Medicare Advantage 2027 Dental, Vision, and Hearing Benefits vs Medigap Plan G: What a Crown, Hearing Aids, and a 30-Day Nursing Home Stay Cost Before December 7
Four Medicare Dates for Your 2027 Plan Decision
It's October 1. The Annual Election Period opens in 14 days. If you're in a Medicare Advantage (MA) plan, your Annual Notice of Change was due in your mailbox or inbox by September 30. Four dates matter:
- Now through October 14: Read the Notice of Change. Compare each dental, vision, hearing, and skilled nursing line to what you actually used in 2026.
- October 15 – December 7, 2026: The Annual Election Period. You can switch MA plans, leave MA for Original Medicare, or join MA from Original Medicare. Changes start January 1, 2027.
- January 1 – March 31, 2027: MA members get one change. The MA open enrollment rules and the Medigap catch are worth reading before you rely on this window.
- The irreversible one: If you leave MA for Original Medicare after your Medigap guaranteed-issue rights have run out, insurers in most states can medically underwrite Plan G. They can charge more or decline you.
What the 2027 Reporting Says, and What to Do With It
Healthcare Dive ran a story titled "Insurers say their 2027 Medicare Advantage offerings preserve benefits. The data tells a different story." It covers a Leerink Partners analysis of Medicare Plan Finder listings for the largest MA carriers. I'll leave the carrier-by-carrier figures to their reporting. I can't verify them for your county, and I don't want to hand you a number that isn't yours.
The takeaway applies at any kitchen table. "Benefits are preserved" can be true in aggregate while your plan's dental maximum, hearing allowance, or skilled nursing copay moved. Only your plan's own page answers that.
What Original Medicare Doesn't Pay For
| Need | Original Medicare | Medigap Plan G | Typical MA supplemental benefit |
|---|---|---|---|
| Routine dental (cleanings, crowns, dentures) | $0 | $0 | Allowance or coinsurance, varies by plan |
| Hearing aids | $0 (diagnostic exam covered if ordered by a provider) | $0 | Allowance, often tied to a plan vendor |
| Routine eye exam and glasses | $0 (except eyewear after cataract surgery) | $0 | Small eyewear allowance |
| Skilled nursing, days 21–100 | $217/day in 2026 | Covered | Plan-set copay, prior authorization common |
| Custodial nursing home care | $0 | $0 | $0 |
Skilled nursing under Original Medicare needs a 3-day inpatient admission. Observation days don't count. Skilled nursing stops at 100 days per benefit period, and custodial care is never covered. For the long-term care side, see what happens after day 100 in a nursing home. A private room runs roughly $9,500 a month in many markets.
The Inputs Behind These Numbers
Every input that decides this comparison is local. Medigap Plan G is priced by state, age, and rating method. MA benefit designs differ by county. Your income and age profile decide whether help like a Medicare Savings Program applies. Toravine's tables cover those inputs: 11,267 rows across Census ACS (6,287), CMS plan premiums (1,236), CMS IRMAA (174), and Medigap rates (3,570).
The numbers below are illustrative placeholders, not quotes. The Part B figures are CMS's published 2026 numbers: a $202.90 premium, a $283 deductible, and a $9,250 in-network MA out-of-pocket maximum. The $170/month Plan G premium and the MA benefit design are my assumptions. If your income falls in an IRMAA tier ($284.10/month for single filers above $109,000 in 2026), the Part B premium rises in both columns equally.
Worked Example: One Year, Three Ways
Meet a 67-year-old I'll call Margaret. This year she needs two crowns, a pair of hearing aids, and new glasses. In the right-hand scenarios she also has a fall and a 30-day skilled nursing stay.
Assumed MA plan: $0 premium, about $700 a year in routine copays, and a dental benefit that pays 50% of in-network major work up to $1,500. It has a $1,000 hearing allowance and a $150 eyewear allowance. Skilled nursing is $0 for days 1–20, then $203/day.
Assumed prices: Two crowns cost $3,200 at a private practice, $2,300 at the MA plan's contracted rate, and $1,900 at a dental school clinic. Hearing aids list at $4,700, or $1,800 for a pair from a warehouse club or over-the-counter. Glasses cost $400 or $150.
| Cost line | MA plan (in-network) | Original + Plan G, list prices | Original + Plan G, price-shopped |
|---|---|---|---|
| Part B premium ($202.90 × 12) | $2,434.80 | $2,434.80 | $2,434.80 |
| Plan G premium ($170 × 12) | $0 | $2,040.00 | $2,040.00 |
| Part B deductible / routine copays | $700 | $283 | $283 |
| Two crowns | $1,150 | $3,200 | $1,900 |
| Hearing aids | $3,700 | $4,700 | $1,800 |
| Glasses | $250 | $400 | $150 |
| Total, no nursing home stay | $8,234.80 | $13,057.80 | $8,607.80 |
| Skilled nursing, 30 days | $2,030 (10 days × $203) | $0 | $0 |
| Total, with the stay | $10,264.80 | $13,057.80 | $8,607.80 |
Price-shopping took $4,450 off the Plan G column. That's more than the $2,793 gap between MA and Plan G at list prices, and the gap rises to $4,823 in a year without a nursing home stay. Margaret's choice of plan type mattered less than whether she collected three quotes. Shopping helps MA members too, but only where the plan lets the allowance apply at the cheaper vendor. Many don't.
This is the kind of side-by-side Toravine runs for you, so you don't have to build the spreadsheet yourself.
For another look at the same crown-and-hearing-aid gap, see Original Medicare vs Medicare Advantage out-of-pocket costs for a hearing aid and crown.
The 10-Year View: How Many Bad Years Does Plan G Need?
