PriorityMedicare Dual Premier (HMO D-SNP)

PriorityMedicare Dual Premier (HMO D-SNP) is a HMO D-SNP plan offered by Corewell Health available for enrollment in 2026 to people living in SE MI, Barry, Wayne and Macomb. This plan received an overall rating of 3.5 out of 5 stars in 2026.

It's important to know that PriorityMedicare Dual Premier (HMO D-SNP) 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 Dual Premier (HMO D-SNP).

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 Dual Premier (HMO D-SNP) plan features an annual prescription drug deductible of $615. Under this plan, you will pay no copay for Tier 1 preferred generic and Tier 2 generic medications filled at standard pharmacies or through standard mail order. This cost-saving benefit applies to one-, two-, and three-month supplies of these generic drugs. For higher-tier medications, you will pay a 25% coinsurance for Tier 3 preferred brand drugs, Tier 4 non-preferred drugs, and Tier 5 specialty drugs. This 25% coinsurance rate applies to standard pharmacies and standard mail order services. While Tier 3 and Tier 4 medications are covered for one-, two-, or three-month supplies, Tier 5 specialty medications are limited to a one-month supply at this rate.

Additional Benefits

The PriorityMedicare Dual Premier (HMO D-SNP) plan offers comprehensive medical coverage with no copays or coinsurance for primary care, specialist visits, routine vision exams, and home health services. For inpatient hospital stays, members pay a $2,000 copay per stay with no coinsurance, while outpatient services generally feature no copays and coinsurance ranging from 0% to 35%. Emergency care requires a $115 copay, which is waived if admitted, and urgently needed care carries a 30% coinsurance up to $40. Routine hearing and vision services, including up to $200 annually for eyewear and two prescription hearing aids every three years, are provided with no copays or coinsurance. Durable medical equipment, dialysis, and prosthetics are covered with no copay and a 20% coinsurance. Skilled nursing facility stays feature no copay for the first 20 days, followed by a $218 daily copay for days 21 through 100.