MyPriority HMO Silver 5500 – St. John Providence Network
| Plan Type: | HMO |
| Plan Tier: | Silver |
| Individual Deductible | $5,500.00 |
| Family Deductible | $11,000.00 |
| Individual Out of Pocket Max | $8,550.00 |
| Family Out of Pocket Max | $17,100.00 |
| Primary Care Visit: | $30.00 |
| Specialist Visit: | $65.00 |
| Emergency Room: | $250 Copay after deductible and 30% Coinsurance after deductible |
| Hospital - Physician: | 30% Coinsurance after deductible |
| Hospital - Facility: | $500 Copay per Day after deductible and 30% Coinsurance after deductible |
| Link to Full SBC: | https://www.priorityhealth.com/-/media/ABE3C51AE14A4DE2B95312CC16F1F80D.pdf |
| Plan Brochure: | https://www.priorityhealth.com/individual-family-health-insurance/2021/silver-5500-st-john-providence?utm_campaign=oep-2021&utm_medium=website&utm_source=ffm-silver-5500-st-john |
Other Coverage:
| Child Dental: | No |
| Adult Dental | No |
Prescription Drug Pricing:
| Generic Drugs: | $5.00 |
| Non-Preferred Brand Drugs: | $125.00 |
| Preferred Brand Drugs: | $75.00 |
| Specialty Drugs: | 50% Coinsurance after deductible |
| 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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