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PriorityMedicare Vintage (HMO-POS)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for PriorityMedicare Vintage (HMO-POS). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on PriorityMedicare Vintage (HMO-POS) in 2026, please refer to our full plan details page.
PriorityMedicare Vintage (HMO-POS) is a HMO-POS plan offered by Corewell Health available for enrollment in 2025 to people living in West, SW, and SE counties. This plan received an overall rating of 4.5 out of 5 stars in 2026.
It's important to know that PriorityMedicare Vintage (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 Vintage (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 Vintage (HMO-POS), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $8.80. 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 $615.00 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 $5600.00 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 Vintage (HMO-POS) prescription drug plan features an annual drug deductible of $615. Tier 1 preferred generic drugs are highly accessible with no copay for one, two, or three-month supplies across all pharmacy and mail-order options. For Tier 2 generic drugs, copays start at $8 for a one-month supply at preferred pharmacies, and you can get a three-month supply with no copay when using preferred mail order. Brand-name and specialty medications under this plan are covered under coinsurance. Tier 3 preferred brand drugs and Tier 5 specialty drugs require a 25% coinsurance. Tier 4 non-preferred drugs have a 35% coinsurance at preferred pharmacies and preferred mail order, while standard pharmacies and mail order charge a 40% coinsurance.
Additional Benefits
The PriorityMedicare Vintage (HMO-POS) plan offers comprehensive medical coverage with no copay and no coinsurance for primary care visits, telehealth services, and annual preventive physicals. Specialist visits feature copays ranging from $0 to $35 with no coinsurance, while emergency room services carry a $130 copay. Inpatient hospital stays require a daily copay of $400 for days one through seven, with no copay for day eight and beyond, and no coinsurance overall. For supplemental care, this plan provides routine dental and hearing exams with no copay and no coinsurance, though prescription hearing aids require a copay ranging from $295 to $1,495. Routine eye exams require a $35 copay, but eyewear is covered with no copay or deductible up to a $100 annual limit. Additionally, diagnostic lab tests and home health services are available with no copay, while durable medical equipment requires a 20% coinsurance and no copay.
Inpatient Hospital See details
PriorityMedicare Vintage (HMO-POS) partially covers inpatient hospital services with no coinsurance, though prior authorization is required. Covered acute stays require a $400 daily copay for days 1-7 and no copay for day 8 and beyond, while psychiatric stays require a $275 daily copay for days 1-6 and no copay for days 7-90. Non-Medicare-covered stays, hospital upgrades, and additional psychiatric days are not covered.
Outpatient Services See details
PriorityMedicare Vintage (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 $35 copay with no coinsurance, outpatient substance abuse sessions have a $20 copay, and outpatient blood services are covered with no copay or coinsurance.
Partial Hospitalization See details
PriorityMedicare Vintage (HMO-POS) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization is required for some of these covered services.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by PriorityMedicare Vintage (HMO-POS), with ground and air ambulance services requiring prior authorization and carrying a $270.00 copay and no coinsurance. For transportation, some services are covered, but transportation to plan-approved or any health-related locations is not covered.
Emergency Services See details
PriorityMedicare Vintage (HMO-POS) covers emergency services with a $130 copay and urgently needed services with a $50 copay, both featuring no coinsurance and waived fees if admitted to the hospital within 24 hours. Worldwide emergency, urgent care, and emergency transportation services are also covered with no coinsurance and copays of $130, $50, and $270 respectively.
Primary Care See details
PriorityMedicare Vintage (HMO-POS) primary care benefits feature no copay and no coinsurance for primary care physician visits and telehealth services, though podiatry services are not covered. Other covered services require no coinsurance, with copays ranging from $0 to $35 for specialists, $25 for physical, occupational, and speech therapy, $20 for mental health and psychiatric sessions, and $15 for up to 12 routine chiropractic visits annually.
Preventive Services See details
PriorityMedicare Vintage (HMO-POS) offers preventive services with no copay and no coinsurance, including annual physical exams, kidney disease education, and diabetes self-management. Additional preventive benefits are partially covered, excluding services such as fitness benefits, personal emergency response systems, medical nutrition therapy, weight management programs, alternative therapies, and therapeutic massage.
Hearing Services See details
Hearing services are partially covered by PriorityMedicare Vintage (HMO-POS), offering routine hearing exams and fittings with no copay and no coinsurance. Prescription hearing aids are covered with no coinsurance and a copay ranging from $295 to $1,495, but OTC hearing aids and inner-ear, outer-ear, or over-the-ear prescription aids are not covered.
Vision Services See details
PriorityMedicare Vintage (HMO-POS) covers routine eye exams with a $35 copay, no coinsurance, and no deductible, limited to one visit per year. Eyewear is also covered with no copay, no coinsurance, and no deductible, providing up to a $100 annual maximum benefit for contacts, eyeglasses, lenses, frames, and upgrades.
Dental Services See details
PriorityMedicare Vintage (HMO-POS) offers partially covered dental services with no copay and no coinsurance for preventive and most comprehensive care, including exams, cleanings, and implants. Medicare-covered dental services require prior authorization and have a copay ranging from $0 to $350 with no coinsurance, while orthodontics, maxillofacial prosthetics, and other diagnostic or preventive services are not covered.
Home Infusion bundled Services See details
PriorityMedicare Vintage (HMO-POS) covers home infusion bundled services with no copay and no coinsurance, subject to prior authorization. Under this benefit, Medicare Part B chemotherapy, radiation, and other drugs require no copay and 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 under the PriorityMedicare Vintage (HMO-POS) plan with no copay and a 20% coinsurance.
Medical Equipment See details
PriorityMedicare Vintage (HMO-POS) partially covers medical equipment, providing 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 available with no copay and no coinsurance, but diabetic supplies and diabetic therapeutic shoes or inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered under PriorityMedicare Vintage (HMO-POS) with no coinsurance, though prior authorization is required. There is no copay for lab services, while diagnostic procedures cost a $5 copay, outpatient X-rays cost $35, therapeutic radiological services cost $25, and diagnostic radiological services require a $210 copay.
Home Health Services See details
Home Health Services are covered by PriorityMedicare Vintage (HMO-POS) with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered under the PriorityMedicare Vintage (HMO-POS) plan, meaning no copay or coinsurance benefits are available for standard cardiac, intensive cardiac, pulmonary, or supervised exercise therapy (SET) services.
Skilled Nursing Facility (SNF) See details
PriorityMedicare Vintage (HMO-POS) partially covers Skilled Nursing Facility (SNF) services because additional days beyond the Medicare-covered limit are not covered. Covered stays require no coinsurance and feature no copay for days 1 to 20, followed by a $218 daily copay for days 21 to 100, with prior authorization required.
Other Services See details
PriorityMedicare Vintage (HMO-POS) partially covers other services, excluding meal benefits. Covered benefits include annual wellness visits and over-the-counter items with no copay and no coinsurance, acupuncture at a $20 copay and no coinsurance for up to 6 treatments yearly, and ambulance stabilization for a $270 copay and no coinsurance.
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