Are Vision and Hearing Benefits Needed in Medicare?

A doctor checks a patient's ears with an otoscope.

Expanding Medicare coverage of vision and hearing services would provide needed benefits to a broad group of enrollees while only modestly increasing current Medicare spending levels.

The Issue

As Congress debates expanding Medicare coverage to include vision and hearing services, research from the Urban Institute shows that the majority of current spending on vision and hearing services among Medicare enrollees are paid out of pocket. One-third of individuals over the age of 65 report vision reduction and nearly half of Medicare enrollees self-report having trouble hearing.

Key Findings

  • In total, Medicare enrollees spent $8.4 billion on vision services in 2020, most of which ($5.4 billion) was paid as out of pocket expenses by enrollees.

  • Medicare enrollees spent $5.7 billion on hearing services in 2020, with $4.7 billion being paid out of pocket.

  • Spending on both vision and hearing services was relatively small compared to total Medicare spending of $1.1 trillion.

  • Utilization of and expenditures on vision and hearing services both increased markedly with income.


Researchers note that if Medicare were to cover vision and hearing services, it would primarily benefit lower income enrollee groups who likely have considerable unmet needs for these services and the increase in overall Medicare spending would be relatively small.

About the Urban Institute

The nonprofit Urban Institute is dedicated to elevating the debate on social and economic policy. For nearly five decades, Urban scholars have conducted research and offered evidence-based solutions that improve lives and strengthen communities across a rapidly urbanizing world. Their objective research helps expand opportunities for all, reduce hardship among the most vulnerable, and strengthen the effectiveness of the public sector. Visit the Urban Institute’s Health Policy Center for more information specific to its staff and its recent research.