Spectrum Health retiree medical plan

Here are your documents with important information about your Priority Health Medicare coverage. We recommend you review this information so you are aware of your benefits for the next year. 

PriorityMedicare plan documents

The Annual Notice of Changes informs you of any changes to the benefits and premium to your plan for the next year. The Evidence of Coverage is the document you should reference in the upcoming year when seeking information about your coverage.

Your dental coverage is administered by Delta Dental Plan of Michigan, Inc.

To find a Delta Dental network dentist call 800.524.0149 (TTY 711), Mon. - Fri.,         9 a.m. - 8 p.m., or go to deltadentalmi.com.

When you go to a participating dentist, they file your claim. You only have to pay your copayment and the cost of any non-covered services.

If you go to a non-participating dentist:

  • Your cost may be higher.
  • The dentist will file an out-of-network claim form on your behalf.
  • Delta Dental will send payment to you, and you will be responsible for making full payment to the dentist, unless you authorize payment directly to the provider on the out-of-network claim form.
  • You are responsible for paying any difference between what Delta Dental pays and the dentist's bill.

Delta Dental services predetermination request and claim form.

The Drug List tells you what Part D prescription drugs are covered by the plan in 2017. It also lets you know if there are any rules that restrict coverage for a drug.

For the most current list of which drugs are covered, use our online Approved Drug List (formulary).

Provider and Pharmacy Directory

The Priority Health Medicare Provider and Pharmacy directory provides a list of Priority Heath Medicare's network providers broken out into five regions of the state. Some network providers may have been added or removed from our network after these directories were created. To get the most up-to-date information about Priority Health Medicare network providers use our online Find a Doctor directory or call Customer Service.


If you have questions after reviewing these documents, call 888.389.6648 or email Customer Service