This legislation, known as the Medicare Dental, Vision, and Hearing Benefit Act of 2025, aims to significantly expand Medicare coverage by adding dental, vision, and hearing care. The bill outlines specific services that will be covered under Medicare Part B, establishing payment rates, coinsurance requirements, and frequency limitations for these new benefits. All amendments made by this Act are scheduled to apply to services furnished on or after January 1, 2026.

For dental and oral health services, the bill defines coverage to include a range of care from preventive services like oral exams and cleanings to basic services such as tooth restorations and extractions, and major services including bridges, crowns, and root canals. Payment for preventive services will be 100% covered starting in 2026, while other dental services will be phased in, reaching 80% coverage by 2029. Low-income individuals will receive 80% coverage for non-preventive services by 2027. Additionally, the bill covers dentures, with a limit of one full or partial set per jaw every five years, and explicitly repeals the current Medicare exclusion for dental services.

Regarding vision care, the bill introduces coverage for routine eye examinations and procedures to determine the refractive state of the eyes. It also provides for eyeglasses, frames, and contact lenses, subject to specific dollar limits and frequency restrictions, such as one pair of lenses every 12 months and frames every 24 months, with inflation adjustments. Low vision devices are also included in the covered benefits. The existing Medicare exclusion for routine eye exams and eyeglasses is repealed.

For hearing care, the legislation covers routine hearing exams and exams for hearing aids, along with other necessary hearing health services. Crucially, it includes coverage for hearing aids, with a limitation of one hearing aid per ear every 48 months. The bill also repeals the current Medicare exclusion for hearing aids and examinations for them.

Across all three new benefit categories, the Secretary of Health and Human Services is granted authority to apply additional reasonable limitations, modify coverage consistent with United States Preventive Services Task Force recommendations, and waive frequency limitations when appropriate. The bill also ensures that dentures, eyeglass lenses, contact lenses, and hearing aids are excluded from competitive acquisition programs. Furthermore, it mandates the inclusion of at least one oral health professional on the United States Preventive Services Task Force.