Service | HAP HMO-POS Medicare Advantage | HAP HMO-POS Non-Medicare |
|---|---|---|
Deductible | $550 single | $600 single/$1,200 family |
Coinsurance | 10% | 10% |
Telehealth | Covered | Covered |
Primary care office visit | $0 copay | $25 copay |
Specialist office visit | $35 copay | $40 copay |
Emergency care visit | $135 copay | $150 copay |
Urgent care visit | $45 copay | $60 copay |
Laboratory and pathology | Covered | 10% coinsurance after deductible |
Radiology | $10 copay after deductible | 10% coinsurance after deductible |
Inpatient hospital services | 10% coinsurance after deductible | 10% coinsurance after deductible |
Outpatient surgery | 10% coinsurance after deductible | 10% coinsurance after deductible |
Skilled nursing | Days 1-20: $0; Days 21-100: 10% coinsurance after deductible | 10% coinsurance after deductible |
Physical therapy | $10 copay | $25 copay |
Chiropractic services | $10 copay | $25 copay |
Plan overview
Health Alliance Plan (HAP) offers comprehensive health care coverage tailored for Michigan Public School Employee Retirees. This page provides an overview of costs, access to care and service areas to help members understand their benefits and make informed health care decisions.
Avoid surprise costs
- You’re covered for an annual preventive visit. View your benefit summaries to find out costs for your specific plan. This can include a review of your medical and social history related to your health. You and your doctor should also discuss preventive services such as screenings recommended for you, shots and referrals for other care, if needed.
- However, if your doctor or other health care provider performs additional tests or services during the same visit that aren’t covered under these preventive benefits, you may have to pay a copay and deductible, if applicable.
Knowing where to go for care can save you money
It’s important to know the difference between urgent and emergency conditions to make sure you get the right care at the right time. This can save you out-of-pocket expenses and ensure you’re treated quickly based on your condition. In most cases, it will cost you less out-of-pocket to visit an affiliated urgent care center than an emergency room. Need help determining where to go for what? Check out our helpful tool.
Understanding deductibles
A deductible is a fixed amount of money you have to pay annually before HAP begins paying its portion of your medical costs.
Generally, prescription drugs and medical services covered by a copay do not count toward the deductible. All other covered services without copays count toward the deductible.
A health insurance deductible works similar to auto insurance. Let’s say you are involved in an accident. First, you have to pay your deductible amount and then your insurance company pays for the rest for the repair work. Health insurance deductibles work the same way.
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Explore HAP’s 2026 plan information brochure
Health Alliance Plan (HAP) has HMO-POS plans with Medicare contracts. Enrollment depends on contract renewal.