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Medicare and Medicaid Dental, Vision, and Hearing Benefit Act of 2023

Source: Congress.gov  ·  5,284 words in original text
What This Bill Does
This bill adds coverage for dental, vision, and hearing services to Medicare and Medicaid. It allows Medicare to pay for services like cleanings, eye exams, and hearing aids. It also increases federal funding for states that cover these services through Medicaid. ##
Who It Affects
- Medicare beneficiaries (people age 65 and older, some younger people with disabilities) - Medicaid beneficiaries (low-income individuals, except those under 21 who already receive certain services) - State governments administering Medicaid - Dentists, optometrists, audiologists, and other healthcare providers ##
Key Provisions
- Medicare covers dental and oral health services including cleanings, fillings, root canals, extractions, and emergency dental care (Sec. 2(b)) - Medicare covers vision services including routine eye exams and procedures to check the focusing state of eyes (Sec. 3(b)) - Medicare covers hearing services including routine hearing exams and exams for hearing aids (Sec. 4(a)(2)) - Medicare payment for these services starts at 0 percent of costs in year one, increases by 10 percentage points each year for seven years, then reaches 80 percent coverage by year eight (Sec. 2(c)(2), Sec. 3(c)(2), Sec. 4(b)(2)) - Medicare limits routine dental cleanings to two per 12-month period and routine eye exams to one per 12-month period (Sec. 2(c)(3)(A), Sec. 3(c)(3)(A)) - States receive a 90 percent federal funding match for covering these services to Medicaid beneficiaries age 21 and older (Sec. 5) ##
What Changes
If this bill becomes law, Medicare begins covering dental work, eye care, and hearing services that are currently excluded. These services were previously not allowed under Medicare rules. Coverage gradually increases over seven years rather than starting immediately at full levels. For Medicaid, states receive higher federal funding to help pay for these same services for eligible adults. The bill removes previous legal prohibitions (called "grounds for exclusion") that prevented Medicare from covering these services. ##
Important Definitions
**Dental and oral health services** include routine cleanings and exams, fillings and crowns, root canals and extractions, emergency dental care, and other services related to dental or oral health as defined by the Secretary of Health and Human Services **Vision services** include routine eye exams and procedures to determine the focusing state of the eyes, plus other necessary services related to eye and vision health **Hearing services** include routine hearing exams, exams for hearing aids, and other necessary services related to hearing health **Low vision device** means a device prescribed by a physician that magnifies, enhances, or otherwise augments or interprets visual images, excluding ordinary eyeglasses or contact lenses **FMAP** (Federal Medical Assistance Percentage) means the share of Medicaid costs that the federal government pays for ##
Effective Date
Services become covered on January 1 of the first year beginning at least six months after the bill is signed into law (Sec. 2(g), Sec. 3(h), Sec. 4(e), Sec. 5)
Important: This plain English summary was generated by AI and is provided for informational purposes only. It is not legal advice. Always consult the official bill text on Congress.gov or a qualified attorney for legal matters.