Plan features

Region 1: Allegan, Barry, Kent, Lenawee, Ottawa

Region 2: Berrien, Calhoun, Cass, Ionia, Isabella, Kalamazoo, Mason, Midland, Missaukee, Montcalm, Muskegon, Newaygo, Oceana, Osceola, Otsego, St. Clair, Van Buren, Wexford

Region 3: Alcona, Antrim, Benzie, Charlevoix, Clare, Crawford, Grand Traverse, Hillsdale, Lake, Lapeer, Leelanau, Manistee, Mecosta, Monroe

Region 4: Alpena, Cheboygan, Eaton, Emmet, Gladwin, Gratiot, Iosco, Jackson, Kalkaska, Montmorency, Oscoda, Presque Isle, Roscommon, Sanilac, Shiawassee, St. Joseph

Region 5: Arenac, Bay, Branch, Clinton, Genesee, Huron, Ingham, Livingston, Macomb, Oakland, Ogema, Saginaw, Tuscola, Washtenaw, Wayne

Your Priority Health vision coverage is administered by EyeMed^SM. Routine vision services covered by your plans include:

• $0 copay for one routine exam each year (includes dilation and refraction)
• $0 copay for one retinal imaging per year
• $100-$125 eyewear allowance per year, depending on plan

See your Certificate of Coverage for details.

As a Priority Health EyeMed member you have access to thousands of independent providers as well as national retailers such as LensCrafters, Pearle Vision and Target Optical.

Routine vision services must be provided by an EyeMed "Select" provider. Call 844.366.5127 (TTY 711), Monday through Friday from 8 a.m. to 8 p.m. Or search here.

When you go to an EyeMed "Select" network provider, they file your claim and you only have to pay the cost of any services or eyewear that exceeds your plan's benefit. Show your Priority Health Medicare member ID card to health care providers when using your vision benefits.

To see the full EyeMed Certificate of Coverage please reference the Vision section in your Certificate of Coverage.

For 2027 members, your dental coverage is administered by Delta Dental Plan of Michigan, Inc®. Preventive (routine) dental services covered by your plan include:

• $0 copay for two cleanings (regular or periodontal) per year
• $0 copay for two exams per year
• $0 copay for one set of bitewing X-rays per year
• $0 copay for one brush biopsy per year
• $0 copay for all other X-rays (one every two years)

2027 PriorityMedicare Key, PriorityMedicare Vital and PriorityMedicare Thrive also cover the following services:

• $0 copay for minor restorative services (fillings once every 24 months and crown repair once per tooth every 12 months)
• $0 copay for simple extractions once per tooth per lifetime
• $0 copay for anesthesia when used during qualifying dental services
• $1,500 annual maximum to use on comprehensive services (periodontal cleanings not included)

2027 PriorityMedicare Value and PriorityMedicare Thrive Plus also cover the following services:

• $0 copay for minor restorative service (fillings once every 24 months and crown repairs once per tooth every 12 months)
• $0 copay for simple extractions once per tooth per lifetime
• 50% of the total cost for root canals, once per tooth per lifetime
• $0 copay for anesthesia when used during qualifying dental services
• $2,500 annual maximum to use towards comprehensive dental services (periodontal cleanings not included)

Always refer to your Certificate of Coverage to verify benefits.

In addition to the dental coverage included in your medical plan, the 2027 Enhanced Dental and Vision package also includes:

