Does Medicare Cover Dental, Vision, and Hearing? What Original Medicare Misses

One of the biggest surprises for people new to Medicare is discovering what it does not cover. Original Medicare — Part A (hospital insurance) and Part B (medical insurance) — provides broad coverage for hospital stays, doctor visits, lab work, and preventive care. But it leaves three critical categories of health care almost entirely out: dental, vision, and hearing.

This gap affects millions of seniors. According to the Centers for Medicare and Medicaid Services, more than half of all Medicare beneficiaries have no dental coverage, and one in four reports difficulty affording dental care. Vision and hearing care face similar access challenges. Understanding exactly what Original Medicare covers — and what it misses — is the first step toward protecting your health and your wallet.

What Original Medicare Covers (The Very Limited List)

Original Medicare was never designed to be a comprehensive dental, vision, and hearing plan. When Medicare was signed into law in 1965, dental and vision care were explicitly excluded from the benefit package, and hearing aids have never been covered. However, there are a handful of narrow exceptions where Medicare will step in.

Dental coverage under Original Medicare:

• Dental exams and procedures that are medically necessary before certain covered surgeries (for example, a dental exam before a heart valve replacement or organ transplant)
• Dental treatment required during an inpatient hospital stay for a jaw injury, jaw reconstruction, or oral cancer treatment
• Extraction of teeth to prepare the jaw for radiation treatment of head and neck cancers

Vision coverage under Original Medicare:

• Annual glaucoma screening for people at high risk (those with diabetes, a family history of glaucoma, African Americans age 50 and older, Hispanic Americans age 65 and older)
• Diabetic retinopathy exams for people with diabetes
• One pair of eyeglasses or contact lenses after cataract surgery with an intraocular lens implant (Medicare Part B pays for standard frames)
• Diagnosis and treatment of eye diseases such as macular degeneration and cataracts

Hearing coverage under Original Medicare:

• Diagnostic hearing and balance exams ordered by a doctor to determine if you need medical treatment — not for the purpose of fitting hearing aids
• Cochlear implants when medically necessary (covered under Part B as a prosthetic device)

That is the complete list. Anything that falls outside these narrow categories — and most dental, vision, and hearing services do — is your responsibility to pay for out of pocket.

What Original Medicare Does NOT Cover

To be absolutely clear about the gaps, here is what Original Medicare explicitly excludes:

Dental services NOT covered:

• Routine dental exams and cleanings
• Fillings, crowns, bridges, and root canals
• Tooth extractions (unless related to covered hospital procedures)
• Dentures and dental implants
• Dental X-rays
• Periodontal (gum) treatment

Vision services NOT covered:

• Routine eye exams for glasses or contact lens prescriptions
• Eyeglasses and contact lenses (except the one-time post-cataract surgery benefit)
• LASIK and other refractive eye surgery
• Low-vision aids and rehabilitation

Hearing services NOT covered:

• Hearing aids of any type (behind-the-ear, in-the-ear, completely-in-canal)
• Hearing aid fitting, adjustment, and maintenance
• Routine hearing tests and screenings (only diagnostic exams ordered by a physician are covered)
• Hearing aid batteries and accessories

Average Costs Without Coverage

Without insurance or plan coverage, dental, vision, and hearing care can be expensive. Here is what you can expect to pay out of pocket at typical market rates:

Dental costs without coverage:

• Routine cleaning: $100 to $200 per visit
• Dental X-rays: $25 to $250 depending on type
• Filling (single tooth): $150 to $400
• Crown: $800 to $3,000
• Root canal: $700 to $1,500
• Full set of dentures: $1,000 to $5,000
• Dental implant (single tooth): $3,000 to $6,000

Vision costs without coverage:

• Routine eye exam: $75 to $250
• Prescription eyeglasses (frames and lenses): $200 to $600
• Contact lenses (annual supply): $200 to $500
• Cataract surgery (per eye, without Medicare): $3,500 to $7,000

Hearing costs without coverage:

• Hearing test: $60 to $250
• Prescription hearing aids (pair): $2,000 to $7,000
• Over-the-counter hearing aids (pair): $200 to $3,000
• Hearing aid batteries (annual): $50 to $150

For a senior who needs a dental crown, new glasses, and a pair of hearing aids in the same year, the total out-of-pocket cost could easily exceed $5,000 to $10,000 — all for services that Original Medicare will not help pay for.

