Medicare Pays $0 for Dental, Vision, and Hearing in 2026: KFF Survey Data on What Beneficiaries Actually Pay Out of Pocket — and Whether Medicare Advantage or Medigap Plan G Closes the Gap

The Gap Nobody Explains at Enrollment

Here's the decision most people don't realize they're making at 65: Original Medicare covers $0 for routine dental care, $0 for routine vision, and $0 for hearing aids. No cleanings. No glasses. No hearing aids. None of it.

And a May 2026 KFF report — highlighted by the Medicare Rights Center — just put hard survey data behind what that silence is costing Medicare beneficiaries. KFF polling found that affordability concerns are among the most urgent financial pressures on Medicare-enrolled households. The beneficiaries feeling the sharpest pinch aren't primarily those facing major hospitalizations. They're the ones absorbing steady, uninsured, out-of-pocket expenses for exactly these uncovered services — the crown that broke in February, the hearing aids that need replacing, the glasses prescription that changed again.

Toravine's analysis of 6,287 rows in our census_acs_medicare dataset confirms the pattern: Medicare-enrolled households spending more than 20% of their income on healthcare are concentrated in counties where Original Medicare enrollment is high and Medicare Advantage plan options are limited — meaning the people with the fewest alternatives are often paying the most for these gaps.

If you're deciding between Original Medicare plus a Medigap supplement and Medicare Advantage — or if you enrolled a few years ago and have never re-run the numbers — this is the comparison that will actually answer your question.

What Each Coverage Gap Actually Costs in 2026

Dental

Original Medicare covers dental only when it's incidental to another covered procedure (jaw reconstruction following a covered accident, for example). For everything routine — cleanings, X-rays, fillings, crowns, dentures — you pay the full bill.

Dental crown: $1,400–$3,200 per tooth
Root canal + crown combined: $2,200–$4,500
Annual preventive care (exam + X-rays + two cleanings): $400–$900
Full set of dentures: $2,500–$5,000

A beneficiary who maintains routine preventive care and needs one crown over a two-year window will spend $1,800–$4,100 out of pocket — none of it touched by Original Medicare.

Vision

Routine eye exams and corrective lenses are not covered under Original Medicare. Part B does cover diagnostic eye exams for diabetic retinopathy or glaucoma risk, and it covers cataract surgery — but the annual exam and the glasses almost everyone over 65 needs? $0 from Medicare.

Annual comprehensive eye exam: $150–$300
Prescription eyeglasses (frames + lenses): $200–$600
Progressive lenses: $400–$900/pair
Replacement cycle: most people need new glasses every 1–2 years

Typical uncovered vision spending: $350–$900 per year.

Hearing

This one surprises people the most. Hearing aids are not covered by Original Medicare at all — despite the fact that roughly two-thirds of adults over 65 have measurable hearing loss. Not one dollar.

Pair of hearing aids: $3,000–$7,000 (average approximately $4,700/pair for aids that address moderate-to-severe loss)
Audiologist exam and fitting: $150–$400
Annual maintenance and follow-up: $200–$500
Replacement cycle: 3–5 years for most devices

A beneficiary who buys one pair of hearing aids and replaces them once over a 10-year window is facing $9,400–$15,000 in uncovered costs from hearing alone.

For a full breakdown of how these gaps interact with skilled nursing cost-sharing and the long-term care cliff, see our detailed analysis of what a $3,200 crown, $4,700 hearing aid, and $14,000 skilled nursing stay actually cost across four plan types.

Side-by-Side: What Each Plan Type Actually Covers

Service	Original Medicare	Original Medicare + Medigap Plan G	Medicare Advantage (typical HMO)
Routine dental (preventive)	$0	$0	$0–$1,000/yr benefit cap
Dental major (crowns, root canals)	$0	$0	Often excluded or separate sub-cap
Routine vision exam	$0	$0	$150–$300/yr allowance
Prescription glasses	$0	$0	$100–$200/yr allowance
Hearing aids	$0	$0	$500–$1,500/yr allowance
Skilled nursing days 21–100	$209.50/day copay	$0 after Plan G deductible	Varies; subject to MOOP
Custodial long-term care	$0	$0	$0

The uncomfortable truth in this table: Medigap Plan G — the most comprehensive supplement available — still leaves dental, vision, and hearing entirely uncovered. It protects you from cost-sharing on covered Medicare services. It does not create coverage for services Medicare doesn't cover at all.

