Medicare Dental, Hearing, and Vision Expansion Act of 2025
Sponsored By: Senator Bernie Sanders
Introduced
Summary
Expands Medicare to cover comprehensive dental, hearing, and vision services. It would add preventive and restorative dental care, dentures and prosthetics, audiology and hearing aids, and routine eye exams with staged start dates and a phased Part B premium rule for 2026–2030.
Show full summary
- Medicare beneficiaries would gain preventive dental services, restorative care, dentures, audiology visits, hearing aids for moderately severe-or-worse loss, and routine eye exams under Part B.
- Providers would be paid under a new Part B dental fee schedule initially set at 70% of the 2020 ADA median. Oral health professionals would receive payment based on 85% of the fee schedule amount.
- Rural Health Clinics and Federally Qualified Health Centers could furnish these services and use temporary 1848-based payment rules until sufficient data are available or January 1, 2031.
- Implementation funding is provided, including $900 million for dental and $500 million for vision implementation support.
- The Secretary would establish fee schedules, designate Medicare Administrative Contractors to manage dental claims, and begin competitive acquisition for hearing aids by January 1, 2031.
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Bill Overview
Analyzed Economic Effects
5 provisions identified: 3 benefits, 0 costs, 2 mixed.
New Medicare dental coverage rules
If enacted, Medicare Part B would cover many dental and oral services starting Jan 1, 2027. Dentures would be covered starting Jan 1, 2026. Preventive care would be paid in full, most other services would pay 80% of the allowed amount, and special rules apply when services are from an oral health professional. The Medicare dental fee schedule would use 70% of a national median fee (area-adjusted) and update yearly using CPI-U minus a productivity adjustment. Preventive services would be limited to set frequencies (for example, up to 2 exams and 2 cleanings per year). The Health Department would pick up to four Medicare contractors to run the dental benefit and process claims.
New Medicare hearing aid benefit
If enacted, Medicare would treat hearing aids as a Part B prosthetic device for people with moderately severe or worse hearing loss starting Jan 1, 2027. Coverage would generally pay 80% up to a cap tied to the 2021 Federal Supply Schedule rate updated to the year. Hearing aids would be limited to one per ear every five years and require a written order from an authorized clinician. The bill would pay hearing-aid exams by qualified hearing aid professionals at 80% of a defined amount. The bill also provides $370 million to HHS (FY2025) to implement the hearing changes, available for use from Jan 1, 2026 through Sept 30, 2035.
Medicare vision exams and glasses
If enacted, Medicare Part B would cover one routine eye exam every two years starting Jan 1, 2027. It would also cover one pair of conventional eyeglasses (lenses and frame) every two years, with an extra pair allowed after cataract surgery. Payment for eyeglasses would be capped at the 2021 Federal Supply Schedule rate updated to the year and deluxe or reading-only glasses would not be paid. The bill also provides $500 million to HHS (FY2025) to implement the vision changes, available for use from Jan 1, 2026 through Sept 30, 2034, and requires competitive buying for eyeglasses by Jan 1, 2030.
Changes to exclusions and self-referral
If enacted, the bill would remove the general Medicare exclusion for certain hearing aids and exams that meet the new Part B rules. It would also add exclusions for dental or vision services given more often than allowed. The bill creates transitional physician self-referral rules for hearing services from Jan 1, 2027 through Dec 31, 2028, and requires stricter regulatory protections for such financial relationships starting Jan 1, 2029.
Rural and community clinics can offer care
If enacted, Rural Health Clinics and Federally Qualified Health Centers could provide dental, hearing, and vision services through staff or contractors starting Jan 1, 2027. While HHS collects payment data (or until Jan 1, 2031), those services would be paid using Medicare physician rates instead of the usual clinic all-inclusive or PPS rules. Costs for those services would be ignored when calculating clinic all-inclusive rates during the temporary period.
Sponsors & CoSponsors
Sponsor
Bernie Sanders
VT • I
Cosponsors
Elizabeth Warren
MA • D
Sponsored 3/11/2025
Cory Booker
NJ • D
Sponsored 3/11/2025
Peter Welch
VT • D
Sponsored 3/11/2025
Edward Markey
MA • D
Sponsored 3/11/2025
Tammy Duckworth
IL • D
Sponsored 3/11/2025
Jeff Merkley
OR • D
Sponsored 3/11/2025
Richard Blumenthal
CT • D
Sponsored 3/11/2025
Adam Schiff
CA • D
Sponsored 12/8/2025
Roll Call Votes
No roll call votes available for this bill.
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