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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 2025, 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 2025.
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 $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 $5300.00 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) plan has a $0 deductible for prescription drugs. During the initial coverage phase, you will 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, while preferred brand drugs have a 40% coinsurance. Once your total drug costs reach $2000, you enter the catastrophic coverage phase where you pay nothing for covered drugs.
Additional Benefits
The PriorityMedicare Vintage (HMO-POS) plan offers a wide range of benefits, including inpatient and outpatient hospital services, with varying copays depending on the service. You'll have access to primary care, specialist visits, and mental health services with copays between $0 and $35. The plan also covers preventive services with no copay, hearing exams with no copay, and routine vision exams with a $35 copay. This plan provides coverage for ambulance, emergency, and skilled nursing facility services, along with home health services with no copay. Dental services include oral exams and cleaning with no copay, and prescription hearing aids with a copay between $295 and $1495. The plan also provides coverage for home infusion, dialysis, and medical equipment, with coinsurance ranging from 0% to 20% depending on the service.
Inpatient Hospital See details
Inpatient Hospital coverage includes Inpatient Hospital-Acute and Inpatient Hospital Psychiatric services, with prior authorization required. For Inpatient Hospital-Acute, you will pay a $320 copay for days 1-7, and no copay for days 8-90, while for Inpatient Hospital Psychiatric, you will pay a $275 copay for days 1-6, and no copay for days 7-90. Additional days and upgrades for Inpatient Hospital-Acute and Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services are covered, including outpatient hospital services with a copay between $0 and $350, observation services with a $120 copay, ambulatory surgical center services with a $350 copay, outpatient substance abuse services with a $20 copay for individual and group sessions, and outpatient blood services with a waived three-pint deductible. Prior authorization is required for outpatient hospital and ambulatory surgical center services.
Partial Hospitalization See details
Partial Hospitalization is covered by the PriorityMedicare Vintage (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, including ground and air ambulance services with a $270 copay per service. Transportation services to plan-approved health-related locations are covered for 30 one-way trips per year.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered. Emergency Services and Worldwide Emergency Coverage have a $120 copay, Urgently Needed Services has a $50 copay, and Worldwide Emergency Transportation has a $270 copay. Worldwide Urgent Coverage has a $50 copay. There is no coinsurance for any of these services.
Primary Care See details
The PriorityMedicare Vintage (HMO-POS) plan covers primary care physician services, chiropractic services with a $20 copay, occupational therapy with a $25 copay, physician specialist services with a copay between $0 and $35, and mental health specialty services with a $20 copay for individual or group sessions. The plan also covers other health care professional services with a copay between $0 and $35, psychiatric services with a $20 copay for individual or group sessions, physical therapy and speech-language pathology services with a $25 copay, additional telehealth benefits, and opioid treatment program services with a $20 copay. Podiatry services are not covered.
Preventive Services See details
The PriorityMedicare Vintage (HMO-POS) plan covers preventive services, including Medicare-covered services with no copay, annual physical exams, health education, in-home safety assessments, post-discharge in-home medication reconciliation, nutritional/dietary benefits, enhanced disease management, telemonitoring services, kidney disease education services, glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, and EKG following Welcome Visit. The plan does not cover 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, additional sessions of smoking and tobacco cessation counseling, fitness benefits, remote access technologies, home and bathroom safety devices and modifications, and counseling services.
Hearing Services See details
Hearing exams are covered with no copay, and routine hearing exams are covered for one visit per year. Prescription hearing aids are covered with a copay between $295 and $1495, but prescription hearing aids for the inner ear, outer ear, and over the ear are not covered, and OTC hearing aids are not covered.
Vision Services See details
Vision Services include routine eye exams with a $35 copay, and other eye exam services. Eyewear is covered with a combined maximum of $100 per year for contact lenses, eyeglasses (lenses and frames), and eyeglass lenses and frames, but upgrades are not covered.
Dental Services See details
The PriorityMedicare Vintage (HMO-POS) plan covers dental services, including oral exams with no copay, dental x-rays, and prophylaxis (cleaning), each with limitations on the number of visits per year, and oral and maxillofacial surgery with no copay. Fluoride treatment, restorative services, adjunctive general services, endodontics, prosthodontics (removable and fixed), implant services, and orthodontics are offered as optional, supplemental benefits. Maxillofacial prosthetics and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including insulin and Medicare Part B drugs. For Medicare Part B insulin drugs, there is a $35 copay and a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the PriorityMedicare Vintage (HMO-POS) plan. You will pay 20% coinsurance.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with a 20% coinsurance and Prosthetic Devices with a 0-20% coinsurance, but Durable Medical Equipment for use outside the home is not covered. Medical Supplies have a 20% coinsurance and Diabetic Equipment is covered, but Diabetic Supplies and Diabetic Therapeutic Shoes/Inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by the PriorityMedicare Vintage (HMO-POS) plan. Diagnostic Procedures/Tests have a $5 copay, Lab Services have no copay, Diagnostic Radiological Services have a copay of at least $180, Therapeutic Radiological Services have a copay of at least $25, and Outpatient X-Ray Services have a $35 copay.
Home Health Services See details
Home Health Services are covered by the PriorityMedicare Vintage (HMO-POS) plan, with no copay or coinsurance. However, additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by PriorityMedicare Vintage (HMO-POS), but the plan does not cover Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services. The copay for Cardiac Rehabilitation Services can be found in the plan details.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the PriorityMedicare Vintage (HMO-POS) plan. For days 1-20, there is no copay, and for days 21-100, there is a $203 copay. Additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other Services includes acupuncture, which has a $20 copay and is limited to 6 treatments per year, and Other 1, which covers Ambulance Stabilization/Non-transport with a $270 copay. Over-the-counter (OTC) Items, Meal Benefit, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered.
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