Does Medicare Cover Dental and Vision? Your Coverage Options in North Carolina
Medicare Parts A and B don't cover routine dental or vision. Here's how to add these benefits through Medicare Advantage or standalone insurance plans in North Carolina.
Medicare Parts A and B don't cover routine dental or vision. Here's how to add these benefits through Medicare Advantage or standalone insurance plans in North Carolina.
If you're on Medicare and wondering about dental and vision coverage, here's the short answer: Original Medicare (Parts A and B) does not cover routine dental care or vision services. That means no coverage for teeth cleanings, fillings, dentures, eye exams, or eyeglasses under your basic Medicare benefits.
This comes as a surprise to many Medicare beneficiaries. Nearly half of the people on Medicare have no dental coverage, and many don't visit the dentist regularly as a result. But you have options. Here's how to get the dental and vision coverage you need in North Carolina.
Medicare Part A (Hospital Insurance) covers inpatient hospital care, skilled nursing facility care, hospice, and some home health services. It does not cover routine dental care. However, Part A may cover certain dental procedures if they're required as part of a covered inpatient hospital stay—for example, jaw reconstruction after an accident or dental work needed before heart valve surgery.
Medicare Part B (Medical Insurance) covers doctor visits, outpatient care, preventive services, and medical equipment. It does not cover routine dental care, such as cleanings, fillings, extractions, or dentures. It also doesn't cover routine eye exams for glasses or contact lenses.
Limited Vision Coverage Under Part B: While Part B doesn't cover routine vision care, it does cover certain medically necessary eye services, including annual glaucoma screenings for high-risk individuals, diabetic retinopathy exams, macular degeneration testing and treatment, diagnostic eye exams for symptoms or conditions, and cataract surgery (including one pair of eyeglasses or contact lenses after surgery).
New in 2025 – Dental Coverage for ESRD: Beginning in 2025, Medicare started covering dental examinations and necessary treatments for individuals undergoing dialysis for end-stage renal disease (ESRD). This is a limited expansion that applies only to this specific population.
Private insurance companies approved by Medicare offer Medicare Advantage (Part C) plans. These plans provide all the coverage of Original Medicare (Parts A and B) and typically include additional benefits—most importantly, dental and vision coverage.
How common is dental/vision coverage? Very common. According to the Kaiser Family Foundation, 98% of Medicare Advantage plans offer some dental benefits, and 99% offer vision benefits. These are benefits you simply cannot get through Original Medicare.
What's typically covered:
Dental benefits may include preventive care (cleanings, exams, X-rays), basic services (fillings, extractions), and major services (crowns, bridges, dentures, root canals). Coverage levels vary by plan—some cover only preventive care while others include comprehensive dental benefits.
Vision benefits typically include routine eye exams and an annual allowance for eyeglasses or contact lenses. Some plans cover standard lenses at no additional cost; others provide a dollar amount you can apply toward frames and lenses.
Important: Coverage varies by plan. Not all Medicare Advantage plans offer the same dental and vision benefits. Some provide only basic preventive dental coverage, while others include comprehensive benefits with higher annual maximums. Always review the specific plan details—including annual limits, covered services, copays, and network requirements—before enrolling.
Blue Cross NC Medicare Advantage: Blue Cross NC Medicare Advantage plans include dental, vision, and hearing benefits. Plans also include extras like the Blue FlexCard for over-the-counter health items, SilverSneakers fitness memberships (2026 plans), non-emergency medical transportation, and more. Benefits vary by plan, so review the Evidence of Coverage for your specific plan details.
If you want to stay with Original Medicare (perhaps because you also have a Medigap plan or prefer Original Medicare's provider flexibility), you can purchase a standalone dental insurance plan separately.
How standalone dental plans work:
• You pay a monthly premium (typically $20-$50/month for individual coverage)
• Plans cover preventive, basic, and sometimes major dental services
• Most plans have annual maximums (the most the plan will pay per year)
• Many have waiting periods for major services (6-12 months before coverage begins)
• Plans use provider networks—in-network dentists cost less
Blue Cross NC Dental Blue® for Individuals: Blue Cross NC offers individual dental plans with three coverage options. These plans feature a large provider network, simple pricing, and coverage ranging from preventive-focused to comprehensive benefits. You can enroll at any time—there's no limited enrollment period for standalone dental plans.
Like dental coverage, you can purchase standalone vision insurance if you're on Original Medicare or if your Medicare Advantage plan doesn't include sufficient vision benefits.
What vision plans typically cover:
• Annual routine eye exams
• Allowances for eyeglass frames and lenses
• Contact lens coverage
• Discounts on lens upgrades (progressive, anti-reflective coatings, etc.)
Vision plans are typically less expensive than dental plans, often costing $10-$20 per month. Some people prefer discount vision programs (not insurance) that offer reduced rates at participating providers for an annual membership fee.
