Here’s the short answer: Children on Medicaid get vision, hearing, and dental nationwide under EPSDT. For adults, coverage exists in most states—but what’s included (exams, eyeglasses, hearing aids, crowns, dentures, etc.) varies by state and plan. Use the quick-lookup below and the 2-minute verification steps to confirm your benefits today. (EPSDT: Medicaid.gov.) Medicaid
What Medicaid must cover vs. what varies (kids vs. adults)
- Children (<21): The federal EPSDT benefit requires coverage of screening, diagnosis, and treatment for vision, hearing, and dental—including eyeglasses, hearing aids/cochlear implants, and medically necessary dental care. States must arrange treatment with reasonable promptness. (Medicaid.gov.) Medicaid
- Adults (21+): Vision, hearing, and dental are optional under federal law. States choose whether to cover them and set limits like frequency caps, prior auth, annual maximums, or device rules. (Medicaid.gov—Dental for Adults.) Medicaid
Bottom line: Kids—covered everywhere. Adults—check your state and plan.
What’s covered for children everywhere (EPSDT)
EPSDT is comprehensive: when a screening finds a problem, diagnosis and treatment must be covered, even if the service isn’t covered for adults in that state. That includes further testing, eyeglasses, hearing aids (and batteries), and cochlear implants when medically necessary. (Medicaid.gov EPSDT—Vision & Hearing). Medicaid
Source: Medicaid.gov EPSDT pages, last checked: September 9, 2025. Medicaid
Bottom line: If your child needs glasses, hearing aids, or dental treatment, EPSDT requires coverage.
Adult benefits at a glance (nationwide patterns, 2025)
Adult dental
- Availability: 47 states offer some adult dental coverage; generosity ranges from emergency-only to extensive (preventive, restorative, periodontal, dentures). (NCSL, 2025). NCSL
- Depth of coverage: As of 2022, 25 states + DC offered extensive adult dental benefits; others were limited or emergency-only. (KFF analysis). KFF
- Trend: Multiple states expanded adult dental in 2023–2025 (e.g., Hawaii, Tennessee, Maryland, Michigan, Kansas, New Hampshire). (CareQuest). CareQuest
Adult vision
- Variation: Adult routine eye exam and eyeglasses coverage differs widely; an NIH-supported 2024 study found some states cover annual/biannual exams and glasses, while others offer no coverage for one or both. National Eye InstitutePMC
Adult hearing
- Devices/services: Some states cover hearing aids or other devices for adults; coverage type, frequency, and dollar caps vary. (KFF indicators: hearing aids; speech/hearing services.) KFF+1
Sources: NCSL 2025; KFF State Health Facts; NIH/NEI (Health Affairs); CareQuest 2024–2025. Last checked: September 9, 2025. NCSLKFFNational Eye InstitutePMCCareQuest
Bottom line: Most adults have something for dental, many have some vision/hearing, but what and how much depends on your state’s rules.
Comparison table — what’s guaranteed vs. optional
| Benefit | Children (EPSDT) | Adults (21+) |
|---|---|---|
| Vision (exams, eyeglasses, treatment) | Required nationwide when medically necessary. | Optional; many states cover exams, fewer cover eyeglasses; limits common. |
| Hearing (testing, aids, cochlear implants) | Required nationwide when medically necessary. | Optional; some states cover aids/devices with limits (freq or dollar caps). |
| Dental (preventive & treatment) | Required nationwide when medically necessary. | Optional; 47 states offer some coverage; generosity varies. |
Sources: Medicaid.gov (EPSDT); KFF; NCSL. Last checked: September 9, 2025. MedicaidKFFNCSL
Bottom line: EPSDT = guaranteed for kids. Adults: coverage exists in most states but verify details.
How to check your exact state benefits in 2 minutes
- Dental (Adults): Open the CareQuest Medicaid Adult Dental Coverage Checker and select your state for a plain-English summary of what’s covered (preventive, restorative, dentures) and recent changes. CareQuest
- Vision & Hearing (Adults): Use KFF State Health Facts indicators:
- Optometrist services (exams), Eyeglasses, Hearing aids, and Speech/hearing services. Click your state on each map for the current status and limits. KFF+3KFF+3KFF+3
- Children (EPSDT) & disputes: If a child’s medically necessary item is denied (e.g., glasses or aids), cite EPSDT and appeal. Medicaid
Note: Some indicators reflect the most recent data year (often 2022–2024). Always cross-check with your state Medicaid website or your managed care plan.
Bottom line: Use CareQuest + KFF to confirm benefits, then check your plan handbook for specifics like copays or prior auth.
State-by-state quick-lookup table (2025 snapshot)
How to use this table: “Kids” shows EPSDT (always Covered). Adult columns summarize whether coverage typically exists in state policy as reflected by current KFF/CareQuest sources; exact scope & limits vary (e.g., frequency, dollar caps, dentures/implants rules, aid replacement intervals). Always verify via the steps above.
Legend: Dental — Some (limited or extensive), ER (emergency-only); Vision — Exam, Glasses (at least some FFS/MCO coverage reported); Hearing — Aids (some adult coverage). “—” indicates not routinely covered or unclear in latest public tables.
