PriorityMedicare (HMO-POS)

PriorityMedicare (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 (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 (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.

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:

Drug Coverage

The PriorityMedicare (HMO-POS) plan features a $0 drug deductible, meaning your prescription drug coverage begins immediately. For Tier 1 preferred generic drugs, you will pay no copay for a 3-month supply through preferred pharmacies or preferred mail order, while standard pharmacies charge up to an $18 copay. Tier 2 generic drugs are also highly affordable, offering no copay for a 3-month supply via preferred mail order, or copays ranging from $8 to $39 depending on the supply duration and pharmacy type. Higher-tier medications under this plan transition to coinsurance, with Tier 3 preferred brand drugs requiring a flat 25% coinsurance across all pharmacies and mail order options. Tier 4 non-preferred drugs carry a 33% coinsurance at preferred pharmacies and 38% at standard pharmacies, while Tier 5 specialty drugs require 33% coinsurance for a 1-month supply. This structured copay and coinsurance system helps beneficiaries manage their healthcare costs effectively based on their choice of pharmacy and prescription tier.

Additional Benefits

The PriorityMedicare (HMO-POS) plan offers comprehensive coverage with no copay or coinsurance for primary care visits, telehealth, routine physicals, and home health services. For hospital stays, beneficiaries pay a $225 daily copay for the first six days and no copay for days seven through ninety, with no coinsurance required. Specialist visits, physical therapy, and outpatient services are highly affordable, with copays of $40 or less for most visits and no coinsurance. Routine dental and vision exams are covered with no copay or coinsurance, and the plan includes a $100 annual allowance for eyewear. Routine hearing exams also feature no copay, though prescription hearing aids require copays ranging from $295 to $1,495. Additionally, emergency room visits have a $130 copay, while durable medical equipment and dialysis services are covered with no copay and a 20% coinsurance.