Dental and vision coverage basics: what's covered and how to compare
For children, dental and vision care are essential health benefits, so Marketplace coverage must make them available. For adults, dental isn't an essential health benefit, so you may need a separate dental plan. On the Marketplace you can only buy a stand-alone dental plan together with a health plan. Original Medicare generally doesn't cover routine dental care, routine eye exams or glasses, although many Medicare Advantage plans offer some of these extras. Check waiting periods and annual maximums before you buy.
Dental in the Marketplace
- Two ways to get it: a health plan that includes dental, or a separate (stand-alone) dental plan with its own premium.
- You can't buy a Marketplace dental plan on its own; you must be buying a health plan at the same time.
- Kids: dental coverage for children 18 and under must be available, either in a health plan or as a separate plan, though you don't have to buy it.
- Adults: dental isn't an essential health benefit, so health plans don't have to offer it.
- Waiting periods: separate dental plans can have waiting periods before they cover some adult services, and you pay premiums during that time. Ask before you enroll.
Vision coverage
Pediatric vision care is one of the essential health benefits for children in Marketplace plans. Adult vision coverage is usually a separate, optional benefit, offered through stand-alone vision plans, employers, or as an extra in some Medicare Advantage plans.
Medicare and dental/vision
Original Medicare generally doesn't cover routine dental care, dentures, routine eye exams or eyeglasses, and Medigap policies generally don't cover vision or dental either. Most Medicare Advantage plans offer extra benefits like vision, hearing and dental, but what's covered varies widely. Read the plan's Evidence of Coverage.
How to compare dental plans
- Monthly premium and deductible
- Annual maximum: the most the plan pays per year
- Coverage levels for preventive, basic (fillings) and major (crowns, root canals) care
- Waiting periods for basic and major services
- Whether your dentist is in network
- Orthodontia coverage, if you need it
Dental insurance vs discount dental plans
Discount (savings) dental plans aren't insurance. You pay a membership fee and get discounted rates from participating dentists, and you pay the dentist directly. They usually have no annual maximum or waiting period, but you pay every bill yourself. They can make sense for people who need work done soon or who've hit an insurance plan's annual maximum. Compare both on your expected dental costs.
Frequently asked questions
Is dental coverage required in Marketplace plans?
Dental coverage for children must be available, either in a health plan or as a separate dental plan, but you don't have to buy it. Adult dental isn't an essential health benefit.
Can I buy only a dental plan on HealthCare.gov?
No. You can only buy a Marketplace dental plan if you're buying a health plan at the same time. You can buy dental insurance directly from insurers outside the Marketplace.
Does Medicare cover dental and vision?
Original Medicare generally doesn't cover routine dental care, routine eye exams or eyeglasses. Many Medicare Advantage plans offer some dental, vision and hearing benefits.
Is a discount dental plan the same as dental insurance?
No. Discount plans aren't insurance; you pay a membership fee for reduced prices at participating dentists and pay the dentist yourself.
Sources
- HealthCare.gov: Dental coverage in the Marketplace (accessed October 28, 2026)
- HealthCare.gov: What Marketplace health insurance plans cover (accessed October 28, 2026)
- Medicare.gov: Your coverage options (accessed October 28, 2026)