Medicare Coverage by State

Original Medicare (Parts A & B) generally does not cover routine dental care such as cleanings, fillings, extractions, or dentures. However, Medicare Advantage (Part C) plans often include dental benefits, and Medicaid covers dental for dual-eligible beneficiaries in many states. Coverage and availability vary significantly by state — select your state above for details.

Original Medicare does not cover routine eye exams, prescription glasses, or contact lenses. However, Medicare Part B does cover glaucoma screenings for high-risk individuals and dilated eye exams for people with diabetes. Many Medicare Advantage plans offer annual vision benefits including exams and an eyewear allowance. Check your state's Medicaid program if you are a dual-eligible beneficiary.

Original Medicare does not cover hearing aids or hearing aid fitting exams. Since 2022, the FDA has approved over-the-counter (OTC) hearing aids for mild-to-moderate hearing loss, available without a prescription at major retailers for as little as $200–$1,500 per pair. Many Medicare Advantage plans include hearing aid allowances of $500–$2,500 per year. Some state Medicaid programs also cover hearing aids for dual-eligible members.

Medicare Part A covers skilled nursing facility (SNF) care for up to 100 days per benefit period, but only after a qualifying 3-day inpatient hospital stay. Days 1–20 are fully covered; days 21–100 require a daily coinsurance payment (approximately $204/day in 2025). Medicare does not cover long-term custodial care. Medicaid covers long-term nursing home costs for eligible low-income individuals. Contact your state SHIP for guidance.

Medicare Advantage (Part C) is an alternative to Original Medicare offered by private insurers approved by Medicare. It must cover everything Original Medicare covers, and most plans also include dental, vision, hearing, and prescription drug (Part D) benefits. Costs, provider networks, and extra benefits vary widely by plan and state. You can compare plans during the Annual Enrollment Period (Oct 15 – Dec 7) at Medicare.gov.

Dual-eligible individuals qualify for both Medicare and Medicaid. This typically means very low income and limited assets. Dual eligibles often receive significantly expanded benefits including dental, vision, hearing aids, and long-term care covered by Medicaid, with Medicare covering medical and hospital costs. Eligibility rules and covered services vary by state — click your state on the map above for details.

Key enrollment windows include: Initial Enrollment Period (IEP) — a 7-month window around your 65th birthday; Annual Enrollment Period (AEP) — Oct 15 to Dec 7 each year to join, switch, or drop a Medicare Advantage or Part D plan; Open Enrollment Period (OEP) — Jan 1 to Mar 31 to switch Medicare Advantage plans; and Special Enrollment Periods (SEPs) triggered by qualifying life events such as moving or losing employer coverage.

Every state has a SHIP (State Health Insurance Assistance Program) that provides free, unbiased, one-on-one Medicare counseling from trained volunteers. Call 1-800-MEDICARE (1-800-633-4227) anytime, or visit shiphelp.org to find your local SHIP office. Counseling is completely free and not affiliated with any insurance company.