MyPriority HMO Gold Copay+ – St. John Providence Network
| Plan Type: | HMO |
| Plan Tier: | Gold |
| Individual Deductible | $0.00 |
| Family Deductible | $0.00 |
| Individual Out of Pocket Max | $8,550.00 |
| Family Out of Pocket Max | $17,100.00 |
| Primary Care Visit: | $20.00 |
| Specialist Visit: | $45.00 |
| Emergency Room: | $250.00 |
| Hospital - Physician: | No Charge |
| Hospital - Facility: | $1000 Copay per Day |
| Link to Full SBC: | https://www.priorityhealth.com/-/media/BD8EE43618F54A4A9AFBF66C86DBE411.pdf |
| Plan Brochure: | https://www.priorityhealth.com/individual-family-health-insurance/2021/gold-copay-plus-st-john-providence?utm_campaign=oep-2021&utm_medium=website&utm_source=ffm-gold-copay-plus-st-john |
Other Coverage:
| Child Dental: | No |
| Adult Dental | No |
Prescription Drug Pricing:
| Generic Drugs: | $5.00 |
| Non-Preferred Brand Drugs: | $100.00 |
| Preferred Brand Drugs: | $75.00 |
| Specialty Drugs: | 50% |
| Summary of Benefits | https://www.priorityhealth.com/formulary |
This Carrier Offers:
About The Carrier
Priority Health is an award-winning health plan nationally recognized for creating innovative solutions that impact health care costs while maximizing customer experience. It offers a broad portfolio of products for employer groups and individuals including Medicare and Medicaid beneficiaries. As a nonprofit company, Priority Health serves more than 600,000 people and continues to be rated among the best health plans in the nation by the National Committee for Quality Assurance.
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