Your 2016 enhanced vision, dental, hearing plan ($19) information
Find out what our 2016 enhanced vision, dental, hearing plan offers you. Review your benefits below or by downloading any of your coverage documents.
The $19 Enhanced vision, dental hearing plan is for members enrolled in our PriorityMedicare KeySM or PriorityMedicare IdealSM plans.
Your plan documents
Your coverage documents provide detailed explanations about how your plan works.
- Summary of Benefits
- Out-of-network vision services claim form
- Priority Health Vision certificate of coverage
- Delta Dental services predetermination request and claim form
- Delta Dental certificate of coverage, $19 a month package
- Out-of-network hearing services claim form
- Priority Health hearing certificate of coverage
Enhanced vision, dental, hearing coverage summary
In-network vision benefits
One exam every calendar year
Eyewear allowance per calendar year
In-network dental benefits
Exam & cleaning
One exam & one cleaning, per calendar year
One exam and one cleaning per calendar year are already included in your Medicare Advantage plan. This means you will have a total of 2 fully-covered dental visits per calendar year.
One set of bitewing X-rays, per calendar year
50% of the bitewing X-ray cost is already included in your Medicare Advantage plan and the other 50% is included as part of this optional enhanced package.
Cost for fillings, crown repairs and root canals
In-network hearing benefits
One exam every two years
Every 5 years (60 months)
Your plan covers up to $1,000 for both ears every 5 years (based on a calendar year).
Not enrolled yet?
If you don't already have the enhanced vision, dental, hearing 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.