Does Medicare cover dental, vision and hearing?
Original Medicare does not pay for routine dental care, glasses or hearing aids. Here is where the lines fall and what your options are.
- Original Medicare does not cover routine dental care, routine eye exams, glasses, or hearing aids.
- It does pay for medical eye care and for exams that diagnose a problem, and after cataract surgery it covers one pair of glasses.
- Most Medicare Advantage plans add some dental, vision and hearing coverage. The question to ask is how much, on what schedule, and with which dentists.
No. Original Medicare, meaning Part A and Part B, does not cover routine dental care, routine vision care or hearing aids. This is the gap that shocks people most, because these are the three things they expected to use. Medicare states what dental care it will and will not pay for on medicare.gov.
Dental: what Medicare pays for and what it does not
Not covered: cleanings, exams, fillings, extractions, root canals, dentures and implants. That is the everyday dentistry most people mean when they ask.
Sometimes covered: dental work that is a necessary part of a covered medical procedure. Examples are rebuilding a jaw after an accident, or a dental exam required before an organ transplant or certain heart surgeries.
The test is whether the dental care is part of a covered medical service, not whether your teeth hurt.
Vision: exams versus glasses
Not covered: routine eye exams for glasses, and the glasses or contacts themselves.
Covered: medical eye care. Part B, the part of Medicare that pays for doctor visits and outpatient care, pays for glaucoma screening for people at high risk, exams for diabetic eye disease, treatment for macular degeneration, and cataract surgery. After cataract surgery with an implanted lens, Medicare covers one pair of corrective lenses, meaning glasses or contacts.
So the eye disease side is well covered, and the eyeglasses side is not.
Hearing: exams versus hearing aids
Not covered: hearing aids, and the exams to fit them. This is the biggest out of pocket gap of the three, meaning money you pay yourself, because hearing aids routinely cost thousands of dollars.
Covered: a diagnostic hearing and balance exam when your doctor orders it to find a medical problem, such as the cause of vertigo (a spinning kind of dizziness).
That is the pattern across all three. Medicare pays to find out what is wrong, but not for the thing that fixes it.
Ways to get dental, vision and hearing coverage
- Most Medicare Advantage plans, the private plans that deliver your Medicare benefits, include some dental, vision and hearing coverage as extra benefits. This is one of the main reasons people choose that path, and in Hidalgo County these plans are widely available.
- Standalone dental and vision policies, sold on their own, can be bought separately and paired with Original Medicare and a supplement.
- Medigap policies do not cover any of these. A Medigap policy, also called a supplement, pays your share of what Medicare covers, and Medicare does not cover these at all.
That last point surprises people, so it bears repeating. A supplement pays your share of covered services. It cannot pay for something Medicare never covered.
How to read the extra benefits in an Advantage plan
Advantage plans differ a great deal here. Some include a meaningful yearly dental allowance, an amount the plan will pay toward dental work. Some include a small one that a single crown uses up. The same goes for eyewear and hearing aid allowances.
Whether a plan includes dental is the wrong question. Ask how much it pays, on what schedule, and with which dentists. That is a plan by plan conversation, and we would rather have it with you directly than publish it in general terms. See how Advantage dental and vision benefits work.
For the bigger picture, see what Parts A and B cover.
The next step is to ask those three questions of any plan you are considering: how much, on what schedule, and with which dentists. Call our McAllen office at (956) 687 3334, or enter your ZIP code in the plan pricing box on this page.
Common follow-up questions
Will Medicare pay for dentures?
No. Original Medicare does not cover dentures at any point. Some Advantage plans include an allowance toward them.
Are hearing aids ever covered?
Not by Original Medicare. Some Medicare Advantage plans include a hearing aid benefit, and the amounts vary widely from plan to plan.
Does a Medigap plan add dental coverage?
No. Medigap pays your share of services Medicare already covers. Since Medicare does not cover routine dental, there is nothing for the supplement to pay.
Want this looked at properly?
We are an independent agency in McAllen serving Hidalgo, Cameron and Starr counties. There is no obligation to talk it through.
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Gerino Alejos
Licensed insurance agent · License 3128710 · NPN 18243381
Owner of McAllen Insurance Group, an independent agency on North 10th Street in McAllen. Works with clients across Hidalgo, Cameron and Starr counties on Medicare, Marketplace health, life and auto coverage. Se habla español.