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 Hills — 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.

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 Hills.

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

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 Hills 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 Hills 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 Hills 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 Hills 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 Hills (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

Dr. Tom Biernacki, DPM

Dr. Tom Biernacki, DPM is a double board-certified podiatrist and foot & ankle surgeon at Balance Foot & Ankle Specialists in Southeast Michigan. With over a decade of clinical experience, he specializes in heel pain, bunions, diabetic foot care, sports injuries, and minimally invasive surgery. Dr. Biernacki is a member of the APMA and ACFAS, and his patient education content on MichiganFootDoctors.com and YouTube has reached over one million views.