Medicare Set to Cover Dental, Hearing, and Vision Starting in 2027, But Premiums Start Rising in 2026

The Medicare Dental, Hearing, and Vision Expansion Act of 2025 is a massive overhaul that finally brings these three major services under the Medicare umbrella, starting in 2027. This isn't just a tweak; it’s a fundamental expansion of what Medicare actually covers, addressing gaps that have left millions of seniors paying out of pocket for essential care. The bill adds comprehensive dental, hearing care, and routine vision services to Part B, but the funding mechanism means you’ll start feeling the financial impact a year early.

The New Dental Deal: What’s Covered and What You Pay

Starting January 1, 2027, Medicare Part B will cover a wide range of dental services. This includes the basics like preventive care (two cleanings and two exams per year, one fluoride treatment) and major work like fillings, crowns, root canals, and even dentures and implants (SEC. 2). For those preventive services, Medicare covers 100% of the cost. For treatments like a root canal or a crown, Medicare pays 80% of the allowed amount, meaning you’re responsible for the remaining 20% co-pay, just like with many other Part B services.

Here’s a crucial detail: the payment rates are set low. Medicare will base its fee schedule on 70% of the national median fees charged by dentists back in 2020, adjusted for inflation (SEC. 2). While this keeps costs down for the program, it might make it challenging for some dentists to accept Medicare patients, potentially limiting the network available to beneficiaries. However, dentists in Health Professional Shortage Areas (HPSAs) get a 10% bonus payment, which is a smart move to boost access in rural and underserved areas.

Hearing Aids: Coverage with a Five-Year Clock

If you’ve been putting off getting hearing aids because of the cost, this bill offers relief. Also starting in 2027, Medicare will cover hearing aids for individuals with moderately severe, severe, or profound hearing loss (SEC. 3). The coverage includes the device and related services like fitting and training. The catch? You are limited to one hearing aid per ear every five years, so you’ll need to make them last.

Importantly, the bill expands who can provide these services, allowing qualified hearing aid professionals (like licensed dispensers) to bill Medicare directly. This means you won’t need a doctor’s referral for every hearing exam anymore. To control costs, the bill mandates that Medicare’s payment for these devices won't exceed the price listed on the 2021 Federal Supply Schedule, adjusted for inflation, and competitive bidding for hearing aids will start in 2031. This is good news for your wallet, but it puts pressure on manufacturers to keep prices down.

Routine Vision Exams and the Eyeglass Exclusion

Routine vision care is also coming to Medicare Part B in 2027 (SEC. 4). This means coverage for one routine eye exam to check your prescription every two years. If you need glasses, Medicare will generally pay for one pair of conventional eyeglasses every two years. If you get cataract surgery during that time, you get an extra pair covered after the procedure.

But if you like your designer frames, you’re out of luck. The bill explicitly states that Medicare will not pay for “deluxe eyeglasses or simple reading glasses” (SEC. 4). Like hearing aids, competitive bidding rules will apply to eyeglasses starting in 2030, ensuring that the cost to the program remains controlled.

The Cost of Coverage: How Premiums Phase In

Here’s the part that impacts everyone currently on Medicare Part B: paying for the new dental benefits. The cost of this massive expansion won't hit all at once, but it is coming. The bill requires the financial impact of the new dental coverage to be phased into the standard Part B premium calculation over five years, from 2026 through 2030 (SEC. 5).

For 2026 and 2027, your premium will be calculated as if the new dental coverage didn’t exist. Then, starting in 2028, the cost is added back in gradually: 25% of the cost difference in 2028, 50% in 2029, and 75% in 2030. By 2031, the full cost of the new dental coverage will be reflected in the standard Part B premium. This gradual phase-in is designed to prevent a massive premium spike, but it means Medicare enrollees aged 65 and older should expect to see their Part B premiums increase yearly above normal inflation adjustments during this five-year window.