MyPriority HMO Bronze 8550 - Telehealth PCP Plan Details for 2021- HealthPocket

MyPriority HMO Bronze 8550 - Telehealth PCP

$281.71/mo

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Zip Code48228
Applicant9/17/1986 Male
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Benefits & Coverage

Insurance TypeACA (Obamacare)
Plan NameMyPriority HMO Bronze 8550 - Telehealth PCP
Plan IDhhs-29698MI0540416
Plan Year2021
Insurance ProviderPriority Health
Metal LevelExpanded Bronze
Plan TypeHMO
Deductible$8,550
Out-of-Pocket Maximum$8,550
Plan Highlights

Costs for Medical Care

Primary Care Visit to Treat an Injury or Illness$30 Copay
Specialist VisitNot Applicable
Laboratory Outpatient and Professional ServicesNot Applicable
X-rays and Diagnostic ImagingNot Applicable
Diagnostic Imaging such as MRIs, CT, and PET scansNot Applicable
Deductible - Family$17100 per group
Out-of-Pocket Maximum - Family$17100 per group

Prescription drug coverage

Generic Drugs$5 Copay
Preferred Brand DrugsNot Applicable
Non-Preferred Brand DrugsNot Applicable
Specialty DrugsNot Applicable

Access to doctors and hospitals

Provider directory URLhttp://priorityhealth.prismisp.com/
Does this plan have access to a national provider network?No
Is a referral required to see a Specialist?Yes - All Specialist Require Referral
Does this plan cover services outside plan service area?Yes - Urgent/Emergency Care Only
Does this plan cover services outside the country?Yes - Emergency Care Only

Hospital services

Emergency Room ServicesNot Applicable
Inpatient Hospital Services (e.g., Hospital Stay)Not Applicable
Inpatient Physician and Surgical ServicesNot Applicable
Emergency Transportation or Ambulance ServiceNot Applicable

Maternity

Prenatal and Postnatal CareNot Applicable
Delivery and all inpatient services for maternity careNot Applicable

Mental Health

Mental/Behavioral Health Outpatient Services$30 Copay
Mental/Behavioral Health Inpatient ServicesNot Applicable
Substance use disorder outpatient services$30 Copay
Substance use disorder inpatient servicesNot Applicable

Medical Management Programs

Does this plan offer disease managment programs?Asthma, Depression, Diabetes, Heart Disease, High Blood Pressure & High Cholesterol, Low Back Pain, Pain Management, Pregnancy, Weight Loss Programs
Does this plan offer a wellness program?Not Covered

Vision Coverage

Routine Eye Exam for ChildrenIncluded
Eye Glasses for ChildrenIncluded
Routine Eye Exam for AdultsNot Covered

Child Dental Coverage

Child Dental Coverage - Routine Dental CareNot Covered
Child Dental Coverage - Basic Dental CareNot Covered
Child Dental Coverage - OrthodontiaNot Covered
Child Dental Coverage - Major Dental CareNot Covered

Adult Dental Coverage

Adult Dental Coverage - Routine Dental CareNot Covered
Adult Dental Coverage - Basic Dental CareNot Covered
Adult Dental Coverage - OrthodontiaNot Covered
Adult Dental Coverage - Major Dental CareNot Covered

Exclusions and Limitations

More Included BenefitsOther Practitioner Office Visit (Nurse, Physician Assistant)
Preventive Care/Screening/Immunization
Infertility Treatment
Weight Loss Programs
Imaging (CT/PET Scans, MRIs)
Outpatient Surgery Physician/Surgical Services
Urgent Care Centers or Facilities
Inpatient Physician and Surgical Services
Home Health Care Services
Durable Medical Equipment
Applied Behavior Analysis Based Therapies
Allergy Testing
Chemotherapy
Diabetes Education
Dialysis
Infusion Therapy
Laboratory Outpatient and Professional Services
Prosthetic Devices
Radiation
Reconstructive Surgery
Transplant
Treatment for Temporomandibular Joint Disorders
Well Baby Visits and Care
Autism Spectrum Disorders
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)
More Limited BenefitsSkilled Nursing Facility
Bariatric Surgery
Outpatient Rehabilitation Services
Habilitation Services
Hospice Services
Chiropractic Care
Nutritional Counseling
Rehabilitative Occupational and Rehabilitative Physical Therapy
Rehabilitative Speech Therapy
More Excluded BenefitsAcupuncture
Cosmetic Surgery
Hearing Aids
Private-Duty Nursing
Dental Check-Up for Children
Routine Foot Care
Abortion for Which Public Funding is Prohibited
Accidental Dental
Long-Term/Custodial Nursing Home Care
PremiumPlan NameDeductible
from $172HAP Personal Alliance HMO Genesys Choice Catastrophic 8550$8,550.00Select
from $220McLaren Young Adult/Catastrophic$8,550.00Select
from $223MyPriority HMO Bronze 8550 - St. John Providence Network$8,550.00Select
from $224Oscar Secure (Free 24/7 Virtual Visits + Free Personal Care Tea$8,550.00Select
from $231MyPriority HMO Bronze 8550 - Beaumont Health Network$8,550.00Select
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Iamerica Behavioral & Mental Health
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William Prechel, D.O.
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  • Phone Number
    (313) 584-3624
  • Office Locations
    16551 W Warren Ave
    Detroit, MI 48228
16551 W Warren Ave Detroit MI, 48228

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HealthPocket.com is a free information source. We receive our data from government, non-profit and private sources, and you should confirm key provisions of your coverage with your selected health plan. Our website is not a health insurance agency and not affiliated with and does not represent or endorse any health plan. While on our site, if you click on a plan or link, you may be directed to one of our partners who offers health insurance products. HealthPocket, Inc. is part of the Benefytt Technologies, Inc. family of companies.