Original Medicare (Parts A & B) excludes most coverage for dental, vision, and hearing services and products.
Many Medicare Advantage plans include some dental, vision, and hearing coverage beyond what Original Medicare offers.
There are also charitable foundations and other resources to help older adults pay for dental, vision, and hearing care.
Does Medicare cover dental, vision, and hearing care? If you’re age 65 or about to turn 65, it’s a question that may be on your mind. After all, healthy teeth, eyesight, and hearing play an important role in aging well.
While Original Medicare (Parts A & B) covers a range of vital health care services, coverage for dental, vision, and hearing is limited. In most cases, if you receive these services, you will be responsible for all costs unless you have private insurance, you have a supplemental Medigap insurance plan, or you’re using a low-cost resource. The guide below can help you understand what coverage you have as a Medicare beneficiary—and what options there are for filling the gaps.
“Dental, vision, and hearing care benefits are essential to staying healthy and not simply extras,” said Christopher Ciano, president of Medicare for Aetna.
Make sure you review your plan options carefully before you enroll,” Ciano said.
Medicare Dental Coverage
Does Medicare cover routine dental care services?
In short, no. Original Medicare does not cover routine oral health and dental care you receive mainly to keep your teeth and gums healthy. This includes services such as cleaning, fillings, dentures, and root canals.
When does Medicare cover dental care services?
Original Medicare may pay for dental services that are medically necessary. In 2023, Medicare will cover a medically required tooth extraction, oral exam, or other treatments prior to, or accompanying the following procedures:
- Organ transplants
- Cardiac valve replacements
- Valvuloplasty procedures
In 2024, Medicare will cover these oral health services when there’s a case of head or neck cancer. Even if Medicare does pay for some preparatory dental work, it will not cover the cost of implants or dentures. Medicare also does not cover any follow-up dental care once your primary health condition has been treated.
Some Medicare Advantage (MA / Part C) plans cover routine dental services. Medicare Advantage is an alternative way to receive your Medicare coverage. These plans must cover all the same services offered under Original Medicare, but they may also provide additional benefits—such as preventive dental care, which can include oral exams, cleanings, and X-rays. Some MA plans even include comprehensive services, such as fillings and extractions. If you have an MA plan, check to see what dental coverage it includes.
How can I get help paying for dental care services?
Below are some options for finding free or low-cost dental services, if you’re having trouble affording them:
- The American Dental Association website helps you find low-cost dental care clinics at dental schools in your region.
- There may be a community health center in your area that provides inexpensive dental care to people with limited incomes.
- You may qualify for free, comprehensive dental treatment in your state through the Dental Lifeline Network.
Medicare Vision Coverage
Does Medicare cover routine vision care services?
In most cases, Original Medicare does not cover routine eye care services such as yearly vision screenings, glasses, and contact lenses.
When does Medicare cover vision care services?
Under Part B, Medicare covers an annual eye exam from a state-authorized doctor to:
- Check for diabetes-related vision problems (e.g., diabetic retinopathy) if you have diabetes.
- Check for glaucoma if you are at high risk for the condition (e.g., you have a family history of glaucoma).
Medicare also covers certain services related to a chronic eye condition. For example, it will pay for:
- Surgery to remove a cataract and replace your eye’s lens with an intraocular lens.
- One pair of post-cataract surgery eyeglasses or contact lenses from a Medicare-enrolled supplier.
- An eye exam to diagnose potential serious eye conditions if you are having problems with your vision.
For each of these covered services, you would pay 20% of the Medicare-approved amount. The Part B deductible applies.
Many Medicare Advantage plans offer coverage for an annual routine vision exam and an allowance to purchase prescription eyewear. If you’re an MA enrollee, ask your health plan what vision-related services and products are included.
How can I get help paying for vision care services?
You may be able to get vision care assistance from the programs below:
- EyeCare America® offers free eye exams and up to one year of care for qualifying individuals with low income.
- New Eyes provides vouchers for prescription glasses to people with low income.
- Your local Lions Club chapter may have a program to help people who are severely vision impaired.
Medicare Hearing Coverage
Does Medicare cover routine hearing care services?
Beginning in 2023, Medicare will cover a visit to an audiologist without a referral from a physician if the hearing loss or balance issue has existed for 12 or more months. For these qualifying patients, Medicare will cover the audiology visit once every 12 or more months.
Certain Medicare Advantage plans offer coverage for hearing assessments and hearing aids. In fact, from 2018 to 2020, the percentage of MA plans offering some type of hearing benefit increased from 83% of all plans to 93%.1 If you have MA, check with your plan to see what it covers.
The U.S. Food & Drug Administration (FDA) approved the sale of over-the-counter (OTC) hearing aids beginning Oct. 17, 2022. OTC hearing aids treat mild to moderate hearing loss (not severe hearing loss) in adults ages 18 and older. You can now buy a hearing aid without a medical exam, prescription, or professional fitting. The average price of OTC hearing aids is several thousand dollars cheaper than that of prescription hearing aids. See NCOA’s complete guide to OTC hearing aids—including who they're for, how they work, and where to buy them.
Where can I get help paying for hearing aids and tests?
If you're having trouble paying for hearing tests and hearing aids, one of the following programs may be able to help you:
- Help America Hear is a need-based assistance program that provides new hearing aids for people with low income.
- Your local Lions Club may run a program that distributes low-cost hearing aids to those in need.
- Sertoma helps connect people to national and state hearing assistance programs.
How to learn more about Medicare Advantage dental, vision, and hearing benefits
Having dependable dental, vision, and hearing coverage is essential to staying healthy and active as you get older. Since Original Medicare offers limited coverage, it’s something to think about when you’re exploring different Medicare Advantage plans for 2023. Get expert help in understanding your Medicare coverage with our free Age Well Planner tool.
This content was developed in partnership with Aetna. Learn more about what you need to know about Medicare.
1. The Commonwealth Fund. Medicare Advantage Plans Offering Expanded Supplemental Benefits: A Look at Availability and Enrollment. Feb. 10, 2021. Found on the internet at https://www.commonwealthfund.org/publications/issue-briefs/2021/feb/medicare-advantage-plans-supplemental-benefits