Due to space, we provide a compact 50-state reference. For granular sub-benefits (periodontics, bifocals, bone-anchored devices), use the KFF/CareQuest links cited.
| State | Kids (EPSDT) | Adults—Dental | Adults—Vision | Adults—Hearing | Notes |
|---|---|---|---|---|---|
| AL | Covered | Some/ER | —/— | — | Verify plan limits. |
| AK | Covered | Some | Exam+Glasses (annual) | — | Study noted annual coverage. National Eye Institute |
| AZ | Covered | Some | —/— | — | |
| AR | Covered | Some | —/— | — | 2025 updates for special needs dental ABM. CareQuest |
| CA | Covered | Some | Exam+Glasses (biannual) | — | National Eye Institute |
| CO | Covered | Some | Exam (biannual) | — | National Eye Institute |
| CT | Covered | Some | Exam+Glasses (biannual) | Aids (some) | National Eye InstituteKFF |
| DC | Covered | Some | Glasses only (noted) | Aids (some) | National Eye InstituteKFF |
| DE | Covered | Some | —/— | — | |
| FL | Covered | Some/ER | Exam+Glasses (biannual) | — | Study biannual exams/glasses. National Eye Institute |
| GA | Covered | Some/ER | —/— | — | |
| HI | Covered | Extensive (2023 expansion) | —/— | — | CareQuest |
| IA | Covered | Some | Exam+Glasses (biannual) | — | National Eye Institute |
| ID | Covered | Some | —/— | — | |
| IL | Covered | Some | Exam+Glasses (biannual) | Aids (some) | National Eye InstituteKFF |
| IN | Covered | Some | Less frequent | — | National Eye Institute |
| KS | Covered | Some (expanded) | Exam+Glasses (annual) | — | CareQuestNational Eye Institute |
| KY | Covered | Some (expanded) | —/— | — | CareQuest |
| LA | Covered | Some/ER | —/— | — | |
| MA | Covered | Some | Exam+Glasses (biannual) | Aids (some) | National Eye InstituteKFF |
| MD | Covered | Extensive (2023+) | —/— | — | CareQuest |
| ME | Covered | Some | Less frequent | — | National Eye Institute |
| MI | Covered | Some (expanded) | Exam+Glasses (biannual) | — | CareQuestNational Eye Institute |
| MN | Covered | Some | Exam+Glasses (biannual) | — | National Eye Institute |
| MO | Covered | Some | Exam+Glasses (biannual) | — | National Eye Institute |
| MS | Covered | Some/ER | Less frequent | — | National Eye Institute |
| MT | Covered | Some | Exam+Glasses (biannual) | Aids (some) | National Eye InstituteKFF |
| NC | Covered | Some | Exam+Glasses (biannual) | — | National Eye Institute |
| ND | Covered | Some (expanded) | Exam+Glasses (biannual) | — | CareQuestNational Eye Institute |
| NE | Covered | Some | Exam+Glasses (biannual) | — | National Eye Institute |
| NH | Covered | Extensive (2023) | —/— | — | CareQuest |
| NJ | Covered | Some | Exam+Glasses (annual) | — | National Eye Institute |
| NM | Covered | Some | —/— | ABP limits | Hearing aids not in ABP (19–20 yr excepted). KFF |
| NV | Covered | Some | Exam+Glasses (annual) | — | National Eye Institute |
| NY | Covered | Some | Exam+Glasses (biannual) | Aids (some) | National Eye InstituteKFF |
| OH | Covered | Some | Exam+Glasses (annual) | Aids (some) | National Eye InstituteKFF |
| OK | Covered | Some | —/— | — | |
| OR | Covered | Some | Exam (biannual) | — | National Eye Institute |
| PA | Covered | Some | Exam (biannual) | — | National Eye Institute |
| RI | Covered | Some | Exam+Glasses (biannual) | — | National Eye Institute |
| SC | Covered | Some/ER | —/— | — | |
| SD | Covered | Some (expanded) | Exam+Glasses (biannual) | — | CareQuestNational Eye Institute |
| TN | Covered | Extensive (2023) | —/— | — | CareQuest |
| TX | Covered | Some | Exam+Glasses (biannual) | — | National Eye Institute |
| UT | Covered | Some | —/— | — | |
| VA | Covered | Some | Exam (biannual) | — | National Eye Institute |
| VT | Covered | Some | Exam (biannual) | — | National Eye Institute |
| WA | Covered | Some | Exam only (noted) | — | DC glasses-only; WA exam-only noted in study context. National Eye Institute |
| WI | Covered | Some | Exam+Glasses (annual) | — | National Eye Institute |
| WV | Covered | Some | —/— | — | |
| WY | Covered | Some/ER | —/— | — |
Important: This table simplifies complex state policies and draws from the latest public indicators/research (2018–2024 data years for some KFF vision/hearing fields; dental expansions through 2025 noted). Always verify via your plan handbook or state Medicaid site.
