MyPriority Enhanced Gold Southeast Michigan Network

Priority Health · 2026 plan year

Gold
Ind. deductible
$0
Family deductible
$0
Ind. OOP max
$9,200
Family OOP max
$18,400

Compare with other Gold plans in MI

Side by side: deductibles, out-of-pocket limits and copays.

More Priority Health plans in MI

Monthly premiums by age

Rating Area 2 — the lowest-priced of the 2 areas this plan covers. Premiums differ by area.

AgeIndividualIndividual + tobacco
Under 15$444$444
21$580$610
30$659$725
40$742$816
50$1,037$1,192
60$1,575$1,812
64 and over$1,741$2,003

Live premium estimate

$

Benefits & cost sharing

Primary Care

BenefitIn-network
Preventive Care/Screening/ImmunizationNo charge
Primary Care Visit to Treat an Injury or Illness$20.00

Specialist

BenefitIn-network
Specialist Visit$45.00

Hospital

BenefitIn-network
Emergency Room Services$250.00
Inpatient Hospital Services (e.g., Hospital Stay)$1000.00 Copay per Day
Outpatient Surgery Physician/Surgical ServicesNo charge
Urgent Care Centers or Facilities$75.00

Pharmacy

BenefitIn-network
Generic Drugs$5.00
Non-Preferred Brand Drugs$100.00
Preferred Brand Drugs$75.00
Specialty Drugs50.00%

Mental Health

BenefitIn-network
Mental/Behavioral Health Inpatient Services$1000.00 Copay per Day
Mental/Behavioral Health Outpatient Services$20.00

Other

BenefitIn-network
Cosmetic SurgeryNot covered
Basic Dental Care - AdultNot covered
Basic Dental Care - ChildNot covered
Chemotherapy$45.00
Chiropractic Care$45.00
Abortion for Which Public Funding is ProhibitedNot covered
Accidental DentalNot covered
AcupunctureNot covered
Allergy Testing$250.00
Applied Behavior Analysis Based Therapies$20.00
Autism Spectrum Disorders$45.00
Bariatric Surgery50.00%
Delivery and All Inpatient Services for Maternity Care$1,000.00
Dental Check-Up for ChildrenNot covered
Diabetes EducationNo charge
Dialysis$45.00
Durable Medical Equipment50.00%
Emergency Transportation/Ambulance$250.00
Eye Glasses for ChildrenNo charge
Habilitation Services$45.00
Hearing AidsNot covered
Home Health Care Services$45.00
Hospice ServicesNo charge
Imaging (CT/PET Scans, MRIs)$250.00
Infertility Treatment50.00%
Infusion Therapy50.00%
Inpatient Physician and Surgical ServicesNo charge
Laboratory Outpatient and Professional Services$45.00
Long-Term/Custodial Nursing Home CareNot covered
Major Dental Care - AdultNot covered
Major Dental Care - ChildNot covered
Nutritional CounselingNo charge
Orthodontia - AdultNot covered
Orthodontia - ChildNot covered
Other Practitioner Office Visit (Nurse, Physician Assistant)$45.00
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)$1,000.00
Outpatient Rehabilitation Services$45.00
Prenatal and Postnatal CareNo charge
Private-Duty NursingNot covered
Prosthetic Devices50.00%
Radiation$45.00
Reconstructive Surgery50.00%
Rehabilitative Occupational and Rehabilitative Physical Therapy$45.00
Rehabilitative Speech Therapy$45.00
Routine Dental Services (Adult)Not covered
Routine Eye Exam (Adult)Not covered
Routine Eye Exam for ChildrenNo charge
Routine Foot CareNot covered
Skilled Nursing Facility$1000.00 Copay per Day
Specified Sex-Trait Modification Procedures$45.00
Substance Abuse Disorder Inpatient Services$1000.00 Copay per Day
Substance Abuse Disorder Outpatient ServicesNo charge
TransplantSee plan details
Treatment for Temporomandibular Joint Disorders50.00%
Weight Loss Programs$45.00
Well Baby Visits and CareNo charge
X-rays and Diagnostic Imaging$45.00

Plan rules

Service area

This plan covers 3 geographic areas.

Open enrollment coming up?

Get notified when it opens — we'll remind you so you don't miss your window.