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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 a $0 deductible for prescription drugs. In the initial coverage phase, you'll 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 Part D covered drugs. However, you may still pay a share of the costs for excluded drugs covered under any enhanced benefit.
Additional Benefits
The PriorityMedicare Key (HMO-POS) plan offers a wide range of benefits with varying costs. For inpatient hospital stays, you'll pay a copay, and for outpatient services, copays range from $0 to $350. Emergency services, including worldwide coverage, have copays between $50 and $270. This plan covers primary care, preventive services, hearing, vision, and dental services, each with specific copays or coverage limits. Additional benefits include ambulance services, home health, and skilled nursing facility care with specific copayments. The plan also covers diagnostic and radiological services, medical equipment, and other services like acupuncture and over-the-counter items, with varying cost-sharing arrangements.
Inpatient Hospital See details
Inpatient Hospital services are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric. For Inpatient Hospital-Acute, you pay a $350 copay for days 1-7, and no copay for days 8-90, with no coinsurance. For Inpatient Hospital Psychiatric, you pay a $275 copay for days 1-6, and no copay for days 7-90, with no coinsurance. Non-Medicare-covered stays, and upgrades are not covered.
Outpatient Services See details
Outpatient services include coverage for outpatient hospital services with a copay between $0 and $350, observation services with a $120 copay, ambulatory surgical center services with a $350 copay, and outpatient substance abuse services with a $20 copay for individual and group sessions. Outpatient blood services are also covered, including services not usually covered by Medicare plans.
Partial Hospitalization See details
Partial Hospitalization is covered under the PriorityMedicare Key (HMO-POS) plan, but requires prior authorization. You will have a $55 copay for this service.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by PriorityMedicare Key (HMO-POS). Medicare-covered Ground and Air Ambulance Services have a $270 copay and no coinsurance, while Transportation Services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, Worldwide Emergency Coverage, and Worldwide Urgent Coverage have a copay of $120, $50, $120, and $50 respectively, with no coinsurance. Worldwide Emergency Transportation has a $270 copay with no coinsurance.
Primary Care See details
Primary Care includes coverage for primary care physician services, chiropractic services, occupational therapy services, physician specialist services, mental health specialty services, other health care professional services, psychiatric services, physical therapy and speech-language pathology services, additional telehealth benefits, and opioid treatment program services. Chiropractic services have a $20 copay, and other chiropractic services have a $35 copay. Occupational therapy services have a $25 copay. Physician specialist services have a copay between $0 and $40. Individual and group sessions for mental health and psychiatric services have a $20 copay, and opioid treatment program services have a $20 copay. Physical therapy and speech-language pathology services have a $25 copay.
Preventive Services See details
The PriorityMedicare Key (HMO-POS) plan covers preventive services, including Medicare-covered preventive services with a doctor referral, annual physical exams, health education, in-home safety assessments, post-discharge in-home medication reconciliation, kidney disease education services, glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, EKG following Welcome Visit, nutritional/dietary benefit, fitness benefit, enhanced disease management, telemonitoring services, and home and bathroom safety devices and modifications. However, the plan does not cover Personal Emergency Response Systems (PERS), Medical Nutrition Therapy (MNT), 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 of Enrollees, additional sessions of smoking and tobacco cessation counseling, remote access technologies, and counseling services.
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, however, inner ear, outer ear, and over the ear hearing aids are not covered. OTC hearing aids are not covered.
Vision Services See details
PriorityMedicare Key (HMO-POS) covers vision services including eye exams with a $40 copay, and eyewear, including contact lenses, eyeglasses (lenses and frames), and eyeglass lenses and frames. Eyewear has a combined maximum benefit of $100 every year, and upgrades are not covered.
Dental Services See details
The PriorityMedicare Key (HMO-POS) plan covers dental services, including oral exams, dental x-rays, prophylaxis (cleaning), and oral and maxillofacial surgery. Other services, such as fluoride treatment, endodontics, prosthodontics (removable and fixed), implant services, and orthodontics are optional, supplemental benefits, or not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs with a $35 copay and between 0% and 20% coinsurance, Medicare Part B Chemotherapy/Radiation Drugs with between 0% and 20% coinsurance, and Other Medicare Part B Drugs with between 0% and 20% coinsurance. Prior authorization is required.
Dialysis Services See details
Dialysis Services are covered under the PriorityMedicare Key (HMO-POS) plan. You will pay a 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with a 20% coinsurance, Prosthetic Devices with a 0-20% coinsurance, and Medical Supplies with a 20% coinsurance; however, Durable Medical Equipment for use outside the home and Diabetic Supplies/Therapeutic Shoes/Inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including diagnostic procedures and tests with a $10 copay, lab services with no copay, diagnostic radiological services with a minimum $210 copay, therapeutic radiological services with a minimum $25 copay, and outpatient X-ray services with a $35 copay. All services require prior authorization.
Home Health Services See details
Home Health Services are covered by the PriorityMedicare Key (HMO-POS) plan with no copay or coinsurance, but additional hours of care and personal care services are not covered. Authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are technically covered, but the plan does not cover any of the sub-services. This means there is no copay or coinsurance for this benefit.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by PriorityMedicare Key (HMO-POS). You will have no copay for days 1-20, and a $203 copay for days 21-100. Additional days beyond Medicare-covered for SNF 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 for up to 6 treatments per year, and OTC items with a maximum benefit coverage amount of $45 every three months. Other services like meal benefits, and services such as Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, are not covered.
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