Medicare covers a lot — but it doesn't cover everything. Routine dental, vision, and hearing care are excluded from Original Medicare entirely. So are long-term custodial care and most alternative therapies. For a lot of people, these gaps are where the real out-of-pocket spending happens.
What Original Medicare Leaves Out
- Routine dental: cleanings, fillings, crowns, dentures, implants
- Routine vision: eye exams for glasses, frames, lenses, contacts
- Hearing: hearing exams for aids, and the aids themselves
- Long-term custodial care: help with daily living at home or in a facility
- Most care outside the U.S. with narrow exceptions
Dental Coverage — Your Options
| Option | Typical Cost | What to Know |
|---|---|---|
| Standalone dental insurance | $18–$70/mo | Annual max $1,000–$2,500; waiting periods on major work |
| Medicare Advantage bundled dental | $0 extra | Included, but lower caps and narrower networks |
| Dental discount plan | $8–$20/mo | Not insurance — negotiated rates only, no annual max |
| Self-pay | $0/mo | One crown can exceed a year of premiums |
Vision Coverage
Medicare covers medically necessary eye care — cataract surgery, glaucoma screening for high-risk patients, and diabetic retinopathy exams. It does not cover routine refraction exams or eyewear. Standalone vision plans run $12–$30/month and typically include one annual exam plus a $100–$250 eyewear allowance.
Hearing Coverage
Hearing aids average $2,000–$6,000 per pair and are excluded from Original Medicare. Many Medicare Advantage plans include a hearing benefit — often a fitting allowance plus discounted devices through a specific network. Over-the- counter hearing aids (available since 2022) can be a lower-cost option for mild to moderate hearing loss.
Planning Documents Most People Overlook
Coverage isn't only about medical bills. A will, a durable power of attorney, and a healthcare directive protect your family from the costs and delays of probate and legal uncertainty — and they matter most at exactly the age when Medicare begins.
We help California Medicare beneficiaries fill the gaps — dental, vision, hearing, and the legal documents that protect your family.
Meet Ray From Riverside
Ray — Riverside, CA
Ray assumed his Advantage plan's "comprehensive dental" would cover the implant his dentist recommended. The plan paid $500 toward a $4,200 procedure.
A standalone comprehensive dental plan with a $2,500 annual max would have cost him about $55/month — and covered roughly $2,000 more. He enrolled the following year, before starting the second implant.
How to Decide What's Worth Buying
- Look at last three years of spending. Past dental and vision costs predict future ones better than any brochure.
- Compare annual max to expected need. A $1,000 cap doesn't help with a $4,000 procedure.
- Check waiting periods. Major work is often excluded for 6–12 months.
- Don't buy on premium alone. Total annual cost is the number that matters.
Not sure which add-ons are worth it for you?
Book a free call — we'll look at your actual dental, vision, and hearing needs and tell you honestly when self-pay is the better math.
Book a free callHow2Medicare is a free service of J Johnston Insurance, helping California seniors close the gaps Medicare leaves behind.