Almost none of it. Original Medicare does not cover routine dental cleanings, fillings, extractions, dentures or implants; it does not cover eye exams for glasses, or the glasses; and it does not cover hearing aids or the exams to fit them (Medicare.gov).
What it does cover in these three categories is narrow and medical rather than routine — dental work required before a heart valve replacement, an annual glaucoma screening if you are high risk, a diagnostic hearing exam your doctor orders. Everything a person actually walks into an office for on a normal Tuesday is on your side of the line. That gap is not small change: among Medicare beneficiaries who used the services, average out-of-pocket spending was $914 for dental and $914 for hearing, against $230 for vision (KFF analysis of the 2018 Medicare Current Beneficiary Survey).
What Medicare covers for dental — and the five exceptions
Medicare.gov’s language is direct: “In most cases, Medicare doesn’t cover dental services like routine cleanings, fillings, tooth extractions, or items like dentures and implants” (Medicare.gov).
The exceptions all share one logic — the dental work exists to make a covered medical procedure safe, not to take care of your teeth. Medicare may cover:
- Some dental services you get while admitted as a hospital inpatient for the dental procedure
- An oral exam and dental treatment before a heart valve replacement or a bone marrow, organ or kidney transplant
- A procedure such as an extraction to treat a mouth infection before cancer treatment
- Treatment for a complication you experience while getting head and neck cancer treatment
- Dental exams related to Medicare-covered dialysis for end-stage renal disease
Read that list next to the reason people actually see a dentist and the shape of the problem is obvious. A cracked molar at 71 is not covered. A cleaning is not covered. A denture is not covered, even when a dentist writes that you need it to eat properly.
The coverage gap is also the norm rather than the exception: as of 2019, roughly 47% of Medicare beneficiaries — about 24 million people — had no dental coverage at all (KFF).
What Medicare covers for vision
Vision is the least expensive of the three gaps and the one where Medicare’s exceptions are most useful, because the covered items are the ones that actually threaten your sight.
Not covered: routine eye exams — the page calls them “eye refractions” — for eyeglasses or contact lenses, and the eyeglasses or contacts themselves (Medicare.gov).
Covered under Part B:
- Glaucoma screening once a year if you are at high risk
- Diabetic retinopathy exam once a year if you have diabetes
- Tests and treatment for macular degeneration
- Cataract surgery, including one pair of eyeglasses or contact lenses afterward
That last item is worth knowing before you buy anything. Cataract surgery is common after 65, and the post-surgical glasses are the one pair of eyeglasses Medicare will pay toward. If surgery is on your calendar for this year, that changes the math on buying a vision policy for the same year.
The average out-of-pocket vision cost — $230 among beneficiaries who used vision services — is a fraction of the dental and hearing numbers, which is why vision is usually the smallest reason to buy a policy and the piece most often bundled in alongside the other two at little added premium.
What Medicare covers for hearing — and why the hearing aid is the whole bill
Medicare splits hearing cleanly into the exam and the device, and it pays for one of them.
Covered: Part B covers diagnostic hearing and balance exams when your doctor or other provider orders them to find out whether you need medical treatment. You can also see an audiologist once every 12 months without an order from a provider, for non-acute hearing conditions or for diagnostic services related to a surgically implanted hearing device (Medicare.gov).
Not covered: hearing aids, and the exams for fitting them.
Because the covered exam runs through Part B, you pay the 2026 Part B deductible of $283 first, then 20% of the Medicare-approved amount (CMS). The device that follows is 100% yours.
This is where the spending shows up. Hearing tied the highest average out-of-pocket figure of the three at $914 — and the tail is long. Among beneficiaries who used hearing services, the top 10% spent $3,600 or more (KFF, 2018 MCBS). Dental has a long tail too, with the top 10% of users at $2,136 or more, but hearing is the category where one purchase decides the year.
One thing that changed, and it is not insurance
The FDA established an over-the-counter hearing aid category for adults 18 and older with perceived mild to moderate hearing loss. OTC devices require no medical exam, no prescription and no professional fitting; prescription hearing aids remain the route for severe loss and for anyone under 18 (FDA).
