Key Takeaways

• Medicare does not automatically include dental and vision benefits, but some Medicare Advantage plans offer these services.

• To get dental and vision coverage, you need to actively select the right type of plan or purchase standalone options.

What Original Medicare Covers—and What It Doesn’t

If you’re enrolled in Original Medicare (Part A and Part B), it’s important to understand what is and isn’t included. In 2025, Medicare continues to cover many essential health services, including hospital stays, skilled nursing, and outpatient care. But there are some crucial gaps, and dental and vision services fall into that category.

What’s Not Covered Under Original Medicare

Original Medicare does not typically cover:

• Routine dental exams, cleanings, fillings, or dentures

• Routine eye exams for eyeglasses or contact lenses

• Eyeglasses and contact lenses (unless after cataract surgery)

• Most procedures related to oral health and vision maintenance

You may be surprised to learn that even preventive services like cleanings and eye checks are excluded unless tied to a medical condition that Medicare does cover.

Why Dental and Vision Matter More as You Age

Dental and vision health often decline with age. Tooth loss, gum disease, cataracts, and glaucoma are more common after age 65. Neglecting these aspects of your health can affect your overall well-being:

• Poor dental health can contribute to heart disease, diabetes, and malnutrition.

• Vision loss can lead to falls, isolation, and reduced independence.

Because of these risks, it’s important to make sure you have access to dental and vision services through the right Medicare coverage.

What Options Do You Have in 2025?

If you’re on Medicare and want dental and vision coverage, you essentially have two choices:

1. Enroll in a Medicare Advantage Plan That Includes Dental and Vision

Medicare Advantage (Part C) is a private alternative to Original Medicare. Many Medicare Advantage plans in 2025 include extra benefits beyond what’s available through Part A and Part B, and that often includes:

• Routine dental cleanings, exams, x-rays, and sometimes extractions or dentures

• Vision exams, lenses, frames, and sometimes contact lenses

However, not all Medicare Advantage plans offer the same coverage. Some provide extensive dental and vision benefits, while others offer only minimal services. You must read the summary of benefits to understand what’s included.

Also, you should pay attention to:

• Annual limits on dental spending

• Network restrictions (you may have to see specific dentists or eye doctors)

• Frequency of covered services (e.g., one eye exam per year)

2. Purchase a Standalone Dental and Vision Plan

If you choose to stay with Original Medicare or enroll in a Medicare Advantage plan that doesn’t include sufficient coverage, you can purchase standalone dental and vision insurance. These plans are not part of Medicare, but they’re available through private companies.

In 2025, many retirees choose this option to supplement their coverage, especially if they need higher levels of dental work or more comprehensive vision support. However, these plans come with their own costs and limitations, such as waiting periods or service caps.

What About Medicaid and Other Programs?

Medicare doesn’t cover routine dental and vision, but if you qualify for both Medicare and Medicaid (known as “dual eligibility”), you may have access to additional benefits.

Medicaid programs vary by state. In some states, Medicaid covers basic dental care or eyeglasses for dual-eligible individuals. In other states, coverage may be very limited or nonexistent.

It’s also worth checking if you qualify for:

• PACE (Program of All-Inclusive Care for the Elderly)

• VA benefits (for veterans)

• State-run or local senior health programs

These can sometimes include dental and vision coverage not available through Medicare alone.

When to Review Your Coverage

The best time to assess or change your dental and vision benefits is during the Medicare Open Enrollment Period, which runs annually from October 15 to December 7. Changes you make during this period take effect on January 1 of the following year.

Additionally, you may qualify for a Special Enrollment Period (SEP) if you experience certain life changes such as:

• Moving to a new address

• Losing other health coverage

• Gaining or losing Medicaid eligibility

Questions to Ask Before Choosing a Plan

When you evaluate your Medicare coverage options, don’t forget to ask these important questions:

• Does the plan offer routine dental and vision coverage?

• What specific services are included (cleanings, x-rays, fillings, eyeglasses)?

• Are there annual limits or caps on coverage?

• Are my preferred providers in-network?

• What is the estimated cost of dental or vision services under this plan?

Why It’s Not Automatic—And Why That Matters

You might assume that dental and vision are part of every health insurance plan for older adults, but Medicare works differently. The reason these benefits aren’t automatically included in Original Medicare dates back to how the program was designed.

Medicare was originally created to cover hospital and medical services—not what were considered “ancillary” benefits. While that may have made sense in the past, the current needs of older adults go well beyond hospitalization and basic doctor visits.

Medicare Advantage has stepped in to fill this gap—but only if you choose a plan that offers these extra services.

Understanding the Costs Involved

Medicare Advantage plans offering dental and vision coverage may come with:

• Monthly premiums (in addition to your Part B premium)

• Deductibles or copayments for specific services

• Annual spending limits on dental coverage

Standalone dental and vision plans have their own premiums, often paid monthly, and may require you to pay part of the cost for more expensive procedures like crowns, dentures, or progressive lenses.

As of 2025, there is no federal cap on what you might spend out-of-pocket for dental or vision care unless you have a specific limit within your plan. Understanding those limits is essential to prevent financial surprises.

Medicare’s Future and Calls for Expansion

In recent years, there have been proposals to expand Medicare to include dental, vision, and hearing. Some lawmakers and advocacy groups argue that these services are essential to aging well and should be core benefits.

However, as of 2025, Congress has not passed legislation to include dental and vision as part of Original Medicare. Until that changes, you’ll need to be proactive about choosing a plan that meets your needs.

Making the Best Decision for Your Needs

Your dental and vision needs in retirement are just as important as any other aspect of your health. Since Medicare doesn’t automatically include these benefits, you’ll need to make informed decisions to ensure you’re protected.

Some people are comfortable with occasional cleanings and eye checks, while others anticipate more complex care. The right option for you depends on your health history, your budget, and your willingness to manage multiple plans.

Choose Coverage That Protects Your Whole Health

Medicare in 2025 gives you the opportunity to build a coverage plan that includes dental and vision—but only if you take action. Whether through a Medicare Advantage plan or a standalone policy, your choices determine your access to routine and preventive care.

You shouldn’t assume you’re covered. Review your current plan, assess your needs, and—most importantly—get advice from someone who can help.

Speak to a licensed agent listed on this website for help evaluating your options and making confident coverage choices.