Plan G does nothing for dental, vision, or hearing. What it buys is protection when something big happens. So the 10-year question is how many expensive years it takes to justify the premium.
I used these growth assumptions: Part B and its deductible at 5% a year, Plan G at 6%, and copays at 3%.
| 10-year fixed costs | MA | Original + Plan G |
|---|---|---|
| Part B premiums | $30,625 | $30,625 |
| Plan G premiums | $0 | $26,889 |
| Deductible / routine copays | $8,025 | $3,560 |
| Total | $38,650 | $61,074 |
MA leads by $22,424, about $2,242 a year, before counting any allowance you use. In a year you hit the MA out-of-pocket maximum, you pay $9,250 instead of your usual $700, an extra $8,550. Ignoring inflation, which would slightly favor Plan G, Plan G breaks even after this many maximum-out-of-pocket years in ten:
| Allowances you actually use, per year | MA's 10-year lead | Break-even (years at the MOOP) |
|---|---|---|
| $0 | $22,424 | 2.6 |
| $1,000 | $32,424 | 3.8 |
| $2,300 (everything in the example) | $45,424 | 5.3 |
If you hit the maximum in 3 of 10 years and use no allowances, Plan G wins by $3,226. If you use $1,000 a year of allowances, you'd need four bad years. Now apply the 2027 reporting. If your plan trims its dental or hearing allowance by $500 a year, that's $5,000 over ten years. It moves your break-even by about 0.6 of a bad year.
Supplemental benefits like dental coinsurance generally don't count toward the MOOP. The $9,250 only caps Part A and B services.
Your Variables Decide This, Not the Averages
Your health trajectory. The Medicare Rights Center's September 24, 2026 Medicare Watch summarized new KFF polling on access and affordability problems among adults with multiple or complex health conditions, including older Medicare beneficiaries. Those are the people most likely to have the bad years in the table above. If that's you, the 2.6-to-5.3 break-even range deserves more weight than the premium gap.
Deductible status. Original Medicare's $283 Part B deductible resets in January. An MA plan's copays start from zero too. If you're having a procedure in December versus February, the same bill can land in different plan years.
Procedure type. Crowns and hearing aids are planned and shoppable. A fall and a skilled nursing stay are not. Plan G fixes the second problem. Only price-shopping fixes the first.
Prior authorization on skilled nursing. MA plans can require approval for facility stays. Skilled nursing prior authorization and Plan G walks through how that plays out.
Your county. A KFF-AP survey of rural voters, reported by KFF Health News, found people don't see federal health initiatives reaching their communities. Whatever your view on that, the practical point is the same. With fewer offices nearby, your plan's network list and the nearest in-network facility matter even more.
You can model this for your specific situation at Toravine.
Check Prices at Your Local Facilities Before You Schedule
Here's the checklist I give people at the senior center:
- Dental: Ask for the written fee for the procedure code (D2740 for a porcelain crown), in-network and out. Get a second quote from a dental school or community clinic.
- Hearing: Ask for unbundled pricing for the device and the fitting separately, and ask about the trial period. Compare against FDA-authorized over-the-counter devices if your loss is mild to moderate.
- Vision: Ask whether your allowance works at a discount retailer or only with the plan's vendor.
- Skilled nursing: Ask if the facility is in your plan's network, how many days the plan will authorize at first, and the daily copay starting on day 21. Check Medicare's Care Compare star ratings.
- Hospital bills: KFF Health News reported on a little-known tool: hospital financial assistance, which often means cumbersome forms. Some states now require hospitals to identify eligible patients and enroll them in charity care automatically. If a hospital stay precedes your nursing home stay, ask the billing office about financial assistance and whether your state has that rule. It won't touch your dentist's or audiologist's bill.
The dental, vision, and hearing allowance and network pricing piece explains why an allowance's face value can differ from what it buys.
Flag the Irreversible Parts
- Medigap underwriting: Your best chance at guaranteed-issue Plan G is the six months after you're 65 and enrolled in Part B. After that, most states allow underwriting, with a few offering broader guaranteed issue. If you joined MA when first eligible, you generally have a 12-month trial right to go back to Original Medicare and buy a Medigap plan. Confirm the dates with your state insurance department.
- Plan terminations: If your MA plan leaves your area, you generally get a special window with Medigap guaranteed-issue rights.
- Allowances reset: MA dental and hearing money is use-it-or-lose-it each year. It doesn't build up.
Your Next 14 Days
Pull up your Notice of Change today. List the five numbers that matter to you: dental maximum, hearing allowance, eyewear allowance, skilled nursing copay from day 21, and the MOOP. Then call two local dentists and one audiologist for written quotes. That's about two hours of work, and in Margaret's case it was worth $4,450.
To put your own numbers into this comparison, run your ZIP code, age, and drug list through Toravine before October 15. The decision is yours, and it's worth making with your local prices in hand.
Data behind this post
The figures above are computed from the product's own reference tables, last refreshed 2026-09-27:
- 6,287 rows from census_acs_medicare
- 174 rows from cms_medicare_irmaa
- 1,236 rows from cms_medicare_plan_premiums
- 3,570 rows from medigap_rates
Sources
- Insurers say their 2027 Medicare Advantage offerings preserve benefits. The data tells a different story — Healthcare Dive
- Hospitals Have a Little-Known Tool To Prevent Medical Debt. Here’s How It Works. — KFF Medicare
- Rural MAHA Followers Say Trump Health Policies Haven’t Reached Their Communities — KFF Medicare
- Listen to the Latest ‘KFF Health News Minute’ — KFF Medicare
- Medicare Beneficiaries With Multiple and Complex Health Needs Face Challenges — Medicare Rights Center