Illinois Medicaid and Medicare 2025 Updates: What’s New for Dental, Vision, and Monthly Costs

ILLINOIS — Millions of older adults and low-income families in Illinois rely on Medicare or Medicaid for health coverage — and 2025 is bringing some major changes. From expanded dental benefits to new vision coverage and rising premiums, it’s more important than ever to understand what’s included and how to access these services.

Here’s a breakdown of the new benefits, application resources, and cost updates for Medicare and Medicaid users across Illinois in 2025.

New Dental Coverage for Medicaid in Illinois (2025)

Adult dental care under Illinois Medicaid has historically been limited, but the state expanded services in recent years — and 2025 brings continued improvements.

According to the Illinois Department of Healthcare and Family Services, Medicaid now covers:

• Routine dental exams and cleanings (every 6 months)

• Fillings, extractions, and x-rays

• Dentures and partials

• Root canals (molars now included under prior authorization)

• Periodontal cleanings for patients with diabetes or gum disease

Coverage applies to:

• Adults aged 21 and older on Medicaid

• Pregnant individuals (expanded prenatal dental program)

• Seniors covered under Medicaid-managed plans (like Meridian, Molina, etc.)

To use benefits, you must go to a Medicaid-participating dentist. Residents can check eligibility and providers through their managed care portal or by calling the Illinois Dental Program Hotline at 1-888-286-2447.

Medicare Vision & Dental: What’s Actually Covered in 2025?

Traditional Medicare Part A and B still do not cover routine dental or vision care — but most Medicare Advantage (Part C) plans in Illinois now include:

• Dental: exams, cleanings, x-rays, basic procedures

• Vision: annual eye exams and prescription glasses or contacts

• Hearing: hearing tests and discounts on hearing aids

For example:

• Aetna Medicare Advantage and Humana Gold Plus offer up to $2,000/year in dental coverage in Chicago ZIP codes

• Most plans include no-cost vision exams and $100–$200/year eyewear allowances

To compare your options, visit the Medicare Plan Finder tool or call 1-800-MEDICARE.

Premium and Deductible Changes for 2025

Medicare:

The Centers for Medicare & Medicaid Services (CMS) confirmed the following updates:

Deductibles are also increasing slightly:

• Part B deductible: now $248 (up from $240)

• Part A inpatient deductible: now $1,656 (up from $1,632)

Those with low income may qualify for:

• Extra Help (Part D subsidy)

• Illinois Medicare Savings Programs (can cover Part B premiums)

Medicaid:

No monthly premiums for standard Medicaid plans, but co-pays may apply for non-preventive services.
Some managed Medicaid plans are adding co-pay assistance for dental services in 2025.

How to Apply for Medicaid or Medicare in Illinois

Medicaid (Low-income families, pregnant individuals, disabled)

Apply through the Illinois ABE portal:
👉 abe.illinois.gov

You’ll need:

• Proof of income

• Social Security Number

• Immigration/citizenship status (if applicable)

In-person help is available through community navigators at:

• Catholic Charities of Chicago

• Erie Neighborhood House

• Access Community Health

Medicare (age 65+ or disabled):

Apply online through ssa.gov/medicare or call 1-800-772-1213

The Medicare open enrollment period is from October 15 to December 7, but you can apply earlier if:

• You’re turning 65

• You recently lost employer coverage

• You qualify for a special enrollment period

What Illinois Residents Should Watch for in 2025

• Vision and dental coverage varies by plan — check before scheduling care

• Many Medicaid users are being asked to renew their coverage for the first time since COVID

• Wait times to see dental or vision providers are increasing — schedule early

• Managed care plans are shifting provider networks — double check if your doctor or dentist still accepts your insurance

Are These 2025 Medicaid and Medicare Changes Helping You?

Let us know what’s working — or not — with your Illinois health coverage. Whether it’s delays, confusing provider lists, or helpful updates, we want to hear from you. Share your story at chicagosuburbanfamily.com and help other residents stay informed.