One of the biggest surprises for new Medicare beneficiaries is discovering that Original Medicare provides almost no coverage for dental, vision, or hearing care. These are services most people need regularly — especially as they age — yet Medicare was designed in 1965 without them. This guide explains exactly what is and is not covered, how to fill the gaps, and what your options are in North Carolina.
What Original Medicare Covers (Limited)
Original Medicare (Parts A and B) does cover a small number of dental, vision, and hearing services, but only when they are considered medically necessary. Here is what falls under that narrow umbrella:
Dental Services Covered by Medicare
- Jaw surgery or reconstruction — when required due to injury, disease, or tumor removal
- Dental exams before organ transplant or heart valve surgery — Part A may cover dental exams and treatment needed to protect you before certain major medical procedures
- Extractions done in a hospital setting — when your medical condition makes it unsafe to have them done in a dental office
Vision Services Covered by Medicare
- Cataract surgery — Part B covers the surgery and one pair of corrective lenses (eyeglasses or contact lenses) after each cataract surgery
- Glaucoma screening — for those at high risk (diabetics, family history, African Americans age 50+)
- Diabetic retinopathy screening — annual eye exam for diabetic beneficiaries
- Macular degeneration treatment — injectable medications administered by an ophthalmologist
Hearing Services Covered by Medicare
- Cochlear implants — Part B covers cochlear implant surgery and the device for beneficiaries who meet specific criteria for severe hearing loss
- Diagnostic hearing exams — when ordered by a physician to diagnose or treat a medical condition (not routine screening)
- Bone-anchored hearing aids (BAHA) — surgically implanted devices covered as prosthetic devices under Part B
What Original Medicare Does Not Cover
The list of excluded services is far longer than the list of covered ones. Original Medicare does not pay for any of the following:
Dental Services Not Covered
- Routine dental exams and cleanings
- Fillings, crowns, and bridges
- Root canals
- Tooth extractions (in a dental office)
- Dentures (full or partial)
- Dental X-rays
- Orthodontics
- Periodontal (gum) treatment
Vision Services Not Covered
- Routine eye exams for glasses or contacts
- Eyeglasses (except the one pair after cataract surgery)
- Contact lenses (except after cataract surgery)
- Refractive surgery (LASIK)
- Low-vision aids and devices
Hearing Services Not Covered
- Routine hearing exams and screenings
- Hearing aids (traditional, behind-the-ear, in-the-ear models)
- Hearing aid fitting, adjustments, and maintenance
- Batteries and accessories for hearing aids
For millions of Medicare beneficiaries, these gaps can add up to thousands of dollars per year in out-of-pocket costs. According to recent data, nearly half of all Medicare beneficiaries had no dental visit in the past year, often citing cost as the primary barrier.
Medicare Advantage Dental, Vision & Hearing Benefits
The most common way Medicare beneficiaries get dental, vision, and hearing coverage is through a Medicare Advantage (Part C) plan. These are private health plans that replace Original Medicare and are allowed to offer extra benefits beyond what Parts A and B cover.
How Common Are DVH Benefits?
In 2026, the vast majority of Medicare Advantage plans include at least some DVH coverage:
| Benefit | % of MA Plans Offering | Typical Coverage |
|---|---|---|
| Dental | ~97% | Preventive + some comprehensive |
| Vision | ~97% | Annual eye exam + eyewear allowance |
| Hearing | ~88% | Annual hearing exam + hearing aid allowance |
What MA Dental Benefits Typically Include
Most Medicare Advantage plans split dental benefits into two tiers:
- Preventive dental: Two cleanings per year, oral exams, and dental X-rays — copays vary by plan
- Comprehensive dental: Fillings, extractions, crowns, root canals, and dentures — typically subject to copays and annual benefit maximums that vary by plan
What MA Vision Benefits Typically Include
- Annual routine eye exam — copays vary by plan
- Eyewear allowance for glasses or contacts — amounts vary by plan
- Some plans cover contact lens fittings and lens upgrades
What MA Hearing Benefits Typically Include
- Annual routine hearing exam — copays vary by plan
- Hearing aid benefit with annual allowance amounts that vary by plan
- Some plans partner with specific hearing aid providers for discounted pricing
For a full comparison of Medicare Advantage vs. Original Medicare with Medigap, see our guide: Medicare Advantage vs. Original Medicare with Medigap: How to Choose
Need Help Finding a Plan With Dental, Vision & Hearing?
