Does Priority Health cover therapy? Using your Priority Health plan for online counseling in Michigan
What Priority Health says about outpatient and virtual therapy, how to find an in-network therapist and the numbers to call for your plan type.
Key takeaways
- Sessions with Iryna can be billed to Priority Health, and your individual plan sets coverage and costs.
- Priority Health is one of Corewell Health's four divisions and offers employer, MyPriority, Medicare and Medicaid plans.
- Priority Health says outpatient therapy can be provided in person or virtually and that some outpatient treatment needs prior authorization.
- Members can verify behavioral health benefits by calling Priority Health's Behavioral Health Department at 800.673.8043 (TTY 711).
- Priority Health Medicaid and Healthy Michigan Plan members should confirm whether their specific plan can be used.
Priority Health cards are everywhere in West Michigan and well beyond: in wallets at Grand Rapids hospitals, Holland factories and Lansing offices. If one of them is yours and you are thinking about counseling, you probably want two answers quickly. Does Priority Health cover therapy? And can you use it with a therapist you choose? Here is what Priority Health says, and how to check your own plan.
Can I see Iryna with Priority Health?
Yes. Sessions with Iryna Morhunova-Sutton, LLMFT, can be billed to Priority Health through her group practice’s billing system. Whether you owe a copay or coinsurance, how the deductible works, and whether a spouse or family can be part of covered sessions all come down to which Priority Health plan you have. If you have a Priority Health Medicaid or Healthy Michigan Plan, please confirm when you reach out whether your specific plan can be used.
Who Priority Health is
Priority Health is a Michigan health plan and one of Corewell Health’s four divisions, alongside Corewell Health East, South and West. Corewell Health describes it as a provider-sponsored health plan serving over 1.2 million members across Michigan. Its roots go back to Lakeshore HMO, founded by Holland Hospital in 1985, and Butterworth HMO, which opened in 1986; the two merged in 1992.
Priority Health sells several kinds of coverage:
- Employer group plans for businesses large and small.
- Individual and family plans, sold as MyPriority.
- Medicare plans, including Medicare Advantage HMO-POS and PPO plans, Dual Eligible Special Needs Plans and Medigap.
- Medicaid plans, including the Healthy Michigan Plan, MIChild and Children’s Special Health Care Services.
Does Priority Health cover therapy?
Priority Health lists outpatient therapy among its behavioral health services and says outpatient therapy can be provided in person or virtually. It also notes that prior authorization is needed for some outpatient treatment, and that your provider requests it on your behalf. Most important, Priority Health says plainly: “Coverage varies depending on plan.”
To verify your benefits, Priority Health directs members to its Behavioral Health Department at 800.673.8043 (TTY 711) during business hours. It adds that crisis support is available 24 hours a day, seven days a week. If you are ever in crisis, you can call or text 988 at any hour, or call 911.
In everyday terms, that means two Priority Health members can have very different therapy benefits. An employer plan in Kent County and a MyPriority plan bought on your own may differ in deductible, copay and authorization rules, even with the same logo on the card.
Finding a therapist in the Priority Health network
Log in to your Priority Health member account, choose Find Care, then Find a doctor. For behavioral health, Priority Health recommends starting with Advanced Search, where specialties include Marriage and Family Therapy. Member services numbers differ by plan type, according to Priority Health:
- Employer group plans: 800.446.5674
- MyPriority plans: 800.528.8762
- Medicare Advantage plans: 888.389.6648 (TTY 711)
- Medicaid and Healthy Michigan Plan: 888.975.8102
Questions to ask Priority Health
- Is outpatient therapy covered under my plan, and what is my copay or coinsurance?
- Are virtual sessions covered at the same cost as in-person visits?
- Does my deductible apply, and does outpatient therapy need prior authorization?
- Does my plan pay for family psychotherapy (90847 or 90846), and does it exclude marital counseling?
Couples and family sessions with Priority Health
Priority Health’s behavioral health pages do not describe couples counseling as its own benefit, so coverage generally follows medical necessity. A partner or parent joining sessions may be covered when that helps treat someone’s diagnosis. For Medicaid members, note that Michigan’s Medicaid bulletin MSA 16-14 states that marriage counseling is not a Medicaid covered service. Our guide to whether insurance covers couples therapy explains more.
If you have Priority Health Medicare
Priority Health Medicare Advantage plans set their own networks and cost sharing, separate from Original Medicare. Use the Medicare Advantage member number above, and see our Medicare therapy guide for how Medicare treats mental health care.
Online, anywhere in Michigan
Iryna meets with clients by secure video only, so there is no office to drive to. Wherever you are in the state, from Muskegon to Mount Pleasant, being in Michigan at session time is the one requirement. Read more about how online therapy in Michigan works.
Take the first step
Ready to talk about couples therapy, family sessions or support for yourself? Request an appointment and mention your Priority Health plan when you reach out, including whether it is an employer, MyPriority, Medicare or Medicaid plan. See all nine plans on the insurance overview.
Common questions
Does Priority Health cover therapy?
Priority Health lists outpatient therapy among its behavioral health services and says it can be provided in person or virtually. Coverage varies by plan, and some outpatient treatment needs prior authorization. Call the Behavioral Health Department at 800.673.8043 (TTY 711) or check your member account to confirm your benefits.
Does Priority Health cover couples counseling?
Priority Health does not describe couples counseling as a separate benefit, so coverage usually depends on medical necessity: joint sessions may be billable when they help treat a diagnosed condition. For Medicaid plans, Michigan's Medicaid bulletin states marriage counseling is not a covered service. Ask your plan about family psychotherapy codes 90847 and 90846.
How do I find a therapist with Priority Health?
Log in to your member account, choose Find Care, then Find a doctor, and start with Advanced Search, where specialties include Marriage and Family Therapy. You can also call the Behavioral Health Department at 800.673.8043 for help. Sessions with Iryna can be billed to Priority Health through her group practice's billing system.
Can I use Priority Health Medicaid for therapy with Iryna?
Please confirm first. Sessions with Iryna can be billed to Priority Health, but whether a specific Priority Health Medicaid or Healthy Michigan Plan can be used needs to be checked. Mention your exact plan when you reach out, and call Priority Health's Medicaid member line at 888.975.8102 with coverage questions.
Sources
- Priority Health, Mental health services
- Priority Health, Find a behavioral health provider
- Priority Health, Michigan health plans
- Priority Health, Michigan Medicare & Medigap plans
- Priority Health, History
- Corewell Health, For Michigan, By Michigan
- MDHHS Medicaid Bulletin MSA 16-14: Enrollment of Marriage and Family Therapists as Medicaid Providers (issued June 1, 2016)
- AAPC Codify, CPT code 90847 (family psychotherapy with the patient present)