Dental, Vision, and Hearing Coverage Under Medicare
Original Medicare has very limited dental, vision, and hearing coverage, but Medicare Advantage plans and standalone options can fill these gaps.
What Original Medicare Covers
Original Medicare (Parts A and B) provides very limited coverage for dental, vision, and hearing services. Understanding what is and is not covered helps you plan for these essential healthcare needs.
Dental: Original Medicare does not cover most dental care, including routine cleanings, fillings, tooth extractions, dentures, or other dental devices. Medicare Part A may cover certain dental services performed in a hospital setting when they are integral to another covered procedure (for example, jaw reconstruction after an accident).
Vision: Original Medicare covers annual glaucoma screening tests for high-risk individuals, diagnostic eye exams if you have symptoms of an eye disease, and cataract surgery (including one pair of eyeglasses or contact lenses after surgery). It does not cover routine eye exams, eyeglasses, or contact lenses.
Hearing: Original Medicare covers diagnostic hearing and balance exams ordered by a physician to determine if you need medical treatment. It does not cover routine hearing exams, hearing aids, or hearing aid fittings.
Dental, Vision, and Hearing Through Medicare Advantage
The most common way Medicare beneficiaries access dental, vision, and hearing benefits is through Medicare Advantage plans. The majority of MA plans include some level of these benefits at no extra cost.
Typical dental benefits in MA plans include preventive dental (cleanings, exams, X-rays) with low or $0 copays, and some plans offer comprehensive dental including fillings, crowns, root canals, and dentures with higher cost-sharing. Annual dental benefit allowances typically range from $1,000 to $5,000.
Typical vision benefits include annual routine eye exams with low copays ($0-$25), plus an annual allowance of $100-$300 toward eyeglasses or contact lenses.
Typical hearing benefits include annual hearing exams with low or $0 copays, plus a hearing aid allowance of $500-$3,000 per ear (varies significantly by plan).
Benefit levels and annual allowances vary greatly between plans. Always compare the specific dental, vision, and hearing benefits when evaluating Medicare Advantage options.
Standalone Dental Plans for Medicare Beneficiaries
If you have Original Medicare or want dental coverage beyond what your Medicare Advantage plan provides, standalone dental insurance plans are available.
Dental HMO/DHMO plans typically cost $15-$30 per month and require using in-network dentists. They often have lower out-of-pocket costs but limited provider choices.
Dental PPO plans typically cost $30-$75 per month and offer more provider flexibility. They usually cover 100% of preventive care, 50-80% of basic procedures, and 50% of major procedures after a waiting period.
Dental discount plans are not insurance but membership programs offering 10-60% discounts at participating dentists. Monthly fees are typically $10-$20.
Consider your dental health needs when choosing: if you need only preventive care, a lower-cost option works. If you need crowns, implants, or dentures, a more comprehensive plan with higher annual maximums is worth the premium.
Standalone Vision Plans
For vision coverage outside of Medicare Advantage, standalone vision plans are available from companies like VSP, EyeMed, and others.
Typical standalone vision plan costs range from $15-$30 per month and include an annual eye exam with a small copay ($10-$25), an annual allowance of $100-$250 toward eyeglasses or contacts, and discounts on lens options and LASIK.
If you wear glasses or contacts and need annual prescriptions, a standalone vision plan typically pays for itself through the exam coverage and frame/lens allowance.
Hearing Aid Coverage Options
Hearing aids are among the most expensive healthcare items not covered by Original Medicare. A single hearing aid typically costs $1,000-$6,000, and most people need two.
Medicare Advantage plans with hearing benefits can significantly reduce hearing aid costs. Some plans offer allowances of $1,000-$3,000 per ear, making hearing aids much more affordable.
Other options include over-the-counter hearing aids, which became available in 2022 for mild to moderate hearing loss at significantly lower prices ($200-$800 per pair), Costco and warehouse club hearing centers that offer brand-name hearing aids at 50-60% below retail, state hearing aid assistance programs available in some states, and nonprofit organizations that provide free or low-cost hearing aids.
The Veterans Affairs (VA) healthcare system also provides hearing aids to eligible veterans at no cost.
Frequently Asked Questions
Does Original Medicare cover dental cleanings?
No. Original Medicare does not cover routine dental care including cleanings, fillings, extractions, or dentures. You need a Medicare Advantage plan with dental benefits, a standalone dental plan, or to pay out of pocket.
Do all Medicare Advantage plans include dental, vision, and hearing?
Not all, but the vast majority of Medicare Advantage plans include some dental, vision, and hearing benefits. The level of coverage varies significantly between plans, so compare specific benefit details and annual allowances when choosing a plan.
Does Medicare cover hearing aids?
Original Medicare does not cover hearing aids or routine hearing exams. Many Medicare Advantage plans include hearing aid benefits with allowances ranging from $500 to $3,000 per ear. Over-the-counter hearing aids are also available for mild to moderate hearing loss.
Are over-the-counter hearing aids a good alternative?
OTC hearing aids can be a good option for adults with mild to moderate hearing loss. They cost significantly less ($200-$800 per pair) than prescription hearing aids and do not require a professional fitting. However, they are not suitable for severe hearing loss and lack the customization of prescription devices.
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Disclaimer: Plan availability, benefits, and premiums vary by location. Contact Medicare.gov or 1-800-MEDICARE for complete information. We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.