By NextBestFitDental, vision, and hearing are mostly uncovered
Traditional Medicare excludes dental, routine vision, and hearing aids; adult Medicaid dental varies by state; dental is the care most often skipped because of cost.
Evidence
- Out-of-pocket dental spending was $72.5B in 2024.Sources: CMS Office of the Actuary (2025)
Who's affected
Who is hurt
- Older adults: Coverage gaps and costs lead them to skip dental and other excluded care.
- Low- and middle-income households: Coverage gaps and costs lead them to skip dental and other excluded care.
Who gains while it lasts
- Health insurers, brokers, and their shareholders: Private Medicare plans market extra benefits missing from traditional coverage.
- Cash-pay and private care practices: Coverage gaps support cash-pay care.
Under your mix of paths
Paths that create or worsen it
Paths that fix or soften it
Using your saved plan. 0 paths picked.Edit all picks
Root causes
- Historical separation of dental from medical insurance
Related costs
Open questions
- Should dental, vision, and hearing be covered like medical care?
Caused or worsened by these paths
This problem only matters if one of these paths is chosen.
Fold Medicare Advantage into the public programMedicare Advantage overpayments and coding intensityChosen
Enrollees lose extra benefits, including gym and dental benefits, unless the public plan adds them.
Fix Medicare Advantage paymentsMedicare Advantage overpayments and coding intensityChosen
Plans may cut extra benefits as payments decline.
Solution paths (2)
Open a path for what it fixes, what it creates or worsens, who gains and who loses, precedents, and how it connects to other paths. See all paths as a decision tree.
Include in the standard benefit.
- +Dental, vision, and hearing are mostly uncovered
- −Longer waits if demand grows faster than capacity
- −Raises spending or loosens control over it
Cover exams, cleanings, fillings, extractions; limited coverage for crowns, implants.
- +Dental, vision, and hearing are mostly uncovered
- −Copays keep billing systems alive and still deter poorer patients