That did not create any Medicare coverage. What it created is a second price tier that did not exist before, and it belongs in the calculation before you buy a hearing benefit. If a plan’s hearing allowance only applies at the plan’s contracted providers for prescription devices, an OTC purchase may not touch it at all.
What the gap actually costs
| Category | Average out-of-pocket among users | Top 10% of users spent |
|---|---|---|
| Dental | $914 | $2,136 or more |
| Hearing | $914 | $3,600 or more |
| Vision | $230 | — |
Source: KFF analysis of the 2018 Medicare Current Beneficiary Survey Cost Supplement. Figures are national averages from 2018 and are not a quote; your own cost depends on the care you need and what you pay for it.
The same analysis found that beneficiaries in Medicare Advantage plans spent less on average than those in Traditional Medicare — $766 versus $992 on dental, and $194 versus $242 on vision — while hearing showed no significant difference between the two groups. That is the honest version of the “Advantage plans include dental” claim: on average it reduced dental spending by a couple hundred dollars, not to zero.
Route 1: A Medicare Advantage plan with the benefits built in
Most Medicare Advantage plans bundle some dental, vision and hearing coverage — in 2021, 94% of enrollees in individual Medicare Advantage plans had access to some dental coverage (KFF). That is the single most common way people on Medicare get these benefits.
Two features decide whether the benefit is worth much:
The annual dollar cap. Among plans offering more extensive dental benefits in 2021, the average annual limit was about $1,300, and 59% of enrollees in those plans had dental benefits capped at $1,000 or less (KFF). Set that against the $2,136 figure for the top tenth of dental users and you can see where the cap stops mattering — a crown-and-denture year runs past it.
The network. The benefit generally applies at the plan’s contracted dentists, optometrists and hearing providers. If your dentist of twenty years is not contracted, the allowance is a number on a page.
A plan advertised at $0 monthly premium is not free coverage: it means no monthly plan premium. You still pay your Part B premium — $202.90 a month in 2026 — plus the plan’s copays and coinsurance when you use care (CMS). The dental allowance is part of a whole package that also includes a network, prior authorization rules and an out-of-pocket maximum. Choosing a plan for its dental benefit alone is how people end up with a plan their cardiologist does not take. Our Medicare Advantage travel and network post covers the network side of that trade-off in detail.
Route 2: A standalone dental, vision and hearing policy
The second route is a separate policy you buy alongside whatever Medicare coverage you have. It is the usual answer for someone on Original Medicare with a Medicare Supplement, because Medigap plans are standardized by letter and none of the letters include dental, vision or hearing.
Before anything else, be clear about what this product is:
- It is not health insurance and not a substitute for it. A dental-vision-hearing policy pays against a schedule of dental, vision and hearing services. It does not cover doctor visits, hospital stays or prescriptions, and nobody should hold one in place of real coverage.
- It is not part of Medicare. It is not government-issued, not government-endorsed and not required by Medicare.
- It is not a Medicare Supplement. Medigap pays a share of your Medicare-approved cost sharing under standardized plan letters; a DVH policy pays dental and vision bills Medicare never touches.
How these policies generally work: you pay a monthly premium, the policy pays according to a benefit schedule — often a percentage that steps up over the first few years for basic and major services — and there is an annual maximum that stops the payments for the year. Many policies apply waiting periods before covering basic or major services, and some apply a longer one to hearing aids. A few carriers sell versions without waiting periods, generally at a higher premium. Every one of those terms — the schedule, the maximum, the waiting periods, whether there is a network at all, and whether the policy is even sold in your state — varies by carrier. Read the outline of coverage; that is the document that governs, not the brochure.
The arithmetic worth doing is one line: twelve months of premium, plus your share of the expected bills, versus what the same care costs in cash. For someone facing a crown, a partial denture or a hearing aid, the policy usually wins. For someone who wants two cleanings and an eye exam, it is often close to a wash, and the honest answer is that a discount plan or cash may serve better. This is the same test we applied to hospital indemnity coverage: a supplemental product is worth its premium only when it fills a gap you actually have.