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☎ (910) 994-6464Standalone Dental Plans for Original Medicare Users
If you prefer to stay on Original Medicare with a Medigap plan, you will need separate coverage for dental care. There are two main options:
Dental PPO (DPPO) Plans
Standalone dental insurance plans work similarly to the dental coverage you may have had through an employer. Key features include:
- Monthly premiums: Typically $20 to $60 per month depending on coverage level
- Preventive care: Usually covered at 100% (cleanings, exams, X-rays)
- Basic services: Fillings and simple extractions typically covered at 50–80%
- Major services: Crowns, bridges, dentures covered at 20–50%
- Annual maximum: Most plans cap benefits at $1,000 to $2,500 per year
- Waiting periods: Many plans have 6–12 month waiting periods for major services
Dental Discount Plans
Not insurance, but membership programs that offer reduced rates at participating dentists:
- Monthly cost: $8 to $20 per month (or $80 to $200 annually)
- Savings: Typically 10–60% off dental services at participating providers
- No waiting periods and no annual maximums
- No claims to file — you pay the discounted rate directly at the dentist
Popular standalone dental plan carriers for Medicare beneficiaries include Delta Dental, Humana, Cigna, and AARP/UnitedHealthcare. Availability varies by county and state.
Standalone Vision Plans
Similar to dental, you can purchase separate vision insurance if you have Original Medicare. Common options include:
- VSP (Vision Service Plan): One of the largest vision networks. Individual plans start around $13 to $25 per month and cover annual eye exams, plus an allowance for frames and lenses.
- EyeMed: Another major vision network with similar pricing. Look for plans that include large retail chains like LensCrafters or Target Optical.
- AARP Vision Plans: Available through UnitedHealthcare, these plans are designed for Medicare-age adults with monthly premiums starting around $15.
Most standalone vision plans cover one routine eye exam per year plus an eyewear allowance of $100 to $200. Some plans also offer discounts on LASIK or other corrective procedures.
Hearing Aid Options and Costs
Hearing loss affects approximately one in three adults between ages 65 and 74, and nearly half of those over age 75. Despite how common it is, hearing care remains one of the most expensive gaps in Medicare coverage.
Hearing Aid Costs Without Insurance
The cost of hearing aids varies widely depending on the type and technology level:
| Hearing Aid Type | Approximate Cost (Per Pair) | Features |
|---|---|---|
| Basic behind-the-ear (BTE) | $1,000 – $2,000 | Amplification, basic noise reduction |
| Mid-range BTE or in-the-ear (ITE) | $2,000 – $4,000 | Bluetooth, directional microphones, rechargeable |
| Premium/advanced | $4,000 – $6,000+ | AI noise processing, app control, tinnitus masking |
| Over-the-counter (OTC) | $200 – $1,500 | For mild to moderate hearing loss, no prescription needed |
Over-the-Counter Hearing Aids
Since 2022, the FDA has allowed over-the-counter hearing aids to be sold without a prescription to adults with perceived mild to moderate hearing loss. These are available at pharmacies, electronics stores, and online retailers, offering a more affordable alternative for many seniors. Popular brands include Jabra Enhance, Sony, Lexie, and Eargo.