• $0 copay for fillings and crown repair - on all plans except PriorityMedicare Key, PriorityMedicare Thrive, PriorityMedicare Thrive Plus PriorityMedicare Value, and PriorityMedicare Vital
• $0 copay for emergency treatment for dental pain and anesthesia
• 50% of the total cost of simple extractions on all plans except PriorityMedicare Key, PriorityMedicare Thrive, PriorityMedicare Thrive Plus PriorityMedicare Value, and PriorityMedicare Vital
• 50% of the total cost of onlays, crowns and associated substructures
• 50% of the total cost for oral surgery
• 50% of the total cost of bridge repairs
• 50% of the total cost of root canals — on all plans except PriorityMedicare Thrive Plus and PriorityMedicare Value
• 50% of the total cost of bridges ONLY on PriorityMedicare Thrive Plus and PriorityMedicare Value
• 50% of the total cost of dentures, denture relines and repairs
• 50% of the total cost for implants and implant related services
• $0 copay for one fluoride treatment per year
• PriorityMedicare Thrive Plus and PriorityMedicare Value: $5,000 total annual coverage limit (includes the $2,500 annual maximum on the embedded dental services) to use towards both embedded and comprehensive dental services.
• All other plans $2,500 annual coverage limit on enhanced dental services only (does not include fluoride treatment)

Always refer to your Certificate of Coverage to verify benefits.

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

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 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.

• $0 copay for routine hearing exam per year
• Most plans have four levels of hearing aids: $295, $695, $1,095 or $1,495 copay, per ear per year

For 2027, PriorityMedicare Vital members only

• $99 copay for TruHearing-branded 'Advanced' or $399 copay for TruHearing-branded 'Premium' aids, one per ear, every two years

For 2027, PriorityMedicare D-SNP members only

• $0 copay for up to two TruHearing-branded Advanced hearing aids, one per ear every two years

For 2027, PriorityMedicare Dual Premier members only

• $0 copay for up to two TruHearing-branded Advanced hearing aids, one per ear every three years

Because this is a benefit offered to Priority Health members, all appointments must be made through TruHearing directly by calling 833.714.5356 (TTY 711), Monday through Friday 8 a.m. to 8 p.m. A TruHearing consultant will verify your plan enrollment, answer all your questions, and schedule an appointment with an in-network provider.

Routine hearing services must be received from a TruHearing provider. There is no out-of-network coverage. Members must seek services and care covered by approved providers by following the steps above.

Show your Priority Health Medicare member ID card to health care providers when using your hearing benefits.

See your plans Certificate of Coverage document for details.

Contact your doctor's office to see if they offer virtual care or access virtual care in your member account.

Log in Sign up

Teladoc Health Mental Health is a free mental wellness resource that offers support for stress, depression, sleep and more to help you live your happiest and healthiest life.

Teladoc Health Mental Health empowers you with:

• A personalized plan. Answer a series of questions and Teladoc Health will create a plan designed just for you.
• Recommended digital content and resources. Explore self-guided activities and tools based on your goals and needs.
• In-the-moment tools. Mindfulness and meditation techniques to boost your mood and help you focus on the present.
• Dedicated support. Connect with a coach to encourage and support you through your journey.

Simply go to the Teladoc Health website or app, click "Create a new account" or "Set up your account" to get started.

As a Priority Health Medicare member, you have access to our Medication Therapy Management services, or MTM for short, at no additional cost to you if you meet the Medicare MTM program requirements or are identified as an At-Risk Beneficiary through the Priority Health Drug Management Program. The MTM program connects you with a registered pharmacist for a yearly comprehensive medication review that can help reduce your costs and improve your health. In addition, your medications are reviewed quarterly to address potential issues by sending your provider a Targeted Medication Review (TMR).

Learn more about the MTM program

The preferred way of disposing unused controlled medications is to bring them to community take-back sites near you. Before bringing your medications to take-back sites, use a marker to cover any personal information, such as your name or prescription number. The US Drug Enforcement Administration (DEA) allows unused prescription medications to be mailed back to pharmacies or other authorized sites using packages made available at pharmacies or other drug disposal sites. Contact your local pharmacy prior to mailing unused medications. Other medication collection sites in your area and information about medication disposal may be found at the websites below:

• Information regarding drug take back
• Additional take-back sites near you
• Flush list for Certain Medicines
• Safely Dispose of Drugs