Medicare Dental, Vision, and Hearing Benefits

Summary#

This bill adds dental, vision, and hearing coverage to the Medicare program. It defines which dental, vision, and hearing services are covered, adds dentures, eyeglasses, contact lenses, low vision devices, and hearing aids as covered items or durable medical equipment, and sets payment rules, frequency limits, and secretarial authority to limit or change coverage. Many coverage provisions take effect for services furnished on or after January 1, 2026.

What it means for you#

  • People enrolled in Medicare would be eligible for a range of dental services (preventive, basic, major, emergency, and related services), vision services (routine eye exams and related care), and hearing services (routine hearing exams, audiology services, and hearing aids).
  • Preventive dental services are paid at 100% beginning in 2026. Other dental services phase in: 0% before 2027, 30% in 2027, 60% in 2028, and 80% in 2029 and later. Certain low-income subsidy-eligible individuals receive higher coverage percentages earlier.
  • Dentures and many other items are covered; dentures have a limit of typically one full upper and one full lower denture once every five years.
  • Vision: routine eye exam coverage is limited to one exam per 12 months; payment is generally 80% of the lesser of charge or fee schedule. Eyeglass lenses, frames, and contact lenses have payment shares of 80% and dollar limits (for example, lens and frame limits with inflation adjustments starting 2027) and frequency limits. Low vision devices are covered at 80%.
  • Hearing: audiology and hearing services are generally paid at 80% of the lesser of charge or fee schedule. Hearing aids are covered at 80% with a typical limit of one hearing aid per ear in a 48-month period.
  • The Secretary of Health and Human Services may apply additional reasonable limitations, prior authorization requirements, modify coverage consistent with U.S. Preventive Services Task Force recommendations, or waive frequency limits for individuals or groups.
  • The bill removes prior statutory exclusions that barred Medicare coverage of many dental, vision, and hearing items and adds an oral health professional to the U.S. Preventive Services Task Force.

Expenses#

No publicly available information on cost estimates or budget effects is included in the bill text.

Proponents' View#

No publicly available information in the bill text about proponents' statements or arguments.

Opponents' View#

No publicly available information in the bill text about opponents' statements or arguments.