MyPriority
Short-term plans

Short-term insurance plans do not cover pre-existing conditions. This means any illness, injury or condition for which you received medical care or treatment for within the past five years won't be covered under a short-term plan.

With a MyPriority Individual and family plan, you can't be turned down due to pre-existing conditions like chronic illnesses. In addition, all MyPriority ACA Individual and family plans include chronic condition management, which means that certain services, supplies, and prescriptions used to treat common long-term health conditions are covered before deductible with cost share or in full.

Examples of pre-existing conditions include:

• Heart disorders
• Emphysema or chronic obstructive pulmonary disease (COPD)
• Crohn's disease, ulcerative colitis or hepatitis
• AIDS or tested positive for HIV
• Stroke
• Diabetes (except gestational diabetes)
• Cancer or tumor (except basal cell skin cancer which has been removed)
• Alcoholism, chemical dependency, drug or alcohol abuse

No. Preventive care services are not covered under short-term insurance plans. You would be responsible for all preventive care costs.

With a MyPriority Individual and family plan, preventive care is covered in full, before your deductible is met. This includes wellness exams, immunizations and certain cancer screenings.

• Priority Health Preventive Health Care Guidelines

No. Maternity care is not covered under a MyPriority Short-term plan. You would be responsible for all costs.

With a MyPriority Individual and family plan, routine prenatal and postnatal care is covered in full, before your deductible is met. Labor and delivery care is covered at the inpatient hospital visit cost-share.

With a MyPriority Short-term plan, you'll get Priority Health's discounted cost on your prescription drugs at in-network pharmacies, which is significantly lower than the retail price.

With a MyPriority Individual and family plan, you'll get low prescription copays on Tier 1 generic drugs and have access to a program that automatically helps members save money at in-network pharmacies.

You can enroll in a MyPriority Short-term plan any time and get coverage as soon as the next day.*

With a MyPriority Individual and family plan, you can only enroll during Open Enrollment Period (OEP), which takes place from Nov. 1 to Jan. 15 each year. You may be able to enroll outside OEP if you have a qualifying life event; this would make you eligible for a Special Enrollment Period (SEP).

No. Short-term insurance plans are not required to comply with certain federal market requirements for health insurance, principally those contained in the Affordable Care Act (ACA), and it's not considered Minimum Essential Coverage (MEC).

MyPriority Individual and family plans are ACA-compliant which means–unlike short-term plans–there's no coverage maximums and you can't be turned down due to pre-existing conditions like chronic illnesses. Plans must also include coverage for the following 10 essential benefits:

• Hospitalization
• Ambulatory services (doctor visits and outpatient hospital care)
• Emergency services
• Maternity and newborn care
• Mental health and substance abuse treatment
• Prescription drugs
• Lab work
• Preventive care services
• Pediatric dental and vision care
• Rehabilitative and habilitative services

No. Since short-term insurance plans don't meet ACA requirements, they aren't eligible for federal subsidies to help with coverage costs.

If you choose an ACA compliant plan, such as a MyPriority Individual and family plan, you may be eligible for financial assistance through premium tax credits and cost-sharing reductions. When you shop for a MyPriority plan, we'll check to see if you qualify for this kind of assistance and show you the best plan to meet your needs.

To learn more about premium tax credits and cost-sharing reductions, visit our Learning Center.

In Michigan, short-term insurance plans are limited to an initial coverage period of three months, with a total duration (including renewals and extensions) not exceeding four months per 365 days.

 

ACA plans, or Individual and family plans, provide coverage for an entire year. During the Open Enrollment Period, which takes place from Nov. 1 to Jan. 15 each year, you have the opportunity to review your current plan and decide whether to keep it for another year or switch to a different ACA plan that better meets your needs for the following year.