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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 a $200 drug deductible before initial coverage begins. For Tier 1 preferred generics, you pay no copay for a three-month supply at preferred pharmacies or through preferred mail order, while standard pharmacies charge a $7 copay for a one-month supply. Tier 2 generic medications cost as low as an $8 copay for a one-month supply at preferred locations, with no copay required for a three-month supply ordered through preferred mail. Brand-name and specialty drugs require coinsurance instead of flat copays. Tier 3 preferred brands carry a 22% coinsurance at preferred pharmacies and 25% at standard pharmacies. Tier 4 non-preferred drugs range from 25% to 30% coinsurance, while Tier 5 specialty drugs require a flat 30% coinsurance.
Additional Benefits
The PriorityMedicare Key (HMO-POS) plan offers comprehensive medical coverage with predictable out-of-pocket costs, featuring no coinsurance for many key services. Members enjoy no copay for primary care doctor visits, telehealth, and routine preventive services, while specialist visits require a $40 copay. For hospital care, inpatient acute stays have a $350 daily copay for the first seven days and no copay thereafter, while emergency room visits carry a $130 copay that is waived if you are admitted. This plan also includes valuable everyday health benefits, offering dental exams and cleanings with no copay and no coinsurance, alongside routine hearing exams with no copay. Routine eye exams are covered with a $40 copay, and there is no copay for eyewear up to a $100 annual limit. Additionally, diagnostic lab services and home health care are available with no copay, while services like skilled nursing facility stays require no copay for the first 20 days.
Inpatient Hospital See details
PriorityMedicare Key (HMO-POS) covers inpatient hospital services with no coinsurance, requiring prior authorization for stays. Acute stays have a $350 daily copay for days 1 to 7 and no copay for day 8 and beyond, while psychiatric stays require a $275 daily copay for days 1 to 6 and no copay for days 7 to 90. Hospital upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
PriorityMedicare Key (HMO-POS) covers outpatient hospital services with copays ranging from $0 to $350 and no coinsurance, while observation services require a $130 copay per stay and no coinsurance. Ambulatory surgical center services have a $40 copay and no coinsurance, outpatient substance abuse sessions require a $20 copay and no coinsurance, and outpatient blood services are provided with no copay, coinsurance, or deductible.
Partial Hospitalization See details
PriorityMedicare Key (HMO-POS) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization is required for some of these services.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by PriorityMedicare Key (HMO-POS) with a $270 copay and no coinsurance for both ground and air ambulance services, which require prior authorization. Routine transportation services to plan-approved or any health-related locations are not covered.
Emergency Services See details
PriorityMedicare Key (HMO-POS) covers emergency services with a $130 copay and no coinsurance, with the copay waived if you are admitted to the hospital within 24 hours. Urgently needed services have a $50 copay and no coinsurance, and worldwide emergency services are also covered with no coinsurance and copays ranging from $50 to $270.
Primary Care See details
PriorityMedicare Key (HMO-POS) offers partially covered primary care benefits with no coinsurance, though podiatry services are not covered. Covered services feature no copay for primary care and telehealth, while other benefits range from a $15 to $20 copay for chiropractic and mental health services up to a $40 copay for specialists.
Preventive Services See details
PriorityMedicare Key (HMO-POS) covers preventive services, including annual physical exams, kidney disease education, and glaucoma screenings, with no copay and no coinsurance. Additional preventive services are partially covered with no copay and no coinsurance, excluding Personal Emergency Response System (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
PriorityMedicare Key (HMO-POS) partially covers hearing services, offering one routine exam per year and unlimited fitting evaluations with no copay and no coinsurance. Up to two prescription hearing aids are covered per year with no coinsurance and a copay between $295.00 and $1,495.00, but OTC hearing aids and inner ear, outer ear, or over the ear prescription models are not covered.
Vision Services See details
PriorityMedicare Key (HMO-POS) covers routine eye exams and retinal imaging with a $40 copay and no coinsurance, limited to one visit of each per year. Eyewear, including glasses and contact lenses, is covered with no copay and no coinsurance up to a $100 combined maximum benefit limit per year.
Dental Services See details
PriorityMedicare Key (HMO-POS) provides partially covered dental services with no copay and no coinsurance for most preventive and comprehensive care, though Medicare-covered dental services require 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, though prior authorization and step therapy are required. Associated Medicare Part B chemotherapy, radiation, and other Part B drugs have no copay and a 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 by PriorityMedicare Key (HMO-POS) 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, while prosthetic devices have no copay and 0% to 20% coinsurance. Diabetic equipment is offered with no copay and no coinsurance but is only partially covered, with diabetic supplies and therapeutic shoes or inserts not covered by the plan.
Diagnostic and Radiological Services See details
PriorityMedicare Key (HMO-POS) covers diagnostic and radiological services with no coinsurance, though prior authorization is required. Diagnostic tests and procedures have a $10 copay, lab services have no copay, outpatient X-rays have a $35 copay, and diagnostic and therapeutic radiological services require minimum copays of $225 and $25, respectively.
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) covers cardiac, intensive cardiac, and pulmonary rehabilitation services, as well as supervised exercise therapy (SET) for symptomatic peripheral artery disease (PAD). These covered services require a $10 copay and have no coinsurance.
Skilled Nursing Facility (SNF) See details
PriorityMedicare Key (HMO-POS) covers Skilled Nursing Facility (SNF) services with no coinsurance, offering no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, but a prior three-day hospital stay is not, and additional days beyond the standard Medicare limit are not covered.
Other Services See details
PriorityMedicare Key (HMO-POS) partially covers other services, featuring acupuncture for a $20 copay and no coinsurance (limit of 6 treatments per year), 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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