Sources: KFF State Health Facts (vision/hearing indicators; dental services), CareQuest (adult dental checker), NIH/NEI 2024 study on adult vision coverage. Last checked: September 9, 2025. KFF+4KFF+4KFF+4CareQuestNational Eye Institute
Bottom line: Use this as a directional guide, then confirm specifics (frequency limits, device caps, dentures) for your plan.
Managed care vs. fee-for-service (FFS): why it matters
Many states deliver Medicaid through managed care organizations (MCOs). An MCO may add benefits (e.g., adult eyeglasses) or adjust provider networks, prior authorization, or frequency caps—so two people in the same state can see different experiences. KFF and Medicaid.gov note state flexibility beyond federal minimums; always check both the state policy and your plan handbook. KFF
Bottom line: Your plan can change the real-world benefit you get—even within the same state.
What’s changing in 2024–2027
- Adult dental momentum: States continued expanding adult dental in 2023–2025 (e.g., HI, TN, MD, MI, KS, NH; plus state-specific updates like AR in 2025 for special-needs adult dental). CareQuest+1
- Potential EHB shift: CMS now allows states to add routine adult dental to their Essential Health Benefits benchmarks, with the earliest effect Jan 1, 2027 (if submitted by May 7, 2025). This doesn’t automatically change Medicaid, but it may influence market alignment and access. State Health and Value Strategies
Bottom line: Expect more adult dental benefits in some states, but timelines and scope differ.
How to use your benefits (and avoid denials) — checklist
- Confirm eligibility & plan: Verify you’re enrolled and check your member handbook for vision/hearing/dental sections.
- Use the tools: CareQuest (adult dental) + KFF maps (adult vision/hearing) for a quick policy view; then confirm with your state Medicaid site. CareQuestKFF+3KFF+3KFF+3
- Find an in-network provider: Use your MCO’s directory; call to confirm they accept your specific plan.
- Get referrals/pre-auth: For hearing aids, crowns, dentures, or specialty care, obtain required documentation.
- For kids (EPSDT): If medically necessary services (e.g., eyeglasses, hearing aids) are denied, appeal citing EPSDT and include clinical notes. Medicaid
- Keep records: Save EOBs, prior-auth letters, and denial notices.
Bottom line: A few minutes upfront avoids surprise denials later.
Sensitive facts & citations (inline callouts)
- EPSDT scope (kids): Coverage of eyeglasses, hearing aids, batteries, cochlear implants when medically necessary. Source: Medicaid.gov, last checked Sept 9, 2025. Medicaid
- Adult dental availability: 47 states offer some adult dental (2025). Source: NCSL, last checked Sept 9, 2025. NCSL
- Extensive adult dental: 25 states + DC (as of 2022). Source: KFF, last checked Sept 9, 2025. KFF
- Adult vision variation: NIH/NEI-summarized 2024 study documents states with no coverage for exams/glasses vs. annual/biannual coverage. Source: NEI/Health Affairs, last checked Sept 9, 2025. National Eye Institute
Disclaimer
This article is educational and not legal, medical, or financial advice. Medicaid policies change; always confirm with your state Medicaid agency and your plan.
Key takeaways
- Kids: EPSDT guarantees medically necessary vision, hearing, and dental nationwide. Medicaid
- Adults: Benefits exist in most states, but what’s covered (glasses, hearing aids, dentures) varies. NCSLKFF
- Trends: Adult dental coverage is expanding in some states, and EHB changes could broaden access by 2027. CareQuestState Health and Value Strategies
- Action: Use CareQuest + KFF to verify your state today, then check your MCO handbook. CareQuestKFF+1
Next steps: Look up your state via the tools above, call your plan to confirm specifics, and book preventive visits now (cleanings/exams) to avoid emergency-only situations later.
FAQs
Does Medicaid cover eyeglasses for adults?
In many states, yes—but coverage frequency and lens/frame limits vary; some states offer no adult eyeglasses. Check KFF’s eyeglasses indicator and your plan. KFF
Are hearing aids covered by Medicaid for adults?
Some states cover adult hearing aids or related devices with frequency/dollar caps; others don’t. Confirm via KFF’s Hearing Aids and Other Hearing Devices indicator. KFF
Which states have extensive adult dental coverage under Medicaid?
As of 2022, 25 states + DC offered extensive adult dental; by 2025, several more states expanded benefits (e.g., HI, TN, MD, MI, KS, NH). Verify your state via CareQuest’s checker. KFFCareQuest
What dental benefits are guaranteed for children on Medicaid?
Under EPSDT, children get medically necessary dental screening and treatment in all states. Medicaid
What if my child’s glasses or hearing aids are denied?
Appeal and cite EPSDT—states must cover medically necessary diagnosis and treatment, including eyeglasses and hearing aids. Medicaid
Why do benefits differ between neighbors in the same state?
Managed care plans can add limits or extras and have different networks/prior auth rules; check your MCO handbook. KFF
Are adult dental benefits at risk during budget shortfalls?
Adult dental is optional and can face cuts; watch state budget updates and use preventive care early. Commonwealth Fund