Costs & IRMAA
Medicare Advantage Plans Offer Dental and Hearing Benefits in Almost All Cases, but Coverage Limits Leave Many Seniors With High Bills
Nearly all Medicare Advantage plans list dental and hearing coverage among their features, but annual dollar caps and service restrictions mean enrollees can still face hundreds or thousands of dollars in out-of-pocket costs each year, KFF research finds.
By the Goodsurance editorial teamAugust 4, 2026
In 2026, 98 percent of individual Medicare Advantage plans offer some form of dental benefit, and 95 percent include hearing coverage, according to KFF. That near-universal availability has been a standard marketing point for private Medicare plans for years. The practical experience of many enrollees, however, runs up against dollar limits and service exclusions that leave significant costs with the member.
KFF research examining actual spending found that among Medicare beneficiaries who used dental services, average out-of-pocket spending was 874 dollars per year. For hearing care, the figure was 914 dollars. Both are averages, and costs ran far higher for those who needed more extensive care. About 2.7 million beneficiaries paid at least 2,136 dollars in a year for dental services, and roughly 360,000 paid at least 3,600 dollars for hearing care.
98 percent of Medicare Advantage plans offer dental benefits, but the average enrollee still paid 874 dollars out of pocket for dental care. Coverage limits are the reason.
The gap between benefit availability and real-world costs reflects how these benefits are typically structured. Annual dollar maximums for dental care in Medicare Advantage plans commonly fall between 1,000 and 1,500 dollars, and most plans cover preventive and basic care at higher rates than restorative work such as crowns, bridges, or implants. Hearing aid allowances frequently cap the plan contribution per device, leaving the enrollee responsible for any amount above that limit.
Original Medicare covers neither routine dental care nor hearing aids, so beneficiaries in traditional Medicare typically bear the full cost.
With the 2027 open enrollment period opening October 15, consumer advocates suggest going beyond whether a plan advertises dental or hearing benefits, and instead reading the specific dollar limits, covered service types, and in-network requirements before selecting a plan.
In plain words
Most Medicare Advantage plans say they cover dental and hearing care. But covering something is not the same as paying for all of it. Dental benefits usually have a yearly spending limit, often between 1,000 and 1,500 dollars. If your care costs more than that limit, you pay the rest. Research from KFF found that the average Medicare enrollee who used dental care still paid 874 dollars out of pocket. Those who needed the most care paid 2,136 dollars or more. For hearing care, some enrollees paid 3,600 dollars or more. Before open enrollment in October, read what your plan actually pays for, not just whether it says it offers dental or hearing benefits.
Understand the basics first
Source: KFF
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