What Medicare Really Covers for Dental, Vision, and Hearing
We often hear people say, “Medicare is great—until I need a dentist or new glasses.” And they’re not wrong. While Medicare does an excellent job covering hospitals, surgeries, and chronic conditions, it falls short in three important areas: dental, vision, and hearing.
These services are essential to staying healthy and independent, especially in retirement. Let’s walk through what Medicare covers, where it falls short, and how you can fill those gaps affordably.
What Medicare Covers—and What It Doesn’t
Let’s start with the basics. Original Medicare (Parts A and B) does not cover routine dental care, glasses or contacts, or hearing aids. These are considered “non-medical” services, even though we all know they’re essential.
Dental Care: Cleanings, fillings, extractions, and dentures? Not covered. Medicare only steps in when dental services are medically necessary and tied to something more serious—like prepping for heart surgery or treating jaw cancer.
Some examples of what is covered:
- Tooth extraction before chemotherapy
- Dental exam before a heart valve replacement
- Treatment linked to oral cancer or jaw reconstruction
Vision Care: Medicare does provide decent coverage for medical conditions like:
- Cataracts (including surgery and one set of post-surgical glasses)
- Glaucoma testing
- Macular degeneration treatments
- Diabetic retinopathy screenings
But routine eye exams, glasses, and contacts? Not unless they’re tied to a medical procedure like cataract surgery.
Three Medicare Path Options—and Their Perks and Pitfalls
When it comes to how you get your Medicare, there are three general paths:
- Original Medicare only – This is the riskiest choice. About 10% of people go this route, but it leaves you exposed to unlimited financial liability.
- Original Medicare + Supplemental Plan (like Plan G or Plan N) – This combo gives you great coverage for medical care, but you still need separate plans for dental and vision.
- Medicare Advantage (Part C) – These are bundled plans managed by private insurance companies. About 50% of Medicare beneficiaries go this route. Many Advantage plans include dental, vision, and hearing extras, though the quality and limits of those perks vary widely.
Filling the Dental Coverage Gap
Since Medicare doesn’t cover regular dental care, many people buy a standalone dental plan.
Here’s what to expect:
- Monthly premiums: $30–$80 depending on coverage
- Annual benefit limits: $1,500–$5,000 per year
- Coverage tiers:
- Preventive care (cleanings, exams): 100% covered immediately
- Basic care (fillings, simple extractions): 80–90% after a 6-month wait
- Major care (crowns, root canals, dentures): 50% after 12 months
To avoid waiting periods, the best time to sign up is within 30–60 days of losing group coverage. Plans often waive those waits if you’re coming off an employer policy.
Adding Vision Coverage to Your Plan
Standalone vision plans are affordable and easy to bundle with dental coverage.
- Monthly premiums: $12–$18
- Annual benefits: About $300 for glasses or contacts
- Included perks:
- One annual eye exam at no cost
- Discounts on frames and lenses
- Large networks like EyeMed and VSP
Just like dental, it’s smart to enroll when you leave a group health plan or when you’re signing up for a dental policy.
Medicare Advantage: Bundled Coverage with Perks—But with Trade-Offs
Medicare Advantage plans, managed by private insurers, often include built-in dental and vision coverage—or let you add optional “riders” to extend those benefits.
Dental benefits can include:
- $1,000–$2,000 annual allowances
- Full coverage for cleanings and exams
- 50% coinsurance for out-of-network services
- Optional dental riders (e.g., $54/month for $1,500 in benefits)
Vision benefits often include:
- One routine eye exam per year (zero copay)
- $100–$300 annual eyewear allowances
- Some reimbursement for out-of-network eyewear purchases
But remember: Advantage plans come with networks. If your preferred dentist or eye doctor isn’t in-network, you could end up paying more—or not be covered at all. Also, not all Advantage plans are created equal, so it’s important to read the fine print.
What About Hearing Aids?
While this outline didn’t focus heavily on hearing coverage, it’s worth noting that Original Medicare doesn’t cover hearing exams or hearing aids either. However, many Medicare Advantage plans include some level of hearing aid benefits, often through partner networks.
Final Thoughts: Making the Right Move for Your Needs
If dental, vision, and hearing are important to you—and let’s be honest, they are—then make sure you’re not relying on Original Medicare alone.
Here’s what you can do:
- Add standalone dental and vision plans to your supplemental Medicare coverage
- Compare Advantage plans if you want bundled extras, but check the provider networks and coverage limits
- Sign up early, especially when leaving group insurance, to avoid waiting periods and penalties
Our team at Medicare School is here to help walk you through your options. With the right plan in place, you’ll have peace of mind—not just for your health, but for your wallet, too.
