Medicare Expansion Proposed: Bill Aims to Add Dental, Vision, and Hearing Coverage Starting 2026

A new proposal, the "Medicare Dental, Vision, and Hearing Benefit Act of 2025," aims to significantly expand what Medicare covers. If enacted, starting January 1, 2026, Medicare would begin incorporating dental, vision, and hearing services, areas previously excluded from standard coverage. The bill outlines a phased approach to integrating these benefits, aiming to make essential care more accessible for millions of recipients.

What's New for Your Smile?

The bill proposes adding a range of dental services. Starting in 2026, preventative care like exams, cleanings (up to two per year), x-rays, and fluoride treatments would be covered at 100%. For other services, coverage phases in: basic work (fillings, extractions) and major procedures (root canals, crowns, bridges) would see coverage increase from 0% before 2027, to 30% in 2027, 60% in 2028, and finally 80% from 2029 onwards. Dentures get a boost too, with 80% coverage starting in 2027, limited to one set every five years. Importantly, the Secretary of Health and Human Services gets the authority to add limitations, like requiring prior authorization, or adjust coverage based on recommendations.

Seeing Clearly with Medicare?

Vision care also gets attention. Starting January 1, 2026, routine eye exams would be covered at 80%, limited to one exam per year unless waived by the Secretary. Eyeglasses and contact lenses are included, with Medicare paying 80% up to certain limits: $100 for lenses (one pair per year), $100 for frames (one set every two years), and $200 for contacts (every two years). These dollar limits would be adjusted for inflation starting in 2027. Low vision devices prescribed by a physician would also be covered at 80%. Like dental, the Secretary can impose additional limits or modify coverage.

Hearing Aid Help on the Horizon?

For hearing care, the bill proposes covering audiology services, including hearing exams and exams specifically for fitting hearing aids, starting January 1, 2026. Medicare would cover 80% of the cost for these services. Hearing aids themselves would also be covered at 80%, but limited to one aid per ear every 48 months. Again, the Secretary holds the power to waive this frequency limit or add other restrictions. Notably, dentures, eyeglasses, contact lenses, and hearing aids would be excluded from Medicare's competitive bidding program, potentially affecting how these items are priced and supplied.

The Fine Print

Across all these new benefits, a key theme is the significant authority granted to the Secretary of Health and Human Services. While the bill sets initial coverage levels and limits, the Secretary can modify these, apply prior authorization requirements, and adjust coverage based on recommendations from the United States Preventive Services Task Force (USPSTF). The bill also mandates that at least one oral health professional be added to the USPSTF. This structure provides flexibility but also means the specifics of coverage could change over time based on administrative decisions rather than just the legislative text.