Using your Medicare dental benefits

Dental services included in your plan

For 2025 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) 

2025 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) 

2025 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
  • $2,000 annual maximum to use towards comprehensive dental services (periodontal cleanings not included)

Refer to your Certificate of Coverage for additional details.

2025 Optional Enhanced Dental services

In addition to the dental coverage included in your medical plan, the 2025 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 PriorityMeidcare Value: $4,500 total annual coverage limit (includes the $2,000 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)

Refer to your Certificate of Coverage for more information.

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? 

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