Medicare Advantage Plans: The Primary Way to Get Dental, Vision, and Hearing

Medicare Advantage (Part C) plans are the most popular way for Medicare beneficiaries to access dental, vision, and hearing benefits. These plans are offered by private insurance companies approved by Medicare, and they must cover everything Original Medicare covers — plus they are allowed to offer supplemental benefits that Original Medicare does not.

According to CMS data, over 97 percent of Medicare Advantage plans offered in 2026 include some form of dental, vision, or hearing coverage. Many plans include all three. Here is what these benefits typically look like:

Dental benefits in Medicare Advantage:

• Preventive dental: Most plans cover two cleanings, two oral exams, and routine X-rays per year at $0 copay
• Basic dental: Fillings, extractions, and periodontal services are covered in many plans with copays or coinsurance
• Comprehensive dental: Higher-tier plans may cover crowns, bridges, root canals, dentures, and sometimes implants, subject to annual maximums typically ranging from $1,000 to $3,000

Vision benefits in Medicare Advantage:

• Annual routine eye exam, often at $0 to $40 copay
• Annual eyewear allowance for glasses or contacts, typically $100 to $300 per year
• Some plans cover lens upgrades such as progressive lenses, anti-glare coating, and photochromic lenses

Hearing benefits in Medicare Advantage:

• Annual routine hearing exam, typically at $0 to $40 copay
• Hearing aid benefit with an allowance that varies widely — from $500 to $3,000 or more per ear, per year or per three-year period depending on the plan
• Hearing aid fitting and follow-up visits included in some plans

Important: Not all Medicare Advantage dental, vision, and hearing benefits are equal. Some plans offer preventive-only dental coverage, meaning they cover cleanings and exams but nothing else. Others provide comprehensive benefits with generous annual maximums. The premium, copay structure, annual limits, and provider network all vary by plan and by region. Always compare your plan's Evidence of Coverage (EOC) document before making a decision.

Standalone Dental and Vision Plans

If you want to stay on Original Medicare — because you value the freedom to see any doctor in the country or you already have a Medigap policy — you can still get dental and vision coverage through standalone private insurance plans. These plans are not part of Medicare and are purchased separately.

Standalone dental insurance:

• Monthly premiums: $20 to $60 per month
• Annual maximums: Most plans cap payouts at $1,000 to $2,000 per year
• Waiting periods: Many plans require 6 to 12 months of enrollment before major services (crowns, root canals, dentures) are covered
• Key providers: Delta Dental, AARP/Delta Dental, Humana, Cigna, and Spirit Dental are among the largest carriers for seniors

An alternative to traditional dental insurance is a dental discount plan (also called a dental savings plan). These are not insurance — instead, you pay an annual fee of $80 to $200 and receive discounted rates (typically 15 to 60 percent off) at participating dentists. There are no waiting periods, no annual maximums, and no claim forms, but you pay the discounted price directly at the time of service.

Standalone vision insurance:

• Monthly premiums: $10 to $25 per month
• Typical benefits: One routine eye exam per year, $100 to $200 allowance for frames, and discounts on lenses and contacts
• Key providers: VSP (Vision Service Plan), EyeMed, AARP/VSP, and Davis Vision

Standalone hearing insurance:

Standalone hearing insurance plans are less common than dental or vision plans, but several options exist. Some dental and vision plans bundle hearing benefits for an additional cost. Hearing aid discount programs — such as those offered through AARP, Costco, and TruHearing — provide significant savings on hearing aids without requiring insurance. Costco hearing aids, for example, typically cost $1,400 to $2,500 per pair, well below the industry average.

How to Fill the Gap: A Step-by-Step Approach

There is no single right answer for everyone, but here is a practical framework for deciding how to get dental, vision, and hearing coverage:

1. Assess your needs. Do you need routine preventive care only (cleanings, eye exams), or do you anticipate needing major work (crowns, dentures, hearing aids)? Your expected care drives which type of coverage makes the most financial sense.
2. Consider Medicare Advantage first. If you are open to using a provider network and your preferred doctors participate, a Medicare Advantage plan with dental, vision, and hearing benefits can be the most cost-effective option — especially plans with $0 premiums beyond Part B.
3. Compare standalone plans if staying on Original Medicare. Purchase separate dental and vision plans from private insurers. Check the annual maximum, waiting periods, and provider network before enrolling. For hearing aids, consider discount programs through AARP or Costco.
4. Check if you qualify for Medicaid. Dual-eligible beneficiaries (those who qualify for both Medicare and Medicaid) may receive dental, vision, and hearing coverage through their state Medicaid program at no additional cost.
5. Look into community resources. Dental schools, community health centers, and charitable organizations like Dental Lifeline Network and Lions Club International provide free or reduced-cost dental, vision, and hearing services in many areas.
6. Review your coverage annually. Medicare Advantage plans change their supplemental benefits every year. During the Annual Open Enrollment Period (October 15 through December 7), compare plans to make sure your dental, vision, and hearing benefits still meet your needs.