Route 3: Pay cash, deliberately
Paying cash is a legitimate plan, not a failure to plan — as long as it is a decision rather than a default. It tends to fit people whose dental history is stable, who want to keep a dentist who takes no plans, or whose expected annual spending sits under any policy’s annual maximum anyway.
Two things make cash cheaper than it looks. Dental schools and federally funded community health centers provide care on sliding scales in most metro areas. And on the hearing side, the OTC category the FDA established gives a second price tier for mild to moderate loss that did not exist a few years ago.
What cash does not survive well is the tail: the implant, the full denture, the pair of premium prescription hearing aids. If your budget has no room for a $3,000 year, that is the exposure a policy is priced against.
Which route fits which person
| Your situation | Usually points toward |
|---|---|
| Original Medicare + Medigap, want dental predictability | A standalone dental-vision-hearing policy |
| Already choosing a Medicare Advantage plan on network and drug grounds | The plan’s embedded benefit, with the annual cap checked |
| Major work ahead — crowns, dentures, implants, hearing aids | Compare a policy’s annual maximum against a real treatment plan estimate from your dentist |
| Two cleanings a year, stable teeth, dentist you will not leave | Cash, possibly with a discount plan |
| Cataract surgery scheduled this year | Note that Medicare covers one pair of glasses after surgery before you buy a vision benefit |
| Income and assets near Florida Medicaid limits | Check Florida’s Medicaid dental program first — see below |
None of this is a recommendation for your situation. It is the set of questions worth answering before you buy anything.
The Florida version of this question
Two things make this a specifically Florida conversation.
The Advantage market here is unusually deep. For 2026 there are 133 Medicare Advantage and Part D plan options in Hillsborough County alone (source: CMS CY2026 MA & Part D Landscape). Those plans do not carry one interchangeable dental benefit — allowances, annual caps, denture coverage and hearing provider networks differ plan to plan, and availability is set county by county, so a plan sold in Tampa may not be sold in Sarasota or Naples. “Advantage plans include dental” is not a fact you can shop on; the specific plan’s allowance is.
Florida runs Medicaid dental separately. Under Statewide Medicaid Managed Care, dental benefits come through a separate statewide dental plan rather than through the medical plan, and every Medicaid enrollee picks one — for 2026 the statewide dental plans are DentaQuest and Liberty Dental (Florida AHCA). Adults 21 and older have a base benefit that includes limited and problem-focused exams, X-rays, extractions, dentures, pain management and sedation, with expanded benefits such as cleanings and periodontal care available; members 65 and older have additional services including crowns and root canals.
That matters for Florida readers who qualify for both Medicare and Medicaid, because it is the one route where dental coverage is not something you buy. Anyone whose income and assets are anywhere near the limits should check eligibility before purchasing a dental policy. Our post on whether Florida Medicaid pays for nursing home care walks through how the state’s income and asset tests work.
Before you buy anything, check these six things
- The annual maximum, and how it compares to a written treatment estimate from your own dentist — not to a hypothetical.
- Waiting periods on basic services, major services and hearing aids specifically.
- Whether your providers participate, by name. Call the office and ask; do not trust a directory alone.
- How the hearing benefit works — whether it applies to prescription devices only, at contracted providers only, and whether OTC devices count.
- What is excluded. Implants and orthodontia are commonly excluded or capped separately.
- What happens next January. Medicare Advantage benefits, including dental allowances, are set for one plan year at a time and can change; standalone policies renew on their own terms.
If you are still assembling the whole picture of what a year on Medicare costs, our annual Medicare cost estimator puts the premium and deductible side in front of you, and the Parts of Medicare guide explains how A, B, C and D fit together before you add anything on top.
The short version
Original Medicare was designed in 1965 without dental, vision or hearing benefits, and apart from the medical exceptions listed above, that is still true in 2026. The gap is real, it is expensive in the years it lands, and there are three defensible ways to handle it — a plan that includes the benefits, a policy that covers them, or a cash plan you have actually costed out. What does not work is assuming it is in there somewhere.
If you want a second set of eyes on which of those three fits your teeth, your ears and your budget, Virginia is glad to walk through it with you — no pressure, no obligation. Book an appointment and bring your dentist’s treatment estimate if you have one; it makes the math a lot more concrete.