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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) prescription drug plan features an annual drug deductible of $200. For Tier 1 preferred generic drugs, you pay a $2 copay for a 1-month supply and no copay for a 3-month supply at preferred pharmacies or through preferred mail order. Tier 2 generic drugs cost an $8 copay for a 1-month supply at preferred pharmacies, with no copay for a 3-month supply when filled via preferred mail order. Brand name and specialty medications are subject to coinsurance rather than flat copayments. Tier 3 preferred brand drugs require a 22% coinsurance at preferred locations and 25% at standard locations. Tier 4 non-preferred drugs carry a 25% coinsurance at preferred locations and 30% at standard locations, while Tier 5 specialty drugs require a 30% coinsurance for a 1-month supply across all network pharmacies.
Additional Benefits
The PriorityMedicare Key (HMO-POS) plan offers comprehensive medical coverage featuring no copay and no coinsurance for primary care visits, telehealth, and preventive services. For inpatient hospital stays, members pay a daily copay of $350 for the first seven days of acute care, while outpatient hospital services range from no copay up to a $350 copay. Emergency room visits require a $130 copay, which is waived if admitted, and urgent care visits carry a $50 copay. Ancillary benefits include routine hearing exams with no copay, alongside a $100 annual allowance for eyewear and prescription hearing aids starting at a $295 copay. Home health services and over-the-counter items are also covered with no copay, while durable medical equipment and dialysis services require a 20% coinsurance. Diagnostic lab work is available with no copay, and standard X-rays carry a $35 copay.
Inpatient Hospital See details
PriorityMedicare Key (HMO-POS) offers partially covered inpatient hospital services with no coinsurance and required prior authorization, excluding upgrades, additional psychiatric days, and non-Medicare-covered stays. Acute care requires a $350 daily copay for days 1 to 7 with no copay thereafter, while psychiatric care requires a $275 daily copay for days 1 to 6 and no copay for days 7 to 90.
Outpatient Services See details
PriorityMedicare Key (HMO-POS) covers outpatient services 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 with no coinsurance, outpatient substance abuse sessions have a $20 copay with no coinsurance, and outpatient blood services are covered with no copay or coinsurance.
Partial Hospitalization See details
PriorityMedicare Key (HMO-POS) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization may be required for some of these covered services.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by PriorityMedicare Key (HMO-POS), with ground and air ambulance services requiring prior authorization, a $270 copay, and no coinsurance. For transportation, some services are covered but transportation to plan-approved health-related locations and any health-related locations are 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 with no coinsurance and copays waived if admitted to the hospital within 24 hours. Worldwide emergency, urgent, and emergency transportation services are also covered with no coinsurance, carrying copays of $130, $50, and $270, respectively.
Primary Care See details
PriorityMedicare Key (HMO-POS) provides primary care physician services and telehealth benefits with no copay and no coinsurance, although podiatry services are not covered. Other covered benefits feature no coinsurance and copayments ranging from $0 to $40 for specialists, $15 to $35 for chiropractic visits, $20 for mental health, psychiatric, and opioid treatments, and $25 for physical and occupational therapy.
Preventive Services See details
Preventive services are covered by PriorityMedicare Key (HMO-POS) with no copay and no coinsurance, though the benefit is only partially covered. While annual physical exams, fitness benefits, and home safety devices are covered, sub-services such as personal emergency response systems (PERS), medical nutrition therapy, weight management programs, and alternative therapies are not covered.
Hearing Services See details
Hearing services are covered by PriorityMedicare Key (HMO-POS), offering routine hearing exams and fitting evaluations with no copay and no coinsurance. Prescription hearing aids are partially covered with no coinsurance and a copay ranging from $295.00 to $1,495.00, but OTC hearing aids and inner ear, outer ear, and over the ear prescription hearing aids are not covered.
Vision Services See details
PriorityMedicare Key (HMO-POS) covers vision services, including annual routine eye exams and retinal imaging for a $40 copay and no coinsurance. Eyewear, including contacts and eyeglasses, is also covered with no copay and no coinsurance up to a $100 annual maximum benefit.
Dental Services See details
PriorityMedicare Key (HMO-POS) partially covers dental services, offering Medicare-covered dental with a $0 to $350 copay and no coinsurance, and other covered services with no copay or coinsurance. Other diagnostic dental, other preventive dental, maxillofacial prosthetics, and orthodontics are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by PriorityMedicare Key (HMO-POS) with no copay, though prior authorization is required. Associated Medicare Part B chemotherapy, radiation, and other drugs require no copay and no coinsurance to 20% coinsurance, while Medicare Part B insulin drugs carry a $35 copay and no coinsurance 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
Diagnostic and radiological services are covered by PriorityMedicare Key (HMO-POS) with no coinsurance, although prior authorization is required. There is no copay for lab services, a $10 copay for diagnostic tests, a $35 copay for X-rays, and copays starting at $25 for therapeutic radiology and $225 for diagnostic radiology.
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
PriorityMedicare Key (HMO-POS) indicates some services are covered under its cardiac rehabilitation benefit with no coinsurance; however, cardiac rehabilitation, intensive cardiac rehabilitation, pulmonary rehabilitation, and supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD) are not covered and carry a $10 copay.
Skilled Nursing Facility (SNF) See details
Skilled nursing facility (SNF) care is covered by PriorityMedicare Key (HMO-POS) with no coinsurance, requiring prior authorization but no prior three-day hospital stay. There is no copay for days 1 through 20 and a $218 daily copay for days 21 through 100, with additional days beyond the Medicare-covered limit not covered.
Other Services See details
PriorityMedicare Key (HMO-POS) provides partially covered other services, including acupuncture for a $20 copay and no coinsurance (limited to 6 treatments annually), ambulance stabilization for a $270 copay and no coinsurance, and annual wellness visits and over-the-counter items with no copay and no coinsurance. Meal benefits are not covered under this plan.
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