Priority Health Podiatry Coverage in Michigan

Quick answer: Priority Health Podiatry Michigan affects roughly 1 in 4 adults in our practice. Effective treatment starts with a targeted diagnosis, conservative-first treatment, and escalation only when needed. We treat this regularly at our Howell and Bloomfield Township practices. Book online, or call (810) 206-1402.

Related Conditions

Priority Health Podiatry Coverage in Michigan

If you have Priority Health insurance in Michigan, you have podiatry coverage. Balance Foot & Ankle — with offices in Howell and Bloomfield Township — is in-network with Priority Health. Here’s everything you need to know about your Priority Health podiatry benefits.

Priority Health Podiatry Coverage Overview

Plan type: Michigan-based insurer with commercial employer plans, individual marketplace plans, and Medicare Advantage.
Referral required? PPO: No referral. HMO: PCP referral required.
Typical specialist copay: Typically $30-$55 specialist copay.

What Priority Health Covers for Podiatric Care

• New patient evaluation and established patient visits
• Diagnosis and treatment of all medically necessary foot and ankle conditions
• Podiatric surgery with pre-authorization when required
• In-office X-rays and ultrasound imaging
• Diabetic foot care and wound management
• Cortisone and therapeutic injections
• Custom orthotics when medically necessary
• Nail care for patients with qualifying systemic conditions

Special Notes for Priority Health Members

Call our office to confirm current in-network status for your specific Priority Health plan, as network participation can vary.

Typical Costs with Priority Health

Not in your Priority Health network, or paying cash? You do not need a benefits check. A first visit is a flat $250 — exam, any X-rays taken that day, and same-day treatment included. Follow-ups are $100. See exactly what the $250 covers.

Office visit copay: $20–$40 for most Priority Health plans.
Specialist copay: $30–$50 depending on your plan tier.
Diagnostic imaging: Typically covered at 80–100% after deductible.
Custom orthotics: Covered with prior authorization. Patient coinsurance typically 20–30%.
Surgery: Covered as medically necessary. Most plans cover 80–90% after deductible and pre-authorization.

Priority Health Referral Requirements

Priority Health HMO: Referral from your primary care physician is required before seeing a specialist.
Priority Health POS: Referral required for in-network specialist visits at the lowest cost.
Priority Health PPO: No referral needed — you can book directly with our office.

How to Verify Your Priority Health Benefits at Balance Foot & Ankle

The fastest way to know exactly what you’ll pay is to call our office. We contact your insurance company directly and verify your deductible status, copay amount, referral requirements, and covered services — before your appointment, at no charge to you.

📞 Call (810) 206-1402 to verify your Priority Health podiatry benefits — we’re in-network in Howell and Bloomfield Township.

Priority Health Podiatry Coverage in Michigan: In-Network Benefits and Authorization Guide

Reviewed by Dr. Tom Biernacki, DPM, FACFAS

Board-certified foot & ankle surgeon · 3,000+ surgeries · @MichiganFootDoctors (950K+ subscribers)

Last reviewed May 11, 2026 · (810) 206-1402

Priority Health, the Grand Rapids-based Michigan health insurer, offers commercial and Medicare Advantage plans to residents in Livingston and Oakland counties. Balance Foot & Ankle participates in Priority Health’s network for most commercial and Medicare Advantage plan designs, allowing members to access our Howell and Bloomfield Township locations at in-network benefit levels. Priority Health PPO members can typically self-refer to a podiatrist without a PCP referral; Priority Health HMO members should verify referral requirements with their primary care provider before scheduling. Priority Health covers medically necessary podiatric services including office evaluation, diagnostic imaging, cortisone injection, custom orthotics (with prior authorization and medical necessity documentation), wound care, and surgical procedures.

Priority Health Medicare Advantage members in Livingston and Oakland counties benefit from podiatry coverage that mirrors traditional Medicare Part B with Priority Health-specific cost-sharing. The annual comprehensive diabetic foot exam is covered for qualifying diabetic members, medically necessary nail care is covered when systemic condition documentation supports it, and surgical podiatric care is covered with prior authorization. Priority Health members who want to know their expected cost-sharing for a specific podiatric service should call Balance Foot & Ankle at (810) 206-1402 — our insurance verification team reviews Priority Health benefits and provides a cost estimate before your appointment. Same-week appointments at our Howell and Bloomfield Township offices are available for Priority Health members with urgent foot conditions.

Patients covered under this plan who are uncertain about network participation or authorization requirements for specific services are encouraged to call Balance Foot & Ankle at (810) 206-1402 before scheduling. Our insurance team verifies benefits for every new patient — confirming in-network status, identifying specialist cost-sharing, and flagging any prior authorization requirements for planned procedures. This verification call is free and typically takes less than 5 minutes, eliminating the uncertainty that leads many patients to defer necessary foot care. Same-week appointments are available in Howell and Bloomfield Township for most foot and ankle concerns.

Michigan patients with this insurance coverage who experience foot pain, nail problems, or any foot condition that has been bothering them should not wait for symptoms to worsen before scheduling. Early evaluation at Balance Foot & Ankle almost always results in a conservative treatment plan that costs far less and requires far less recovery time than the surgical or advanced care that deferred conditions eventually require. Both our Howell office at 4330 E Grand River and our Bloomfield Township office at 43494 Woodward Ave #208 offer convenient access for Livingston and Oakland county patients. Call (810) 206-1402 today.

Related Treatment Guides

• Plantar Fasciitis & Heel Pain Treatment
• Custom 3D Orthotics
• Sports Foot & Ankle Injury Treatment
• Bunion Treatment

Michigan patients experiencing foot or ankle problems can schedule an appointment at Balance Foot & Ankle — with locations in Howell (4330 E Grand River) and Bloomfield Township (43494 Woodward Ave #208). Call (810) 206-1402 for same-week availability.

Medical References & Sources

• American Podiatric Medical Association — Patient Education
• American Orthopaedic Foot & Ankle Society — Foot Conditions

Your Board-Certified Podiatrists

Dr. Tom Biernacki, DPM

Board-Certified · FACFAS

Dr. Carl Jay, DPM

Board-Certified Podiatrist

Dr. Daria Gutkin, DPM

Podiatrist

Visit Balance Foot & Ankle — Same-Day Appointments Available

Our podiatry team serves patients throughout Michigan including Howell, Brighton, and Bloomfield Township. If you’re dealing with heel pain, ingrown toenails, or a foot injury, we have same-day appointment availability.

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