Using your Medicare dental benefits

Dental services included in your plan

For both 2022 and 2023 members, your dental coverage is administered by Delta Dental Plan of Michigan, Inc®. Preventive (routine) dental services covered by your plan include:
  • $0 for two cleanings (regular or periodontal) per year
  • $0 for two exams per year
  • $0 for one set of bitewing X-rays per year
  • $0 for one brush biopsy per year
  • $0 for all other X-rays (one every two years)

2022 PriorityMedicare Key are also covered for the following services:

  • 50% coinsurance for minor restorative services (filling and crown repair)
  • 50% coinsurance for simple extractions

Refer to the Appendix in your Evidence of Coverage document for details.

2023 PriorityMedicare Key, PriorityMedicare Vital and PriorityMedicare + Kroger are also covered for the following services:

  • $0 for minor restorative services (fillings once every 24 months and crown repair once per tooth ever 12 months)
  • $0 for simple extractions once per tooth per lifetime
  • $0 for anesthesia when used in conjunction with services above
  • $1,500 annual maximum on all comprehensive services (periodontal cleanings not included)

Refer to the Appendix in your Evidence of Coverage document for details.

2022 Optional Enhanced Dental services

In addition to the dental coverage included in your medical plan, the 2022 Enhanced Dental and Vision package also includes:

  • $0 copay for fillings and crown repair
  • 50% of the cost for oral surgery
  • $0 copay for one fluoride treatment per year
  • 50% coinsurance for implants and implant related services
  • $2,500 annual coverage limit

See the appendix in your Evidence of Coverage documents for details.

Show your Priority Health Medicare member ID card to health care providers when using your Enhanced Dental Benefits.

2023 Optional Enhanced Dental services

In addition to the dental coverage included in your medical plan, the 2023 Enhanced Dental and Vision package also includes:

  • $0 copay for fillings and crown repair - on all plans except PriorityMedicare Key, PriorityMedicare Vital and PriorityMedicare + Kroger
  • $0 for emergency treatment for dental pain and anesthesia
  • 50% of the cost of simple extractions on all plans except PriorityMedicare Key, PriorityMedicare Vital and PriorityMedicare + Kroger
  • 50% of the cost of onlays, crowns and associated substructures
  • 50% of the cost for oral surgery
  • 50% of the cost of bridge relines and repairs
  • 50% of the cost of dentures, denture relines and repairs
  • 50% coinsurance for implants and implant related services
  • $0 copay for one fluoride treatment per year
  • $2,500 annual coverage limit

See the appendix in your Evidence of Coverage document for details.

Show your Priority Health Medicare member ID card to health care providers when using your Enhanced Dental Benefits.

Find a Delta Dentist network dentist

To find a Delta Dental Medicare Advantage PPO and Medicare Advantage Premier network dentist call 800.330.2732 (TTY 711), Mon. - Fri., 8 a.m. - 8 p.m., or go to their provider locater.

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:

If out-of-network (non-participating) providers charge more for a service than what Delta Dental has agreed to pay, you will be responsible for the difference. You will likely pay less out-of-pocket by receiving treatment from an in-network (participating) dentist. If you choose to receive services from an out-of-network dentist, be sure to ask the dentist if they have opted out of Medicare. Delta Dental is unable to make payment for any services received from a provider that has opted out of Medicare.

Claim form

Not enrolled in the Enhanced Dental and Vision package yet?

If you don't already have the Enhanced Dental and Vision package, you can add it to your coverage within two months of your Medicare Advantage plan start date, or during the annual enrollment period of Oct. 15 – Dec. 7 of each year.