New Medicare Bill Adds Dental, Vision, and Hearing Coverage—But You Won't See Full Benefits for Eight Years

The new Medicare and Medicaid Dental, Vision, and Hearing Benefit Act of 2025 is a big deal because it finally tackles the three major health areas that Medicare has historically ignored for most people: routine dental, vision, and hearing care. For the first time, Medicare Part B will cover regular exams, cleanings, fillings, glasses, and hearing aids.

The Good News: Coverage Is Coming

This bill officially ends the long-standing exclusion of these essential services from Medicare. If you’re on Medicare, you’ll eventually get coverage for routine dental services (cleanings, exams, root canals, dentures), vision services (routine eye exams, glasses, contact lenses), and hearing services (exams and hearing aids). For example, the bill specifies coverage for two routine dental cleanings and exams per year, one pair of eyeglass lenses every 12 months, and one new hearing aid per ear every 48 months.

Separately, the bill throws a significant bone to states running Medicaid. It boosts the Federal Medical Assistance Percentage (FMAP)—the federal share of the cost—to a flat 90 percent for states that choose to cover these specific dental, vision, and hearing services for adults. This is a massive incentive for states, as it makes offering these benefits much cheaper for their budgets, likely leading to broader coverage for low-income adults.

The Catch: The Eight-Year Slow Roll

Here’s where you need to pay close attention. While the bill establishes the coverage, it phases in the federal payment for Medicare beneficiaries at a glacial pace. The law states that for the first year after enactment, Medicare will pay 0 percent of the cost for all these new services and devices (Sections 2, 3, and 4). That means for the first year, you’re still paying 100% out-of-pocket, just like today.

After that initial 0% year, the federal payment increases by a mere 10 percentage points annually. It will take eight full years before Medicare finally covers the standard 80 percent of the cost. For instance, if the bill passes this year, someone needing a $2,000 dental procedure in Year 3 would only get 20% coverage ($400) from Medicare, leaving them with $1,600 to pay. If you need immediate, comprehensive coverage, this bill doesn't deliver it anytime soon.

The Fine Print: Limits and Administrative Hurdles

Beyond the slow rollout, the Secretary of Health and Human Services is given broad authority to impose “other reasonable limits” on coverage, including requiring prior authorization for services (Sections 2, 3, and 4). If you’ve ever dealt with prior authorization, you know this can be a major roadblock. This provision essentially gives the bureaucracy the power to pump the brakes on the newly established benefits, potentially creating significant administrative hurdles before you can access care like a new set of dentures or a complex root canal.

Another detail to note is the strict limits on devices. For glasses, Medicare pays for frames only once every 24 months. If you’re someone whose prescription changes every year, or if your frames break, you’ll be footing the bill for the replacement frames sooner than the two-year window. Similarly, contact lens coverage is capped at $200 over a 24-month period, which might not cover the full cost for many prescriptions.

The Real-World Impact

What does this mean for you? If you’re a senior or approaching Medicare age, this bill is a long-term win, establishing a necessary foundation for coverage. However, if you have urgent dental or hearing needs now, don't expect Medicare to help much for the better part of a decade. You will still face high out-of-pocket costs until the payment schedule fully kicks in.

For states, the 90% FMAP for adult Medicaid services (Section 5) is a game-changer. This could quickly result in millions of low-income adults gaining access to these crucial services, as the federal government will be covering nine out of every ten dollars spent. This immediate financial boost for Medicaid stands in sharp contrast to the slow-motion implementation planned for Medicare beneficiaries.