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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 2025, 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 2025.
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 no drug deductible. Your prescription medication coverage will start immediately.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $5500.00 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 has an enhanced alternative drug benefit. The plan has no deductible. In the initial coverage phase, you will pay a copay or coinsurance depending on the drug tier and the pharmacy you use. For example, preferred generic drugs have a $15 copay at preferred pharmacies. Once your total drug costs reach $2000, you enter the catastrophic coverage phase where you pay nothing for your Part D covered drugs.
Additional Benefits
The PriorityMedicare Key (HMO-POS) plan offers comprehensive coverage, including inpatient hospital stays with a copay, outpatient services with copays ranging from $0 to $350, and emergency and ambulance services. It also includes coverage for primary care, preventive services, hearing, vision, and dental care. This plan provides additional benefits such as home health services with no copay, and coverage for diagnostic and radiological services. It also covers other services, including acupuncture and over-the-counter items.
Inpatient Hospital See details
The PriorityMedicare Key (HMO-POS) plan covers Inpatient Hospital services, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric. For Inpatient Hospital-Acute, you'll pay a $350 copay for days 1-7, and no copay for days 8-90, with no coinsurance. For Inpatient Hospital Psychiatric, you'll pay a $275 copay for days 1-6, and no copay for days 7-90, with no coinsurance. Additional days for Inpatient Hospital-Acute are covered with no copay, and Non-Medicare-covered stays and upgrades are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services, with a copay ranging from $0 to $350, and observation services with a $120 copay. Ambulatory Surgical Center (ASC) Services have a $350 copay, and outpatient substance abuse services have a $20 copay for both individual and group sessions. Outpatient blood services are also covered, with a waived deductible for three pints.
Partial Hospitalization See details
Partial Hospitalization is covered by PriorityMedicare Key (HMO-POS) with a $55 copay, and prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the PriorityMedicare Key (HMO-POS) plan. Medicare-covered ground and air ambulance services have a $270 copay, and there is no coinsurance. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered under the PriorityMedicare Key (HMO-POS) plan. Emergency Services have a $120 copay, Urgently Needed Services have a $50 copay, Worldwide Emergency Coverage has a $120 copay, Worldwide Urgent Coverage has a $50 copay, and Worldwide Emergency Transportation has a $270 copay.
Primary Care See details
The PriorityMedicare Key (HMO-POS) plan covers primary care physician services, chiropractic services with a $20 copay, occupational therapy services with a $25 copay, physician specialist services with a $0-$40 copay, mental health specialty services with a $20 copay for individual and group sessions, other health care professional services with a $0-$40 copay, psychiatric services with a $20 copay for individual and group sessions, physical therapy and speech-language pathology services with a $25 copay, additional telehealth benefits, and opioid treatment program services with a $20 copay. Podiatry services are not covered.
Preventive Services See details
The PriorityMedicare Key (HMO-POS) plan covers preventive services including Medicare-covered zero-dollar services, annual physical exams, health education, and in-home safety assessments. Additional covered services include nutritional/dietary benefits, fitness benefits, enhanced disease management, telemonitoring services, kidney disease education services, glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, and EKG following a welcome visit. However, the plan does not cover personal emergency response systems, medical nutrition therapy, re-admission prevention, wigs for hair loss related to chemotherapy, weight management programs, alternative therapies, therapeutic massage, adult day health services, home-based palliative care, in-home support services, support for caregivers, additional sessions of smoking cessation, remote access technologies, and counseling services. Home and bathroom safety devices and modifications are covered up to $75 every three months.
Hearing Services See details
Hearing Services include routine hearing exams with no copay, and fitting/evaluation for hearing aids. Prescription hearing aids are covered with a copay between $295 and $1495, but prescription hearing aids for the inner ear, outer ear, and over the ear are not covered. OTC hearing aids are not covered.
Vision Services See details
The PriorityMedicare Key (HMO-POS) plan covers eye exams with a $40 copay, with one routine eye exam covered per year. Eyewear benefits include coverage for contact lenses, eyeglasses (lenses and frames), and eyeglass lenses and frames, with a combined maximum benefit of $100 every year; however, upgrades are not covered.
Dental Services See details
Dental services are covered, with no copay for Medicare dental services, but prior authorization is required. Oral exams, dental x-rays, prophylaxis (cleaning), periodontics, and oral and maxillofacial surgery are covered, but fluoride treatment, prosthodontics (removable and fixed), implant services, endodontics, and orthodontics are offered as optional supplemental benefits, and maxillofacial prosthetics and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs, Medicare Part B Chemotherapy/Radiation Drugs, and Other Medicare Part B Drugs. For Medicare Part B Insulin Drugs, there is a $35 copay and coinsurance between 0% and 20%. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, the coinsurance is between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the PriorityMedicare Key (HMO-POS) plan. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with a 20% coinsurance and no copay, Prosthetics/Medical Supplies with a 20% coinsurance and no copay, and Diabetic Equipment. Durable Medical Equipment for use outside the home, Diabetic Supplies, and Diabetic Therapeutic Shoes/Inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for all diagnostic services, diagnostic procedures/tests with a $10 copay, and lab services with no copay. Radiological services are also covered, including diagnostic radiological services with a $225 copay, therapeutic radiological services with a $25 copay, and outpatient X-ray services with a $35 copay.
Home Health Services See details
Home Health Services are covered by the PriorityMedicare Key (HMO-POS) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered. This benefit requires authorization.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by the PriorityMedicare Key (HMO-POS) plan, but the specific sub-services of Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, and Additional Cardiac Rehabilitation Services are not covered. The plan has a copay for Cardiac and Pulmonary Rehabilitation Services, but the specific amount is not listed.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the PriorityMedicare Key (HMO-POS) plan, but require prior authorization. There is no copay for days 1-20, and a $203 copay for days 21-100. Additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered.
Other Services See details
The PriorityMedicare Key (HMO-POS) plan covers acupuncture with a $20 copay per visit for up to 6 treatments per year, and also covers over-the-counter items with a maximum benefit of $75 every three months. The plan also covers Ambulance Stabilization/Non-transport with a $270 copay, and Annual Wellness Visits. Other services such as meal benefits, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, and several others are not covered.
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