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PriorityMedicare Key (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for PriorityMedicare Key (HMO-POS). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on PriorityMedicare Key (HMO-POS) in 2026, please refer to our full plan details page.
PriorityMedicare Key (HMO-POS) is a HMO-POS plan offered by Corewell Health available for enrollment in 2025 to people living in 68 lower peninsula Michigan counties. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that PriorityMedicare Key (HMO-POS) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Key Plan Facts
Below are a few key facts and commonly-asked questions about PriorityMedicare Key (HMO-POS).
Plan Costs:
The cost of a Medicare Advantage Plan is made up of four main parts.
- First, the monthly premium — the amount you pay every month.
- Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
- Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
- Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.
For PriorityMedicare Key (HMO-POS), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. This is the amount you must pay every month.
This plan does not come with a Part B Premium reduction. You must continue to pay your Part B premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
This plan has a $200.00 drug deductible. You will need to pay this amount towards covered prescriptions before your insurance coverage for prescription medications kicks in.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $5800.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.
Common Services:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
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Drug Coverage
The PriorityMedicare Key (HMO-POS) plan features an annual drug deductible of $200. For Tier 1 preferred generic drugs, you will pay no copay for a 3-month supply at preferred pharmacies or through preferred mail order, while a 1-month supply starts at a $2 copay. Tier 2 generic drugs also offer no copay for a 3-month supply through preferred mail order, with standard pharmacies charging a $15 copay for a 1-month supply. For higher-tier medications, your costs transition to coinsurance. Tier 3 preferred brand drugs require a 22% coinsurance at preferred pharmacies and 25% at standard pharmacies, while Tier 4 non-preferred drugs range from 25% to 30% coinsurance. Specialty drugs in Tier 5 carry a consistent 30% coinsurance for a 1-month supply across all pharmacy and mail-order options.
Additional Benefits
The PriorityMedicare Key (HMO-POS) plan offers comprehensive medical coverage with predictable costs, featuring no copay for primary care visits, telehealth services, and routine preventive care. For specialized care, members pay between no copay and a $40 copay for specialists and mental health services, with no coinsurance. Inpatient hospital stays require daily copays for the first several days before transitioning to no copay, while emergency care is covered with a $130 copay that is waived if admitted. This plan also includes valuable supplemental benefits, such as dental and vision care with no copay up to specified annual limits, and routine hearing exams with no copay. Prescription hearing aids are available with copays ranging from $295 to $1,495, and home health services are fully covered with no copay or coinsurance. While many services feature no coinsurance, some items like durable medical equipment and dialysis require a 20% coinsurance.
Inpatient Hospital See details
PriorityMedicare Key (HMO-POS) partially covers inpatient hospital services with no coinsurance, requiring prior authorization and a copay of $350 per day for days 1 to 7 of acute stays and $275 per day for days 1 to 6 of psychiatric stays, with no copay for remaining days. Non-Medicare-covered stays, hospital upgrades, and additional psychiatric days are not covered.
Outpatient Services See details
Outpatient services under PriorityMedicare Key (HMO-POS) are covered with no coinsurance, featuring a $0 to $350 copay for outpatient hospital services and a $130 copay per stay for observation services. Ambulatory surgical center services require a $40 copay and no coinsurance, outpatient substance abuse sessions carry a $20 copay and no coinsurance, and outpatient blood services are covered with no copay, coinsurance, or deductible.
Partial Hospitalization See details
Partial hospitalization is covered by PriorityMedicare Key (HMO-POS) with a $55 copay and no coinsurance. Prior authorization is required for some of these services.
Ambulance and Transportation Services See details
PriorityMedicare Key (HMO-POS) covers Medicare-approved ground and air ambulance services with a $270 copay and no coinsurance, subject to prior authorization. Although some transportation services are covered, transportation to plan-approved or any health-related locations is not covered.
Emergency Services See details
PriorityMedicare Key (HMO-POS) covers emergency services with a $130 copay and urgently needed services with a $50 copay, both featuring no coinsurance and copays waived if admitted to the hospital within 24 hours. Worldwide emergency, urgent, and transportation services are also covered with no coinsurance and copays of $130, $50, and $270, respectively.
Primary Care See details
PriorityMedicare Key (HMO-POS) offers partially covered primary care benefits, as podiatry services are not covered. Covered services feature no coinsurance, with no copay for primary care and telehealth, a $25 copay for therapy services, and copays ranging from $0 to $40 for specialists, chiropractic, and mental health care.
Preventive Services See details
PriorityMedicare Key (HMO-POS) covers preventive services with no copay and no coinsurance, including annual physical exams, kidney disease education, and diabetes self-management training. Additional preventive benefits are partially covered, excluding services such as medical nutrition therapy, personal emergency response systems, weight management programs, and alternative therapies.
Hearing Services See details
Hearing services are covered by PriorityMedicare Key (HMO-POS), offering routine hearing exams and fitting evaluations with no copay or coinsurance. Prescription hearing aids are partially covered with no coinsurance and a copay ranging from $295 to $1,495 for up to two aids per year, though OTC hearing aids and inner, outer, or over-the-ear prescription models are not covered.
Vision Services See details
PriorityMedicare Key (HMO-POS) covers annual routine eye exams and retinal imaging with a $40 copay and no coinsurance. Eyewear, including contacts and eyeglasses, is covered with no copay or coinsurance up to a $100 annual maximum benefit.
Dental Services See details
PriorityMedicare Key (HMO-POS) partially covers dental services, featuring no copay and no coinsurance for preventive and comprehensive benefits up to a $1,500 annual maximum, while Medicare-covered dental has a $0 to $350 copay and no coinsurance. Other diagnostic dental services, other preventive dental services, maxillofacial prosthetics, and orthodontics are not covered.
Home Infusion bundled Services See details
PriorityMedicare Key (HMO-POS) covers home infusion bundled services with no copay and no coinsurance, though prior authorization is required. Medicare Part B chemotherapy, radiation, and other drugs require 0% to 20% coinsurance, while Part B insulin is covered with a $35 copay and 0% to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered under the PriorityMedicare Key (HMO-POS) plan with no copay and a 20% coinsurance.
Medical Equipment See details
PriorityMedicare Key (HMO-POS) covers durable medical equipment and medical supplies with no copay and 20% coinsurance, and prosthetic devices with no copay and 0% to 20% coinsurance. Diabetic equipment is partially covered with no copay and no coinsurance, though diabetic supplies and diabetic therapeutic shoes or inserts are not covered.
Diagnostic and Radiological Services See details
PriorityMedicare Key (HMO-POS) covers diagnostic and radiological services with no coinsurance, although prior authorization is required. Under this plan, there is no copay for lab services, a $10 copay for diagnostic procedures and tests, a $35 copay for outpatient X-rays, a minimum $25 copay for therapeutic radiological services, and a minimum $225 copay for diagnostic radiological services.
Home Health Services See details
Home Health Services are covered under the PriorityMedicare Key (HMO-POS) plan with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the PriorityMedicare Key (HMO-POS) plan. All key sub-services, including intensive cardiac, pulmonary, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD), are excluded from coverage.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are partially covered by PriorityMedicare Key (HMO-POS) with no coinsurance, requiring no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required and a prior three-day hospital stay is not needed, but additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
PriorityMedicare Key (HMO-POS) partially covers other services, excluding meal benefits. Covered services include acupuncture with a $20 copay and no coinsurance (limited to 6 treatments per year), ambulance stabilization with a $270 copay and no coinsurance, and over-the-counter items and annual wellness visits with no copay and no coinsurance.
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