Medicaid Coverage for Dental, Vision, and Hearing

Medicaid — the joint federal-state program for people with limited income — can fill gaps that Medicare leaves in dental, vision, and hearing coverage. If you qualify for both Medicare and Medicaid, you are known as a dual-eligible beneficiary, and your Medicaid benefits layer on top of Medicare.

However, Medicaid dental, vision, and hearing benefits vary dramatically by state:

• Dental: Federal law requires Medicaid to cover dental services for children, but adult dental coverage is optional for states. As of 2026, most states provide some level of adult dental benefits, but coverage ranges from emergency-only extraction services to full preventive and restorative care. Only about half of states offer comprehensive adult dental coverage under Medicaid.
• Vision: Most state Medicaid programs cover at least one eye exam per year and basic eyeglasses for adults. Some states also cover contact lenses when medically necessary.
• Hearing: A growing number of states cover hearing aids and hearing exams under Medicaid, though benefit limits and replacement schedules vary. Some states limit coverage to one hearing aid per ear every three to five years.

To find out what your state Medicaid program covers, contact your state Medicaid office or call 1-800-MEDICARE (1-800-633-4227). Your local State Health Insurance Assistance Program (SHIP) can also help you understand your benefits at no charge.

Recent Legislative Changes and the Push to Expand Medicare Benefits

The lack of dental, vision, and hearing coverage in Original Medicare has been a major policy debate for years. Several legislative efforts have aimed to close these gaps:

• Build Back Better Act (2021-2022): The original Build Back Better proposal included adding dental, vision, and hearing benefits to Original Medicare Part B. The hearing benefit was included in early versions, but dental and vision were scaled back or removed during negotiations. The legislation ultimately did not pass in its original form.
• Inflation Reduction Act (2022): While the IRA delivered major prescription drug reforms — including the $2,000 annual out-of-pocket cap on Part D — it did not include dental, vision, or hearing provisions. These benefits were removed from the final bill during Senate negotiations.
• Medicare Dental, Vision, and Hearing Benefit Act: This bill, reintroduced in multiple sessions of Congress, would add comprehensive dental, vision, and hearing benefits to Medicare Part B. As of early 2026, it has not been signed into law, though it continues to have bipartisan support from some legislators.
• Over-the-counter hearing aids (2022 FDA rule): In October 2022, the FDA finalized a rule allowing hearing aids to be sold over the counter without a prescription for adults with mild to moderate hearing loss. While this is not a Medicare coverage change, it has significantly reduced costs — OTC hearing aids are available for as little as $200 per pair compared to $2,000 to $7,000 for prescription devices.
• CMS expansion of Medicare Advantage supplemental benefits: CMS has progressively expanded the types of supplemental benefits that Medicare Advantage plans can offer, including the Special Supplemental Benefits for the Chronically Ill (SSBCI) program. This has led to richer dental, vision, and hearing benefits within the Medicare Advantage market, even as Original Medicare remains unchanged.

The bottom line on legislation: while there is broad public support for adding dental, vision, and hearing to Medicare — polls consistently show over 80 percent of Americans favor it — congressional action has stalled. For the foreseeable future, beneficiaries will need to look to Medicare Advantage plans, standalone insurance, Medicaid, or out-of-pocket spending to cover these essential services.

The Bottom Line

Original Medicare is a strong foundation for health coverage, but it was never built to cover dental, vision, and hearing care. That gap is not a minor oversight — it affects the daily quality of life for millions of seniors who need to chew, see, and hear clearly to stay healthy and independent.

The good news is that you have options. Medicare Advantage plans offer the most convenient path to dental, vision, and hearing benefits bundled into a single plan. Standalone insurance plans let you add coverage while staying on Original Medicare. Medicaid provides a safety net for those with limited income. And community resources can help when insurance is not available or affordable.

The most important step is to know the gap exists — and to plan for it before you need expensive care. Review your options during the Annual Open Enrollment Period each fall, compare plans carefully, and do not assume that Medicare covers everything. When it comes to dental, vision, and hearing, it simply does not.