HSA/POS Plan

Summary of Coverage

Medical plans for team members that live in Michigan in the following counties: Allegan, Barry, Berrien, Cass, Ionia, Kent, Lake, Macomb, Mason, Mecosta, Monroe, Montcalm, Muskegon, Newaygo, Oakland, Oceana, Osceola, Ottawa, Van Buren, Washtenaw or Wayne.


  • Access to Tier 1 Corewell Health, Tier 2 Priority Health, Cigna and Tier 3 out-of-network


Medical plans for team members that live in Michigan outside of the counties. Based on where you live, you may not have easy access to Corewell Health locations.


  • Access to Tier 1 AS Corewell Health, Priority Health OR Cigna and Tier 3 out-of-network


Medical plans for team members that live out of the state of Michigan.


  • Access to Tier 1 AS Corewell Health, Priority Health OR Cigna and Tier 3 out-of-network


The Priority Health HSA/POS medical plan is a high deductible health insurance plan with a health savings account (HSA) bank account. In this plan, all services with the exception of preventive care services, are subject to the full payment of the deductible prior to the plan paying for any services.

Coverage Details
Tier 1:
Network Only
Tier 2:

Network Only
Tier 3:

Out-of Network

Annual Deductible

$1,600 individual

$3,200 family

$2,000 individual

$4,000 family

$5,000 individual

$10,000 family

Coinsurance Max.

(per plan year)

-

-

-

Out-of-Pocket Limit*

(per plan year)

$5,000 individual $10,000 family

$5,000 individual $10,000 family

$10,000 individual

$20,000 family

Coinsurance

covered at 90%

covered at 70%

covered at 60%

* the family maximum is limited to no more than $9,100 per person under family for Tier 1 and Tier 2


Service Costs
Tier 1:

Network Only
Tier 2:

Network Only
Tier 3:

Out-of Network

Well Child Exam

no cost

no cost

no cost

Routine Adult

Physical Exam

no cost

no cost

no cost

Primary Care

Office Visit

covered at 90%

covered at 70%

covered at 60%

Specialist Office Visit

covered at 90%

covered at 70%

covered at 60%

Virtual care

(medical & behavioral health)

Covered in full.

Deductible will apply for illness injury virtual care.

Covered in full.

Deductible will apply for illness injury virtual care.

Not Applicable

Hospital

In/Outpatient

covered at 90%

covered at 70%

covered at 60%

Emergency

Department

$150 copayment

after deductible

$150 copayment

after deductible

$150 copayment

after deductible

How your plan pays for care:

You Pay:


Provider bills until you reach the deductible.


  • If a service does not have copay, such as hospitalization, you pay the provider bill.
  • In the HSA/POS plan, the individual deductible only applies to team member-only coverage. Covered families must meet the family deductible.


You + The Plan Pay:


Coinsurance. After the deductible is paid, you split costs with the plan until you reach your plan's out-of-pocket limit for the year.


  • Costs are higher outside of Tier 1 providers: your share of the bill, the deductible, and the out-of-pocket maximum all increase in the Tier 2 network.


The Plan Pays:


Once the out-of-pocket limit is met for the year, the plan will pay 100% for eligible costs.