Spectrum Health retiree medical plan
Scroll down to find everything you need to know about your plan for 2020:
- Links to your plan documents
- Drug coverage
- Information about our provider and pharmacy network
We recommend you review this information so you are aware of your benefits for the next year.
Your 2020 plan documents
Your dental coverage is administered by Delta Dental Plan of Michigan, Inc.
To find a Delta Dental dentist call 800.330.2732 (TTY 711), Mon. - Fri., 9 a.m. - 8 p.m., or go to deltadentalmi.com.
Participating dentists are those in Michigan, Indiana and Ohio who are in Delta Dental’s Medicare Advantage PPO and Medicare Advantage Premier network.
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.
Non-participating dentists are those who do not participate in Delta Dental’s Medicare Advantage PPO or Medicare Advantage Premier networks in Michigan, Indiana or Ohio, or any dentist in any other state or country.
The Drug List tells you what Part D prescription drugs are covered by your plan in 2020. 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.
2020 provider and pharmacy networks
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 tool, or call Customer Service.
If you have questions after reviewing these documents, call our Customer Service department at 888.389.6648 (press #3) or log in to your member account to send us an email.