Medicare Dental, Vision, and Hearing Benefit Act of 2025
Sponsored By: Representative Doggett
Introduced
Summary
Would add dental, vision, and hearing benefits to Medicare. It would define covered services, set phased payment rules, and create frequency and dollar limits for exams, eyewear, dentures, and hearing aids.
Show full summary
- Medicare beneficiaries: Would gain coverage for dental, vision, and hearing services. Vision and hearing services generally pay 80 percent and routine vision exams are limited to one per 12-month period.
- Low-income and subsidy-eligible beneficiaries: Preventive dental services would be covered at 100 percent, and other dental care would phase up to 80 percent as the law's schedule takes effect.
- Device users and durable equipment: Eyeglass lenses, frames, and contact lenses would have set dollar caps with inflation indexing starting in 2027. Dentures and hearing aids would face multi-year frequency limits and the Secretary could require prior authorization or clinical criteria.
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Bill Overview
Analyzed Economic Effects
5 provisions identified: 4 benefits, 0 costs, 1 mixed.
New Medicare dental and dentures coverage
If enacted, Medicare would cover dental care starting January 1, 2026. Preventive care would be paid at 100% of the lower of the bill or the Medicare amount; other dental care would phase in at 30% in 2027, 60% in 2028, and 80% in 2029 and later. Low‑income, subsidy‑eligible people would get preventive care at 100% in 2026+ and 80% for other dental care starting in 2027. Routine cleanings and routine exams would be limited to two each in any 12 months unless waived; the Secretary could set other limits or require prior authorization. Dentures would be covered at 80% starting in 2027, with at most one full upper and one full lower (and one partial upper and one partial lower) every five years. The bill would remove today’s dental exclusion so these services could be covered under Medicare.
Medicare hearing care and hearing aids
If enacted, Medicare would cover hearing and audiology care starting January 1, 2026. Hearing and audiology services would pay 80% of the lower of the bill or the Medicare amount. Hearing aids would pay 80% of the amount payable, with at most one hearing aid per ear in any 48‑month period. The Secretary could require prior authorization, set minimum hearing‑loss rules, and waive frequency limits when appropriate.
Medicare vision care, glasses, and contacts
If enacted, Medicare would cover routine vision care starting January 1, 2026. Exams and services would pay 80% of the lower of the bill or the Medicare amount, with one routine exam allowed every 12 months unless waived. Glasses and contacts would pay 80% but have caps: up to $100 for eyeglass lenses each 12 months, $100 for frames each 24 months, and $200 for contacts each 24 months; the contact cap would start in the first year that begins at least six months after enactment, and lens/contact amounts would be indexed for inflation starting in 2027. Low‑vision devices would be covered at 80% if prescribed by a doctor (ordinary glasses/contacts are not low‑vision devices). The bill would repeal the current ban on covering most eyeglasses and refraction exams so Medicare could pay under these limits.
New billing rules for glasses and hearing aids
If enacted, Medicare would treat hearing aids, eyeglass lenses and frames, contact lenses, and low‑vision devices as durable medical equipment starting January 1, 2026. The Physician Fee Schedule would add cross‑references so providers could bill the new dental, vision, and hearing services. The bill would also keep dentures, eyeglass lenses, contact lenses, and hearing aids out of competitive acquisition programs, which could change how suppliers set prices and how you get these items.
Add oral health expert to prevention panel
If enacted, the U.S. Preventive Services Task Force would include at least one oral health professional. This would start on January 1 of the first year that begins at least six months after enactment. Over time, this could shape preventive oral health advice and related coverage updates.
Sponsors & CoSponsors
Sponsor
Doggett
TX • D
Cosponsors
Adams
NC • D
Sponsored 3/11/2025
Ansari
AZ • D
Sponsored 3/11/2025
Balint
VT • D
Sponsored 3/11/2025
Barragan
CA • D
Sponsored 3/11/2025
Beatty
OH • D
Sponsored 3/11/2025
Beyer
VA • D
Sponsored 3/11/2025
Bishop
GA • D
Sponsored 3/11/2025
Bonamici
OR • D
Sponsored 3/11/2025
Boyle (PA)
PA • D
Sponsored 3/11/2025
Carson
IN • D
Sponsored 3/11/2025
Carter (LA)
LA • D
Sponsored 3/11/2025
Casar
TX • D
Sponsored 3/11/2025
