Your vision, dental and hearing benefits

Page last updated on: 3/27/25

Vision, dental, and hearing benefits come standard on all Priority Health Medicare plans. Our partnership with Delta Dental provides you with a large network of dentists, and your plan covers routine exams and cleanings. Plus, all of our plans include routine vision from EyeMed providers and hearing coverage from TruHearing providers.

In the first 60 days of your coverage, you have the option to enhance your dental and vision benefits by choosing to enroll in our enhanced package for an additional $37 per month. If you choose to enhance your dental coverage, your allowance to use toward comprehensive dental services becomes $4,500 (includes the $2,000 embedded dental allowance), plus an additional $150 to spend toward eyewear.

Apply online

Using your vision benefits

Vision services included in your plan

Your Priority Health vision coverage is administered by EyeMedSM. Routine vision services covered by your plan include:

  • $0 for one routine exam each year (includes dilation and refraction)
  • $0 for one retinal imaging per year
  • $100 eyewear allowance per year

See your Evidence of Coverage document 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-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.

Using your dental benefits

Dental services included in your plan

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)

Plus comprehensive dental services including:

  • $0 for minor restorative services (fillings once every 24 months and crown repair once per tooth every 12 months)
  • $0 for simple extractions once per tooth per lifetime
  • $0 for anesthesia when used during qualifying dental services
  • 50% coverage for root canals, once per tooth per lifetime
  • $2,000 annual maximum to use on all comprehensive services (periodontal cleanings not included)

See your Evidence of Coverage document for details.

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.

You will likely pay less out-of-pocket by receiving treatment from an in-network dentist. If you receive treatment from an out-of-network provider who charges more for a service than what Delta Dental has agreed to pay, you will be responsible for the difference.

Additionally, 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.

Dental claim form

Delta Dental services predetermination request and claim form

Using your hearing benefits

Hearing services included in your plan

Good hearing is important to your health. That’s why Priority Health covers routine hearing services through our partnership with TruHearing®. Services covered include:

  • $0 routine hearing exam per year
  • $295, $695, $1,095 or $1,495 copay, per ear, per year, for hearing aids from top manufacturers, depending on level selected

See your Evidence of Coverage document for details.

All appointments must be made through TruHearing directly by calling 833.714.5356 (TTY 711), Monday-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.

All hearing services must be received from a TruHearing provider. There is no out-of-network coverage. Show your Priority Health Medicare member ID card to health care providers when using your hearing benefits.

H4875_NCMS400040062523X_C 10182024