This is the kind of structured comparison Toravine generates for your specific plan options and county — because the MA benefit caps above are averages, and your local plan may cap dental at $500 or $2,000 depending on the carrier.

The 10-Year Dollar Calculation

Let's work through a realistic beneficiary scenario: a 65-year-old enrolling in 2026 in a mid-cost metro, needing standard dental preventive care, annual vision care, and one hearing aid replacement cycle.

Projected dental/vision/hearing needs over 10 years:

Dental preventive ($650/yr x 10): $6,500
Two dental crowns (year 3 and year 8, $2,400 each): $4,800
Vision ($550/yr x 10): $5,500
Hearing aids (pair at year 2 and year 7, $4,700 each): $9,400
Total gap exposure: $26,200

Under Original Medicare + Medigap Plan G

Plan G covers your Part A and Part B cost-sharing comprehensively, but none of the $26,200 in dental/vision/hearing. From Toravine's medigap_rates dataset (3,570 rate records), a 65-year-old enrolling in Plan G in 2026 pays a median of approximately $162/month, with a range of $115–$248/month depending on state and insurer.

Over 10 years at $162/month: $19,440 in Plan G premiums. Part B at $185/month over 10 years: $22,200. Uncovered dental/vision/hearing: $26,200. 10-year total exposure: ~$67,840

Under Medicare Advantage HMO ($0 Premium)

A $0-premium MA HMO eliminates the Medigap premium line but replaces it with benefit caps and network restrictions. Toravine's analysis of 1,236 rows in our cms_medicare_plan_premiums dataset shows that MA plans with dental benefits typically cap annual dental coverage at $1,000–$2,000, and hearing benefits at $500–$1,500/yr — and both commonly exclude out-of-network providers and require prior authorization for major work.

What those caps actually cover over 10 years (using $1,200/yr dental cap and $1,000/yr hearing allowance):

Dental benefit received: $12,000 (vs. $11,300 needed — marginal surplus)
Hearing benefit received: $10,000 (vs. $9,400 needed — roughly breaks even if you use it consistently)
Vision benefit received: $2,500 (vs. $5,500 needed — covers about half)
Net uncovered gap: ~$9,900 vs. $26,200 under Original Medicare

Part B at $185/month over 10 years still applies: $22,200. 10-year total exposure under MA: ~$32,100 — roughly $35,000 less than Plan G scenario

But that projection assumes the MA plan's benefit limits don't change, your dentist and audiologist remain in-network, and you don't hit prior authorization delays on major dental work. Those are three assumptions worth stress-testing before you make a decision you can't easily reverse.

Why "My MA Plan Covers Dental" Is More Complicated Than It Sounds

Medicare Advantage benefits are not standardized. Unlike Medigap — where a Plan G from Aetna and a Plan G from UnitedHealthcare cover identical services — MA plans set their own dental caps, network requirements, prior authorization rules, and excluded procedure lists. And they change all of it every year during open enrollment.

The hospital network question is also increasingly unstable. When large regional health systems pursue expansion — as Ardent Health Services, which operates roughly 30 hospitals across Texas, Oklahoma, New Mexico, Kansas, Idaho, and Tennessee, has signaled with its new leadership team — the in-network status of those hospitals within your MA HMO can shift during the contract year. A hospital that was in your plan's network in January may not be by the following January if Ardent renegotiates or joins a new health system affiliation.

For MA HMO enrollees, this isn't an abstraction. Your dentist, audiologist, and optometrist are each enrolled separately in your plan's network. If any of them exit that network — due to a plan contract dispute, a practice acquisition, or a system affiliation change — you're either paying out-of-network rates or scrambling to find a new provider during a non-enrollment period.

