Many Americans turning 65 and enrolling in Medicare are surprised to discover a major gap in their coverage: Medicare does not routinely cover dental, vision, or hearing services. These are some of the most essential components of healthy aging, yet they’re excluded from Original Medicare in most cases.
If you’re wondering whether your routine eye exam, new hearing aids, or upcoming dental procedure will be covered under Medicare, you’re not alone. This article breaks down what Medicare does—and doesn’t—cover when it comes to dental, vision, and hearing, and what your options are for getting the care you need.
Why Are Dental, Vision, and Hearing Excluded?
Original Medicare, which includes Part A (hospital insurance) and Part B (medical insurance), was established in 1965. At the time, dental, vision, and hearing were considered “routine” services and excluded from standard coverage.
Despite advances in understanding how oral health, vision, and hearing impact overall wellness, these exclusions have remained—largely due to cost concerns. However, there is a growing push in Congress and among advocacy groups to expand Medicare to include them.
What Dental Services Does Medicare Cover?
For the most part, Medicare does not cover routine dental care, including:
Cleanings
Fillings
Extractions
Dentures
Implants
Routine X-rays
However, Medicare does cover dental procedures that are medically necessary in conjunction with other covered treatments. For example:
If you’re undergoing jaw surgery or hospitalization for a serious health condition and need dental clearance or tooth extraction as part of the treatment, Medicare may pay for it.
If a dental exam is required before a kidney transplant or heart valve replacement, Medicare may cover that exam.
Emergency or complicated dental procedures performed in a hospital setting may be covered under Part A.
Still, routine care like crowns, root canals, and dentures are not covered, even if they affect your quality of life.
What Vision Services Does Medicare Cover?
Original Medicare also excludes most routine vision services, such as:
Annual eye exams for vision correction
Glasses and contact lenses
LASIK or other elective surgeries
Medicare Part B does cover certain medically necessary vision-related services, including:
Glaucoma screenings once per year for high-risk individuals (e.g., those with diabetes or a family history)
Diabetic retinopathy exams for people with diabetes
Macular degeneration treatment (such as injections)
Cataract surgery, including a basic pair of corrective eyeglasses or contact lenses after surgery
It’s important to note that while Medicare pays for cataract removal and lens implants, it does not pay for upgraded lenses or frames unless they’re considered medically necessary.
What Hearing Services Does Medicare Cover?
Medicare’s hearing coverage is similarly limited. It does not cover:
Hearing exams for fitting hearing aids
Hearing aids themselves
Hearing aid repairs or replacements
However, Medicare Part B will cover:
Diagnostic hearing and balance exams, if your doctor orders them to determine a medical condition (like vertigo or hearing loss linked to another disease)
In most cases, if you’re diagnosed with hearing loss and need aids, you’ll be responsible for the full cost—which can easily exceed $1,000 per ear.
The Over-the-Counter Hearing Aid Act of 2017, which went into effect in 2022, allows consumers to purchase lower-cost hearing aids without a prescription, but these are designed for mild to moderate hearing loss and aren’t a replacement for custom-fitted devices.
What About Medicare Advantage Plans?
There’s a silver lining: Medicare Advantage (Part C) plans often fill in the gaps.
These private plans, offered by insurance companies and approved by Medicare, frequently include coverage for:
Routine dental exams, cleanings, and X-rays
Fillings, crowns, root canals, and even dentures (to some extent)
Annual vision exams and eyeglasses
Hearing tests and hearing aids
However, the level of coverage varies widely by plan. Some may offer only basic services, while others offer more generous benefits with annual dollar limits. For example, a plan may cover up to $1,000 for dental services per year, or provide a $500 allowance for hearing aids.
When choosing a Medicare Advantage plan, be sure to compare:
Coverage details and exclusions
Out-of-pocket costs
Annual maximums or benefit caps
Network restrictions (some plans limit which providers you can use)
To find plans with dental, vision, and hearing benefits in your area, use the Medicare Plan Finder.
Can I Buy Standalone Coverage?
Yes. If you’re on Original Medicare and want additional coverage, you can purchase standalone plans, including:
Dental insurance plans from providers like Delta Dental, Aetna, or Cigna
Vision plans that cover exams, lenses, and frames (e.g., VSP, EyeMed)
Hearing discount plans or bundled dental-vision-hearing packages
These plans can be relatively affordable (often $15–$50/month), but always read the fine print. Some have waiting periods for major services, limited provider networks, or low annual coverage caps.
Medicaid and Low-Income Help
If you qualify for both Medicare and Medicaid (i.e., are dual-eligible), your state Medicaid program may cover some or all dental, vision, and hearing costs—depending on the state.
Medicaid dental coverage varies widely. Some states offer comprehensive coverage, while others offer only emergency dental services.
Vision and hearing aid coverage may also be included in your Medicaid benefits, especially for dual-eligible individuals.
To learn what’s covered in your state, check with your State Medicaid Office or review this state-by-state dental benefits summary from MACPAC.
The Push to Expand Coverage
There’s growing political support to expand Medicare to include dental, vision, and hearing coverage. Proposed legislation like the Medicare Dental, Vision, and Hearing Benefit Act would broaden benefits under Original Medicare—but progress has been slow.
In the meantime, many advocates recommend clearer plan communications, higher coverage caps under Advantage plans, and easier access to affordable standalone policies.
Bottom Line
Original Medicare offers very limited coverage for dental, vision, and hearing care. For most people, that means choosing between:
A Medicare Advantage plan with built-in benefits
Standalone insurance or discount plans
Paying out-of-pocket for care
If these services are a priority for you, it’s critical to compare your options carefully during Medicare’s Open Enrollment Period (October 15 to December 7). Don’t assume coverage is included—always check the fine print.
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