Medicare finally covers teeth, eyes, and ears—but questions loom on cost

What it does

This bill adds dental, vision, and hearing benefits to Medicare starting January 1, 2026, covering preventive care (cleanings, exams), basic and major services (fillings, crowns, root canals, hearing aids, eyeglasses), and emergency care. Medicare will pay 80–100% of costs depending on the service type and year, with frequency limits (e.g., two cleanings per year, one hearing aid per ear every 4 years) and dollar caps on eyeglasses ($100 frames, $100 lenses per year). Low-income beneficiaries get 100% coverage for preventive dental and 80% for other services starting 2026.

Why we flagged it

The bill's core function is to expand Medicare coverage to include three previously excluded benefit categories (dental, vision, hearing) with defined payment rates, frequency limits, and phase-in schedules. This is straightforward social insurance expansion, not a tax carve-out, deregulation, or commemorative measure.

What the text implies

• Phased payment percentages (0% in 2026 for non-preventive dental, ramping to 80% by 2029) may create administrative complexity and beneficiary confusion about what is covered when; Secretary discretion to waive frequency limits could lead to inconsistent coverage across regions or demographic groups.
• Inclusion of oral health professional on US Preventive Services Task Force (Section 6) may shift future coverage recommendations toward broader dental coverage, potentially increasing long-term Medicare costs beyond current projections.

The full analysis lists 4 implications of this text.

Who stands to gain

dental service providers and dental equipment manufacturers; optometry and ophthalmology practices; hearing aid manufacturers and audiology providers