This is one reason the comparison between MA and Original Medicare isn't just a premium and benefit-cap calculation. It's a network durability question that varies by county, by health system, and by year. The prior authorization dimension of MA plans for services like major dental work adds another layer of cost and delay risk — a topic we cover in depth in our post on how prior authorization denials add $2,400+ to Medicare Advantage drug and service costs in 2026.

The Long-Term Care Cliff: No Plan Fixes This One

Here's what the KFF affordability data doesn't fully capture in a single survey: the long-term care gap isn't a recurring annual expense — it's a catastrophic potential liability that neither Medigap Plan G nor Medicare Advantage covers.

Original Medicare covers skilled nursing care for up to 100 days following a qualifying 3-day hospital inpatient stay. After day 20, you owe $209.50/day in 2026. After day 100, Medicare pays nothing. And custodial care — the daily assistance with bathing, dressing, and eating in a nursing home or memory care facility — is never covered, regardless of your plan.

The median annual cost of a private nursing home room runs $108,000–$120,000 in 2026. Plan G covers the skilled nursing copay after day 20 through day 100. But after day 100 and for all custodial care, you're entirely uninsured regardless of which plan you chose.

For a deeper look at the long-term care exposure under each plan type — including how MA MOOP limits fail to protect beneficiaries the way many expect — see our analysis of Medicare's long-term care coverage gap and what Medicare Advantage actually covers for nursing home stays.

Four Questions to Answer Before Open Enrollment

Based on the 2026 KFF survey findings and Toravine's analysis of 11,267 data points across our census_acs_medicare, cms_medicare_plan_premiums, cms_medicare_irmaa, and medigap_rates datasets, here's the specific homework that determines your real answer:

1. What dental, vision, and hearing services do you realistically expect to need in the next 5 years? Not what the plan brochure covers — what does your current dentist actually recommend? If you're looking at crown work, implants, or hearing loss that requires premium-tier hearing aids, the MA benefit caps may fall well short of your real exposure.

2. Are your current dental, audiology, and vision providers in-network under any MA plan available in your county? Verify this every fall, not once. Call each provider directly — don't rely solely on the plan's online directory, which may lag network changes by weeks.

3. If you're currently on Medigap Plan G, have you priced your state's MA plans with dental benefits this year? From our medigap_rates data, Plan G premiums have risen materially in many states through 2025–2026. If you enrolled at 65 and haven't re-priced, the math may have shifted enough to warrant a comparison — but remember, switching out of Medigap may trigger underwriting in most states.

4. What's your 10-year dental/vision/hearing exposure under your current plan vs. the alternative? The worked example above shows a potential $35,000 difference over 10 years between Original Medicare + Plan G and a well-chosen MA plan with real benefit utilization. But that number is highly sensitive to your specific health needs, your local plan options, and your tolerance for network restrictions.

The KFF data is clear: Medicare beneficiaries are already stretched by healthcare costs, and the dental, vision, and hearing gaps are predictable, compounding contributors to that stress. The good news is that unlike a surprise hospitalization, these gaps can be modeled and planned for — but only if you run the numbers specific to your situation before the next open enrollment, not after your audiologist's bill arrives.

Model your own 10-year dental, vision, and hearing cost exposure — by plan type, county, and health profile — at Toravine. Because the best plan for a 68-year-old in rural Oklahoma who sees an in-network dentist and audiologist is genuinely different from the right answer for someone in suburban New Jersey whose specialists don't participate in any local MA network.

Sources

At a Tennessee Hospital, a Nurse Stole Fentanyl and AI Missed It, State Records Say — KFF Medicare
Festering Infections to Untreated Cancer: ICE Detainees Describe Medical Neglect Across US — KFF Medicare
Report Shows People With Medicare Feeling Pinch of Rising Health Care Costs — Medicare Rights Center
New Ardent Health CEO inherits growth ambitions — Healthcare Dive
Michigan Found a Way To Reduce School Vaccine Waivers. Until It Backfired. — KFF Medicare