Priority Health
- Company typePrivate
- Founded1999
- HeadquartersGrand Rapids, United States
- Headcount1,001–5,000
- GTM typeB2B and B2C
- OfferingServices
Priority Health firmographics
Firmographics- Name
- Priority Health
- Legal name
- Priority Health Managed Benefits, Inc.
- Website
- https://priorityhealth.com
- Company type
- Private
- Founded year
- 1999
- Operating status
- Operating
- Headcount range
- 1,001–5,000 employees
- Ownership category
- akta.pro rank
Priority Health industry classification
Industry- Product category
- Managed Care Health Insurance
- NAICS
- Direct Health and Medical Insurance Carriers (524114), Direct Life, Health, and Medical Insurance Carriers (52411)
- SIC
- Hospital & Medical Service Plans (6324)
- akta.pro primary industry
- Managed Care / Network-Based Group Health Plans (Carrier Network Products) (FSAIAFAO)
- akta.pro secondary industries
- Medicare Advantage (MA) Plans (FSAIAGAA), Group HMO Plans (FSAIAFAK), Large Group Health Insurance (Mid-Market & National Accounts) (FSAIAFAE), Small Group Health Insurance (2–50/100) (FSAIAFAD)
Keywords
Where Priority Health is headquartered
LocationHeadquarters
- HQ city
- Grand Rapids
- HQ country
- United States
- HQ region
- North America
Offices3 records
Markets served
Priority Health business model
Business model- GTM type
- B2B and B2C
- Offering type
- Services
- Cost components
- Operations, Personnel, Technology or R&D, Marketing or Sales, Others
Revenue model
- Health Insurance Premiums: Recurring premium revenue from Individual & Family plans (MyPriority), Medicare Advantage and Medigap plans, Medicaid plans (MIChild, Healthy Michigan Plan, Children's Special Health Care Services), and Employer group plans (HMO/POS/PPO for small and large businesses)
- Medicare Advantage Plans: CMS-contracted Medicare Advantage plans including HMO-POS and PPO plans, generating premium revenue per member per month
- Employer Group Premiums: Premium revenue from employer-sponsored health plans with options for fully funded, level funded, or self-funded arrangements
Pricing tiers
| Model | Billing | Price |
|---|---|---|
| Subscription | Monthly | Medicare Advantage plans starting at $0 monthly |
| Subscription | Annual | Medigap plans with 12% household discount |
| Unit Pricing | Annual | Hearing aid copays ranging from $495-$1,695 |
| Subscription | Monthly | Metal tier plans (Bronze, Silver, Gold, Platinum) |
Go-to-market motion4 records
Distribution channels5 records
Marketing channels8 records
Priority Health product offering
Product offeringCore offering
Priority Health is a Michigan-based nonprofit health benefits company that sells a multi-line portfolio of health insurance plans to individuals, families, Medicare beneficiaries, Medicaid members, and employer groups. Its core products include MyPriority Individual & Family ACA Marketplace plans (Bronze/Silver/Gold/Platinum tiers), Medicare Advantage HMO-POS and PPO plans, Medigap supplemental insurance, Dual Eligible Special Needs Plans (D-SNP), Michigan Medicaid plans (MIChild, Healthy Michigan, Children's Special Health Care Services), and fully/level/self-funded employer group HMO/POS/PPO plans for small (2-50) and large (51+) businesses. The company layers a "whole-person care" model on top of these plans through integrated navigation, behavioral health, and specialty partnerships (Ayble Health, Virta Health, Carrot Fertility, Sword Health, Kivo Health).
Product overview
Priority Health is a nonprofit health benefits company and the fastest-growing health plan in Michigan, serving over 1.3 million members across the state. The company operates a multi-product health insurance portfolio consisting of: (1) MyPriority Individual & Family Plans offered through Marketplace and direct sales across metal tiers; (2) Medicare products including Medicare Advantage (ranked #1 in Michigan), Medigap supplemental plans, and Dual Eligible Special Needs Plans (D-SNP); (3) Michigan Medicaid plans covering MIChild, Healthy Michigan Plan, and Children's Special Health Care Services; and (4) Employer group plans for small (2-50 employees) and large (51+ employees) businesses with HMO, POS, and PPO network options. The whole-person care model is enabled through integrated add-on programs including PriorityGPS navigation service, Ayble Health (digestive), Virta Health (diabetes/weight), Carrot Fertility, Sword Health (musculoskeletal), and AI-powered COPD care with Kivo Health. Digital infrastructure includes member mobile app, Prism provider portal, Patient Access API via 1UpHealth, and QHP Provider & Formulary APIs. Community wellness initiatives include Priority Pups therapy dog program, Fitness Courts, and children's educational content.
