced dental packages. Policy changes, such as ACA subsidy updates, may affect costs. The company is expanding telehealth and digital tools for better access.
Check Priority Health’s website or Healthcare.gov for updates. Annual plan reviews ensure your coverage aligns with your needs.
Summary
Priority Health insurance offers a range of plans for individuals, families, businesses, and seniors in Michigan. MyPriority, Medicare, Medicaid, and employer plans provide flexibility, affordability, and access to a large network.
With no-referral specialist visits, telehealth, and cost-saving tools, Priority Health prioritizes member satisfaction. By understanding costs, enrollment, and benefits, you can choose a plan that fits your health and budget.
FAQ
What is Priority Health insurance?
Priority Health is a Michigan nonprofit offering MyPriority, Medicare, Medicaid, and employer plans. It covers preventive care, prescriptions, and more with a large network. Plans are affordable with subsidies for many members.
How do I enroll in a Priority Health plan?
Marketplace enrollment is November 1 to January 15, with SEPs for life events. Medicare enrollment is October 15 to December 7. Medicaid and employer plans have separate timelines.
What does Priority Health cover?
Plans cover hospital stays, doctor visits, preventive care, prescriptions, and mental health. Medicare plans add dental and vision. Check your plan’s Summary of Benefits for details.
How can I lower costs with Priority Health?
Apply for Marketplace subsidies, use in-network providers, and take advantage of free preventive care. Tools like PriceMyMeds and Cost Estimator help plan expenses.
How do I find in-network providers?
Use the Find a Doctor tool on Priority Health’s website, filtering by MyPriority or Medicare plans. Confirm provider status before booking to avoid higher costs.