Castro (TX)
TX • D
Sponsored 3/11/2025
Chu
CA • D
Sponsored 3/11/2025
Cleaver
MO • D
Sponsored 3/11/2025
Cohen
TN • D
Sponsored 3/11/2025
Connolly
VA • D
Sponsored 3/11/2025
Crockett
TX • D
Sponsored 3/11/2025
Cuellar
TX • D
Sponsored 3/11/2025
Davis (IL)
IL • D
Sponsored 3/11/2025
Dean (PA)
PA • D
Sponsored 3/11/2025
DeGette
CO • D
Sponsored 3/11/2025
McClain Delaney
MD • D
Sponsored 3/11/2025
DeLauro
CT • D
Sponsored 3/11/2025
Deluzio
PA • D
Sponsored 3/11/2025
DeSaulnier
CA • D
Sponsored 3/11/2025
Dexter
OR • D
Sponsored 3/11/2025
Dingell
MI • D
Sponsored 3/11/2025
Escobar
TX • D
Sponsored 3/11/2025
Espaillat
NY • D
Sponsored 3/11/2025
Evans (PA)
PA • D
Sponsored 3/11/2025
Leger Fernandez
NM • D
Sponsored 3/11/2025
Fields
LA • D
Sponsored 3/11/2025
Friedman
CA • D
Sponsored 3/11/2025
Frost
FL • D
Sponsored 3/11/2025
Garamendi
CA • D
Sponsored 3/11/2025
Garcia (IL)
IL • D
Sponsored 3/11/2025
Garcia (CA)
CA • D
Sponsored 3/11/2025
Garcia (TX)
TX • D
Sponsored 3/11/2025
Goldman (NY)
NY • D
Sponsored 3/11/2025
Gottheimer
NJ • D
Sponsored 3/11/2025
Green, Al (TX)
TX • D
Sponsored 3/11/2025
Grijalva
AZ • D
Sponsored 3/11/2025
Hayes
CT • D
Sponsored 3/11/2025
Hoyle (OR)
OR • D
Sponsored 3/11/2025
Huffman
CA • D
Sponsored 3/11/2025
Jackson (IL)
IL • D
Sponsored 3/11/2025
Jacobs
CA • D
Sponsored 3/11/2025
Jayapal
WA • D
Sponsored 3/11/2025
Johnson (GA)
GA • D
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Johnson (TX)
TX • D
Sponsored 3/11/2025
Kaptur
OH • D
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Khanna
CA • D
Sponsored 3/11/2025
Krishnamoorthi
IL • D
Sponsored 3/11/2025
Landsman
OH • D
Sponsored 3/11/2025
Larsen (WA)
WA • D
Sponsored 3/11/2025
Larson (CT)
CT • D
Sponsored 3/11/2025
Lee (PA)
PA • D
Sponsored 3/11/2025
Lee (NV)
NV • D
Sponsored 3/11/2025
Lieu
CA • D
Sponsored 3/11/2025
McBride
DE • D
Sponsored 3/11/2025
McClellan
VA • D
Sponsored 3/11/2025
McCollum
MN • D
Sponsored 3/11/2025
Cherfilus-McCormick
FL • D
Sponsored 3/11/2025
McGovern
MA • D
Sponsored 3/11/2025
Meeks
NY • D
Sponsored 3/11/2025
Meng
NY • D
Sponsored 3/11/2025
Mfume
MD • D
Sponsored 3/11/2025
Moore (WI)
WI • D
Sponsored 3/11/2025
Nadler
NY • D
Sponsored 3/11/2025
Norcross
NJ • D
Sponsored 3/11/2025
Del. Norton, Eleanor Holmes [D-DC-At Large]
DC • D
Sponsored 3/11/2025
Ocasio-Cortez
NY • D
Sponsored 3/11/2025
Omar
MN • D
Sponsored 3/11/2025
Pingree
ME • D
Sponsored 3/11/2025
Pocan
WI • D
Sponsored 3/11/2025
Pou
NJ • D
Sponsored 3/11/2025
Pressley
MA • D
Sponsored 3/11/2025
Ramirez
IL • D
Sponsored 3/11/2025
Raskin
MD • D
Sponsored 3/11/2025
Ross
NC • D
Sponsored 3/11/2025
Ruiz
CA • D
Sponsored 3/11/2025
Salinas
OR • D
Sponsored 3/11/2025
Sanchez
CA • D
Sponsored 3/11/2025
Scanlon
PA • D
Sponsored 3/11/2025
Schakowsky
IL • D
Sponsored 3/11/2025
Scott, David
GA • D
Sponsored 3/11/2025
Sewell
AL • D
Sponsored 3/11/2025
Sherman
CA • D
Sponsored 3/11/2025
Sherrill
NJ • D
Sponsored 3/11/2025
Smith (WA)
WA • D
Sponsored 3/11/2025
Soto
FL • D
Sponsored 3/11/2025
Stansbury
NM • D
Sponsored 3/11/2025
Swalwell
CA • D
Sponsored 3/11/2025
Takano
CA • D
Sponsored 3/11/2025
Thanedar
MI • D
Sponsored 3/11/2025
Thompson (MS)
MS • D
Sponsored 3/11/2025
Thompson (CA)
CA • D
Sponsored 3/11/2025
Titus
NV • D
Sponsored 3/11/2025
Tlaib
MI • D
Sponsored 3/11/2025
Tokuda
HI • D
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Tonko
NY • D
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Torres (NY)
NY • D
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Trahan
MA • D
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Vargas
CA • D
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Veasey
TX • D
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Velazquez
NY • D
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Wasserman Schultz
FL • D
Sponsored 3/11/2025
Waters
CA • D
Sponsored 3/11/2025
Watson Coleman
NJ • D
Sponsored 3/11/2025
Williams (GA)
GA • D
Sponsored 3/11/2025
Wilson (FL)
FL • D
Sponsored 3/11/2025
McGarvey
KY • D
Sponsored 3/11/2025
Foushee
NC • D
Sponsored 3/11/2025
McIver
NJ • D
Sponsored 3/11/2025
Frankel, Lois
FL • D
Sponsored 3/11/2025
Gomez
CA • D
Sponsored 3/11/2025
Kelly (IL)
IL • D
Sponsored 3/24/2025
Simon
CA • D
Sponsored 3/24/2025
Levin
CA • D
Sponsored 4/7/2025
Bell
MO • D
Sponsored 4/10/2025
Lynch
MA • D
Sponsored 4/10/2025
Horsford
NV • D
Sponsored 4/28/2025
Morelle
NY • D
Sponsored 6/3/2025
Carbajal
CA • D
Sponsored 6/4/2025
Walkinshaw
VA • D
Sponsored 9/30/2025
Riley (NY)
NY • D
Sponsored 11/4/2025
Gonzalez, V.
TX • D
Sponsored 1/20/2026
Grijalva
AZ • D
Sponsored 2/3/2026
Roll Call Votes
No roll call votes available for this bill.
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