Differentiator
Problem solved
Functional benefit
Brands
- PriorityGPS: Concierge navigation service to help members access and coordinate expanded health benefits.
- PriorityPups
- Priority Health Fitness Courts
Products and services
- MyPriority Individual & Family Plans
- Priority Health Medicare Advantage Plans
- Priority Health Medigap Plans
- Dual Eligible Special Needs Plans (D-SNP)
- Michigan Medicaid Plans (MIChild, Healthy Michigan, CSHCS)
- Small Business Health Plans (2-50 employees)
- Large Group Health Plans (51+ employees)
Quantifiable outcome
- 75,000+ Medicare and Individual members added for 2026 (record growth)
- +3 more outcomes
Companies that use Priority Health
Customer profileNamed customers2 records
Segments6 records
Ideal customer profiles5 records
Priority Health technology and API
TechnologyTechnology focussed No
API detail
- Has API
- Yes
- API docs
- API detail
Core technology
AI maturity
App detail
Integration8 records
AI capability3 records
Feature7 records
Priority Health partnerships and signals
Strategic signalPartnerships
Twelve partnerships are on record, tiered core.
- Kivo HealthcoreAI-powered virtual COPD care partnership expanding access to personalized treatment, remote monitoring, and live coaching for chronic obstructive pulmonary disease patients in Michigan.
- Ayble HealthcoreWhole-person care partnership for digestive health support as part of Priority Health's shift from treating isolated conditions to comprehensive physical, mental, and social health model.
- Virta HealthcoreWhole-person care partnership for weight management and diabetes support as part of expanded specialty health partnerships.
- Carrot FertilitycoreExpanded existing partnership for fertility health benefits as part of whole-person care initiative addressing reproductive and family health.
- Sword HealthcoreExpanded partnership for musculoskeletal conditions support as part of whole-person care approach, providing digital physical therapy solutions.
- Canines for ChangecorePriority Pups therapy dog program nonprofit partnership placing facility dogs in clinical and educational settings to provide emotional regulation support, with seven placements including Pine Rest expansion.
- Real Time Medical SystemscorePartnership to support advance care planning efforts through real-time medical data exchange and care coordination technology.
- ProbaricoreStrategic partnership for advance care planning efforts, providing clinical expertise and care management support.
- 1UpHealthcoreInteroperability partnership enabling secure patient, provider and third-party access to electronic health data through FHIR-compliant Patient Access API and Provider Directory API per CMS interoperability requirements.
- Express ScriptscorePharmacy benefits management partnership providing competitive prescription drug rates and pharmacy management procedures through the nation's largest PBM.
- National Fitness CampaigncoreStatewide partnership to expand free access to outdoor Fitness Courts in Michigan communities to fight obesity and improve quality of life, with goal of 30 courts statewide.
- Corewell HealthcoreOrganized Health Care Arrangement (OHCA) partnership for treatment, payment and healthcare operations, with Priority Health sharing PHI with Corewell Health for coordinated care.
Scale indicators8 records
Recent moves7 records
Expansion highlights6 records
Priority Health competitors and assessment
Company assessmentDirect peers
- Blue Cross Blue Shield of Michigan: BCBS Michigan is the dominant Michigan health insurer with significantly larger membership and is Priority Health's primary in-state competitor across all segments including Medicare Advantage, group, and individual ACA plans. Both companies compete for Michigan hospital network inclusion and broker relationships.
- Health Alliance Plan (HAP): HAP is a Michigan-based nonprofit health plan offering HMO, PPO, Medicare Advantage, and Medicaid products directly competing with Priority Health across the same Michigan geographies and customer segments. HAP's Henry Ford Health affiliation creates parallel provider integration dynamics.
- Molina Healthcare: Molina Healthcare is a managed care company with strong Medicaid focus that competes with Priority Health's Michigan Medicaid plans (MIChild, Healthy Michigan, CSHCS). Both companies pursue state Medicaid contracts and government program members with similar value-based care approaches.
- McLaren Health Plan: McLaren Health Plan is a Michigan-based HMO offering Medicare Advantage, Medicaid, and commercial plans competing head-to-head with Priority Health across Michigan. Both plans leverage integrated provider relationships and serve similar employer and individual segments.
Broad incumbents
- Humana: Humana is the largest Medicare Advantage-focused national carrier and directly competes with Priority Health's #1 MA position in Michigan. Humana's larger MA scale, broader broker network, and superior brand recognition in senior markets make it a formidable competitor for the same Medicare-eligible population.
- UnitedHealthcare: UnitedHealthcare is the largest US health insurer and competes with Priority Health across Medicare Advantage, employer group, and individual ACA segments in Michigan and Wisconsin. Its massive scale, Optum care delivery integration, and aggressive Medicare growth strategy make it a primary competitive threat.