No. Medicare Supplement (Medigap) plans do not cover routine dental or vision care. Medigap plans only help pay the out-of-pocket costs associated with Original Medicare—deductibles, coinsurance, and copayments for Medicare-covered services.
Since Original Medicare doesn't cover routine dental or vision, Medigap plans don't either. If you have Original Medicare plus a Medigap plan, you'll need separate dental and vision insurance to get those benefits.
Value-Added Benefits: Some Medigap carriers offer "value-added" extras with their plans, such as discounts on dental, vision, or hearing services. These aren't insurance benefits—they're discount programs that give you reduced rates at participating providers. Ask about value-added benefits when comparing Medigap plans.
When choosing between Medicare Advantage and Original Medicare with a Medigap supplement, dental and vision coverage is often a deciding factor:
Medicare Advantage: Most plans include dental, vision, and often hearing benefits. This is an all-in-one approach—one plan, one premium (usually $0), multiple benefits. However, you're limited to the plan's provider network.
Original Medicare + Medigap: You have more provider flexibility (any doctor who accepts Medicare), but no dental or vision coverage. You'd need to purchase separate dental and vision plans, which would add to your total monthly costs.
Important: You cannot have both Medicare Advantage and Medigap at the same time. If you enroll in a Medicare Advantage plan, your Medigap policy won't pay for anything. Choose one path or the other.
Oral and vision health become increasingly important as you age:
Dental health and overall health: Poor oral health has been linked to heart disease, diabetes complications, and other systemic conditions. Gum disease and tooth loss become more common with age. Regular dental care helps catch problems early and prevents more expensive treatments later.
Vision and quality of life: Good vision is essential for driving, reading, and daily activities. Regular eye exams can detect conditions like glaucoma and macular degeneration early. Vision problems increase the risk of falls, a major concern for older adults.
Cost of care without insurance: Without coverage, dental care is expensive—a single crown can cost $1,000-$1,500, and dentures can run $1,000-$3,000. Having coverage helps you get preventive care that avoids more costly problems and spreads costs over time.
There have been ongoing efforts in Congress to add dental, vision, and hearing benefits to Original Medicare. Bills like H.R. 2045 (Medicare Dental, Vision, and Hearing Benefit Act of 2025) propose expanding Medicare to include these services.
However, as of late 2025, these proposals remain just that—proposals. No legislation has been passed to add routine dental and vision coverage to Original Medicare. Until that changes, beneficiaries who want these benefits must obtain them through Medicare Advantage or standalone insurance plans.
Figuring out how to add dental and vision coverage to your Medicare can be confusing. The right choice depends on your current Medicare coverage, your budget, your dental and vision needs, and which providers you want to see.
At Health Plans of NC, our licensed agents can help you understand your options. Whether you're considering Medicare Advantage plans with built-in dental and vision benefits, standalone dental plans like Blue Cross NC's Dental Blue, or comparing different coverage options, we can help you find the right solution.
Contact us at 1-800-797-0327 for a free consultation. We'll help you compare your options and find coverage that fits your needs and budget.
Does Medicare Part B cover dental and vision?
No, Medicare Part B does not cover routine dental care (cleanings, fillings, extractions, dentures) or routine vision care (eye exams for glasses, eyeglasses, contact lenses). Part B does cover certain medically necessary eye services like glaucoma screenings, cataract surgery, and diabetic eye exams.
What is the best way to get dental coverage with Medicare?
The most common way is through a Medicare Advantage (Part C) plan, which typically includes dental benefits along with your medical coverage. About 98% of Medicare Advantage plans offer some dental coverage. Alternatively, if you want to stay with Original Medicare, you can purchase a standalone dental insurance plan.
Does Medigap cover dental and vision?
No. Medicare Supplement (Medigap) plans only help pay out-of-pocket costs for Medicare-covered services. Since Original Medicare doesn't cover routine dental or vision, Medigap doesn't either. Some Medigap carriers offer discount programs for dental and vision as value-added extras, but these are not insurance benefits.
Can I have Medicare Advantage and separate dental insurance?
Yes. If your Medicare Advantage plan's dental coverage isn't sufficient for your needs, you can purchase a standalone dental plan in addition to your Medicare Advantage plan. Just be sure to compare what's already included in your MA plan before buying additional coverage to avoid paying for duplicate benefits.
Does Medicare cover dentures?
Original Medicare does not cover dentures. However, many Medicare Advantage plans include coverage for dentures as part of their dental benefits, often covering 50% of the cost. Standalone dental plans may also cover dentures, though there's usually a waiting period before this coverage begins.
Does Medicare cover eyeglasses?
Original Medicare only covers eyeglasses in one specific situation: one pair of eyeglasses or contact lenses after cataract surgery with an intraocular lens implant. Otherwise, routine eyeglasses are not covered. Medicare Advantage plans typically include an annual allowance for eyeglasses—check your specific plan for details.