Ways to Reduce Hearing Aid Costs
- Medicare Advantage plans: Many offer annual hearing aid allowances of $500 to $2,500
- Costco and Sam’s Club: Offer bundled hearing aid packages at significantly lower prices than audiologist offices
- State programs: North Carolina’s Division of Services for the Deaf and Hard of Hearing may offer assistance for qualifying individuals
- Nonprofit organizations: Lions Club, Starkey Hearing Foundation, and HLAA offer hearing aid assistance programs
- Manufacturer financing: Many hearing aid makers offer interest-free payment plans
North Carolina-Specific Options and Providers
If you live in North Carolina, here are some specific resources and options for dental, vision, and hearing care:
Medicare Advantage Plans in NC With Strong DVH Benefits
Several carriers offer Medicare Advantage plans in North Carolina with robust dental, vision, and hearing benefits. The availability and specific benefits vary by county, but major carriers to consider include:
- UnitedHealthcare (AARP): Widely available across NC with comprehensive dental benefits including $2,000+ annual dental allowances in some plans
- Humana: Offers plans in many NC counties with preventive and comprehensive dental, plus hearing aid allowances
- Blue Cross Blue Shield of NC: Local carrier with strong provider networks and DVH benefits
- Aetna/CVS Health: Available in select NC counties with competitive DVH packages
NC Dental Resources for Seniors
- NC dental schools: UNC Adams School of Dentistry and ECU School of Dental Medicine offer reduced-cost dental care provided by supervised students
- Community health centers: Federally Qualified Health Centers across NC offer sliding-scale dental services
- NC Missions of Mercy: Free dental clinics held periodically across the state providing cleanings, fillings, and extractions at no cost
Pending Federal Legislation to Add DVH to Original Medicare
There has been ongoing legislative effort to add comprehensive dental, vision, and hearing coverage to Original Medicare. Here is the current status:
Recent Legislative History
The Build Back Better Act of 2021 included provisions to add dental, vision, and hearing benefits to Medicare Part B. While the hearing benefit provision advanced the furthest, the overall legislation did not pass in its original form. Since then, several standalone bills have been introduced:
- Medicare Dental, Vision, and Hearing Benefit Act: Would add comprehensive dental, vision, and hearing coverage to Medicare Part B with modest copays
- Seniors Have Eyes, Ears, and Teeth Act: Similar legislation with bipartisan co-sponsors
As of early 2026, none of these bills have been enacted into law. However, the issue remains a priority for advocacy groups like AARP and the Medicare Rights Center. If passed, these benefits would not take effect immediately — implementation would likely be phased in over 2 to 3 years.
Cost Comparison: Your Options Side by Side
Here is a comparison of the major ways to get dental, vision, and hearing coverage as a Medicare beneficiary:
| Coverage Option | Monthly Cost | Dental | Vision | Hearing |
|---|---|---|---|---|
| Original Medicare alone | $0 extra | Medical only | Medical only | Medical only |
| Medicare Advantage (typical) | $0 – $50 | Preventive + some comprehensive | Exam + $150–$300 eyewear | Exam + $500–$2,500 aid allowance |
| Standalone dental (DPPO) | $20 – $60 | Preventive + comprehensive | Not included | Not included |
| Standalone vision plan | $13 – $25 | Not included | Exam + eyewear allowance | Not included |
| Dental discount plan | $8 – $20 | 10–60% discounts | Not included | Not included |
| All standalone (dental + vision) | $33 – $85 | Preventive + comprehensive | Exam + eyewear allowance | Not included |
As the table shows, Medicare Advantage plans often provide the most value for DVH coverage because these benefits are bundled into the plan at little or no additional cost. However, Medicare Advantage plans come with trade-offs like provider networks and prior authorization requirements that may not suit everyone. Beneficiaries who prefer the freedom of Original Medicare with a Medigap plan will need to budget separately for dental, vision, and hearing needs.
The right choice depends on your individual health needs, how frequently you visit the dentist, whether you wear glasses or hearing aids, and how much flexibility you want in choosing providers. A licensed insurance agent can help you compare options based on your specific situation.