- Aetna (CVS Health): Aetna, owned by CVS Health, offers Medicare Advantage, employer group, and individual plans competing with Priority Health nationally and in overlapping states. Its integrated CVS Health pharmacy and clinical assets create a vertically integrated model that contrasts with Priority Health's PBM partnership approach.
- Elevance Health (Anthem): Elevance Health operates Blue Cross Blue Shield plans in multiple states including neighboring states (Indiana, Wisconsin) where Priority Health is expanding. Its Anthem plans compete with Priority Health for employer group business and through affiliated BCBS brands across the Midwest.
- Centene Corporation: Centene is the largest Medicaid managed care organization in the US and competes with Priority Health's Medicaid business in Michigan and expansion states. Its WellCare and Ambetter brands also compete in the ACA marketplace where Priority Health's MyPriority plans operate.
Regional players
- Dean Health Plan: Dean Health Plan is a Wisconsin-based health plan that competes with Priority Health's newly expanded Wisconsin operations. Both offer HMO-style network products and Medicare Advantage plans with regional provider integration, making them natural competitors in Priority Health's newest expansion geography.
Market position
Strengths1 record
Weaknesses5 records
Competitive moat6 records
Key risks6 records
Key highlights7 records
Customer concentration
Priority Health social profiles
Digital presencePriority Health compliance and trust
Trust signalCompliance8 records
Priority Health financial estimates
Financial estimateRevenue estimate
Valuation estimate
Priority Health leadership team
Management profileNumber of profiles
Profiles4 records
Priority Health subsidiaries and ownership
Company hierarchySubsidiaries1 record
Priority Health funding detail
Funding detailFunding overview
Funding rounds1 record
Investors1 record
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
Priority Health M&A and investment
M&A and investmentM&A2 records
Investments1 record
M&A and investment is available on the Subscription and Enterprise plan.Contact sales →
Frequently asked questions about Priority Health
What does Priority Health do?
Priority Health is a Michigan-based nonprofit health benefits company that sells a multi-line portfolio of health insurance plans to individuals, families, Medicare beneficiaries, Medicaid members, and employer groups. Its core products include MyPriority Individual & Family ACA Marketplace plans (Bronze/Silver/Gold/Platinum tiers), Medicare Advantage HMO-POS and PPO plans, Medigap supplemental insurance, Dual Eligible Special Needs Plans (D-SNP), Michigan Medicaid plans (MIChild, Healthy Michigan, Children's Special Health Care Services), and fully/level/self-funded employer group HMO/POS/PPO plans for small (2-50) and large (51+) businesses. The company layers a "whole-person care" model on top of these plans through integrated navigation, behavioral health, and specialty partnerships (Ayble Health, Virta Health, Carrot Fertility, Sword Health, Kivo Health).
Is Priority Health a public or private company?
Priority Health is a private company. It is classified as nonprofit foundation owned and is currently operating.
When was Priority Health founded?
Priority Health was founded in 1999. It employs 1,001 to 5,000 people.
Where is Priority Health based?
Priority Health is headquartered in Grand Rapids, United States, in the North America region.
How does Priority Health make money?
Three revenue lines are on record. Health Insurance Premiums are the primary driver. The others are medicare Advantage Plans and employer Group Premiums.
Who are Priority Health's main competitors?
Direct peers on record are Blue Cross Blue Shield of Michigan, Health Alliance Plan (HAP), Molina Healthcare and McLaren Health Plan. Broad incumbents are Humana, UnitedHealthcare, Aetna (CVS Health), Elevance Health (Anthem) and Centene Corporation. Dean Health Plan is listed as a regional player.
Does Priority Health have an API?
Yes. Priority Health offers public-facing APIs for interoperability and transparency compliance. The Patient Access API (via 1UpHealth partnership) enables members to access claims, medical history, encounters, and clinical data including laboratory results. Provider Directory API provides provider information. QHP Provider & Formulary APIs provide machine-readable provider and drug formulary data files in JSON format. Machine-readable pricing files are available for in-network rates (HMO, PPO, POS, EPO) and out-of-network historical payments. APIs support FHIR R4, HL7 FHIR US Core IG STU 3.1.1, SMART Application Launch Framework, CARIN IG for Blue Button, and Da Vinci Payer Data Exchange standards. FHIR metadata endpoint available at api.priorityfhir.com/r4/metadata. Developer documentation is at www.priorityhealth.com/developers.
What industry is Priority Health in?
Priority Health's product category is Managed Care Health Insurance. Its primary akta.pro industry code is FSAIAFAO, Managed Care / Network-Based Group Health Plans (Carrier Network Products), with a secondary code of FSAIAGAA, Medicare Advantage (MA) Plans. Its NAICS code is 524114 and its SIC code is 6324.