Sponsors (131)
Introduced March 11, 2025 by Lloyd Alton Doggett · Last progress March 11, 2025
The bill meaningfully expands Medicare coverage for dental, vision, and hearing—improving access and lowering some costs for beneficiaries—but does so with phased rollouts, cost‑sharing, service caps, and new administrative limits that will leave some beneficiaries facing delays, out‑of‑pocket costs, and increased federal spending.
Medicare beneficiaries (seniors and disabled) gain new coverage for preventive dental, routine vision, and audiology/hearing services beginning in 2026, reducing barriers to basic oral, eye, and hearing care.
Many beneficiaries — especially subsidy-eligible and low-income individuals — will pay substantially less out-of-pocket for covered services and devices because Medicare will assume a large share of costs through coinsurance/subsidies for dental, hearing, and (to an extent) vision items.
Medicare explicitly covers key assistive devices (dentures, hearing aids as durable medical equipment, and low-vision devices), improving access to prosthetics and assistive technologies that support daily functioning.
Millions of Medicare beneficiaries — particularly low-income seniors — will still face substantial out-of-pocket costs during the phased rollout and because some services/devices carry coinsurance (phased dental payments 2027–2029 and 20% coinsurance for certain items), leaving cost burdens in early years and for some long-term services.
Caps, strict frequency limits, and authorization authorities (e.g., two routine dental cleanings per year, one vision exam per 12 months, one hearing aid per ear every 48 months, and allowance for prior authorization) risk delaying or denying medically necessary care for people with chronic or rapidly changing conditions.
Expanding dental, vision, and hearing benefits increases federal spending and could exert pressure on Medicare premiums or the Trust Fund over time, creating long‑term fiscal tradeoffs for taxpayers and beneficiaries.
Based on analysis of 6 sections of legislative text.
Expands Medicare Part B to cover dental, vision, and hearing services, sets payment/coinsurance rules, frequency limits, and device payment caps.
Adds dental, vision, and hearing coverage to Medicare Part B, creates payment rules and coinsurance levels for those services and related items (eyeglasses, contact lenses, hearing aids), and sets limits on frequency and payment amounts. It phases in payment rates for many dental services over 2026–2029, makes hearing aids durable medical equipment with limits, excludes certain items from a competitive acquisition program, and requires the USPSTF to include at least one oral health professional.