The short answer
Original Medicare, Parts A and B, generally does not cover routine dental care, eye exams for glasses or contacts, glasses, hearing aids or the exams to fit them. There are narrow exceptions. Medicare may pay for dental work that is closely tied to a covered medical service, such as before a heart valve repair or organ transplant, as part of some cancer treatment or for dialysis. Part B covers some eye care, including yearly diabetic eye exams, glaucoma tests for people at high risk and one pair of glasses after cataract surgery with a lens implant. It covers diagnostic hearing and balance exams when a doctor orders them. Medicare Advantage plans often add dental, vision and hearing benefits, but they vary and have limits. Medigap generally does not fill the gap. Medicaid, community health centers and dental schools are other places to look.
The short answer by service
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| Service | Covered? | The exception |
|---|---|---|
| Routine dental: cleanings, fillings, extractions, dentures | No | Some dental care closely tied to a covered procedure, such as a heart valve repair, an organ transplant, cancer treatment or dialysis |
| Routine eye exam for glasses or contacts | No | Yearly diabetic eye exams, glaucoma tests for people at high risk and treatment for conditions like macular degeneration are covered |
| Glasses and contact lenses | No | One pair of standard glasses or one set of contacts after cataract surgery that implants a lens |
| Hearing aids and fitting exams | No | None. Diagnostic hearing and balance exams are covered when a doctor orders them |
The pattern is that Medicare pays when the service is part of diagnosing or treating a medical condition, and not when it is routine upkeep. You still pay your Part B deductible and 20 percent of the cost for the exceptions.
Dental: the exceptions that matter
If a dental problem could threaten a covered procedure, the dental care is treated as part of the procedure. A dentist may need to clear an infection before a heart valve replacement or an organ transplant, or treat the jaw before radiation for head and neck cancer. For people with kidney failure, some dental services tied to dialysis can be covered.
These are specific and require the medical team to document why the care is needed. If you expect one, ask the specialist's office to confirm with Medicare before the dental work and not after. Everything else, including a cleaning, a filling, a crown or dentures, you pay for, unless you have other coverage.
Vision: what Part B covers
Eyeglasses are not covered, but certain eye care is, because it treats disease. Yearly diabetic eye exams, glaucoma screening for people at high risk and treatment of macular degeneration are in that group. Cataract surgery is covered, and so is one pair of standard glasses or one set of contacts afterward, if the surgery implants a lens.
A routine exam to update a prescription is not covered, even if it finds a problem. If the exam is billed as a medical visit because of a symptom, such as sudden vision loss, it can be. Ask how the visit will be billed before you book. Many Medicare Advantage plans cover a yearly eye exam and an allowance toward frames or lenses, so check the plan's limit.
Hearing: exams but not aids
Part B covers diagnostic hearing and balance exams when a doctor or another provider orders them to find out whether you need medical treatment. It does not pay for hearing aids or for the exams to fit them, and neither does Medigap.
Since 2022, adults with mild to moderate hearing loss can buy hearing aids over the counter without a prescription or a fitting visit, and prices are often well below the prescription models. They are not covered by Medicare, but they have lowered the price of a first pair for many people. Prices vary widely, from a few hundred dollars for some over-the-counter models to a few thousand dollars a pair for prescription aids with fittings. A hearing test with an audiologist can tell you which kind is right, and the diagnostic part of that visit may be covered when a doctor orders it.
Where Medicare Advantage fits
Many Medicare Advantage plans include dental, vision and hearing benefits that Original Medicare does not. Our guide to Original Medicare and Medicare Advantage compares the two. The benefits are optional, so they vary by plan, and the details are in the plan's Evidence of Coverage, which is where to look before you enroll.
Check four things. First, the yearly dollar limit: a plan may pay for a cleaning and an exam but cap other dental care at a modest amount a year. Second, the network: the dentist you see must take the plan. Third, waiting periods and prior authorization for crowns, dentures or hearing aids. Fourth, the plan's other costs, because a plan with generous extras may have narrower doctor networks. The choice to change plans comes in the fall open enrollment period, so a plan bought for the dental benefit is a commitment for the year.
The extras often look better in the brochure than in practice. A plan may cover cleanings and exams in full but cap all other dental care at about $1,000 a year, so a crown that costs more than that leaves the member paying the difference. The plan still saves money compared with paying everything out of pocket, but not the full cost, which is why the limit is worth reading before you enroll.
Choosing what to do
Start with why you need the care, because that decides which door to knock on. If the need is medical, such as diabetes, a cataract or a pending transplant, check Part B first, because the covered exceptions may apply. If the need is routine and your income is limited, Medicaid, a community health center or a dental school is likely to cost far less than any plan. If your income is comfortable and you want predictable costs, add up what you expect to use in a year, such as two cleanings, an exam, new glasses and a hearing test, and compare it with the premium and limits of a plan.
A plan is worth buying only if the benefits you will use exceed what you pay in premiums, waiting periods and the part of each bill you still owe. For people who need little care, paying out of pocket is sometimes cheaper.
Other ways to pay less
- Medicaid. Adult dental coverage is optional for states, so it ranges from emergency care only to full coverage. Some states also cover hearing aids and eyeglasses. Our guide to Medicare and Medicaid explains how the two work together.
- Community health centers. Federally supported health centers charge on a sliding scale based on income, and many offer dental care.
- Dental schools. Accredited dental schools often offer care by students under supervision at reduced prices.
- Stand-alone dental or vision plans. A separate plan costs a monthly premium and usually has waiting periods and yearly limits, so compare the total cost to the care you expect.
- Veterans' benefits. The VA covers dental and hearing care for some veterans, depending on service history and enrollment.
If your income is limited, a Medicare Savings Program will not add dental coverage, but it can free up money by paying your premiums.
Questions about dental, vision and hearing
Does Medigap cover dental, vision or hearing?
Generally no. Medigap pays costs Original Medicare leaves behind for covered services, such as coinsurance. It does not usually add dental, routine vision care or hearing aids.
Does Medicare cover dentures?
No. Dentures are excluded, even after tooth removal, unless a Medicare Advantage plan or other coverage pays for them.
Can I add dental coverage to Original Medicare?
Medicare does not sell dental add-ons. You can buy a stand-alone dental plan from a private insurer, or join a Medicare Advantage plan that includes dental benefits during an enrollment period.
Is a hearing test covered?
A diagnostic hearing exam is covered when a doctor orders it to see whether you need medical treatment. A test for the purpose of fitting a hearing aid is not.
What changes
Coverage rules and plan benefits change each year, and the exceptions depend on your medical situation and the plan you have. Check the Medicare coverage pages and your plan's Evidence of Coverage before you book care, and call 1-800-MEDICARE with questions.
Official sources
Before you book
Decide which of the three you need most, then ask three questions: does Medicare cover it, does your plan, and does a lower-cost option exist near you. If a plan change is on the table, our guide to when to sign up for Medicare lists the dates.
