Does Medicare Cover Ostomy Supplies?

Medicare typically does cover ostomy supplies that are deemed medically necessary by a doctor if you’ve had a colostomy, urinary ostomy or ileostomy.

Medicare Advantage (Part C) plans can also cover ostomy supplies if they are medically necessary.

A man smiles and talks with his doctor

What ostomy supplies does Medicare cover?

Ostomy supplies are covered by Medicare as prosthetic devices. Other prosthetic devices that can be covered by Medicare in certain instances include catheters, cardiac pacemakers and artificial limbs.

The ostomy supplies that Medicare Part B (medical insurance) may cover include:

  • Ostomy bags
  • Irrigation and flushing equipment
  • Necessary pieces required for ostomy attachment

Medicare will cover only the amount of ostomy supplies that you need, as determined by your doctor and based on your condition.

How much do ostomy supplies cost with Medicare?

If Medicare Part B covers your ostomy supplies, you will likely be responsible for paying the following out-of-pocket costs:

  • Part B deductible
    In 2019, the Part B deductible is $185 per year. Your Part B coverage does not kick in until you meet your deductible.

  • Part B coinsurance or copayment
    Once you meet your Part B deductible, you are typically responsible for a coinsurance or copayment of 20 percent of the Medicare-approved amount for your Part B-covered ostomy supplies.

Medicare Advantage plans can offer additional benefits

Medicare Advantage plans are sold by private insurance companies as an alternative to Original Medicare (Part A and Part B). These plans are required to offer at least the same benefits that are covered by Original Medicare.

If your ostomy supplies are covered by Original Medicare, they will also be covered by a Medicare Advantage plan.

Most Medicare Advantage plans cover prescriptions.

Some Medicare Advantage plans may also offer additional benefits, such as:

A licensed insurance agent can help you compare Medicare Advantage plans in your area that may cover your ostomy supplies. Learn more and find a plan that fits your needs if you’re eligible to enroll.

 

Compare Medicare Advantage plans in your area

Compare Plans

Or call TTY Users: 711 24/7 to speak with a licensed insurance agent.

Copyright © 2019 TZ Insurance Solutions LLC. All rights reserved.

MedicareAdvantage.com is a website owned and operated by TZ Insurance Solutions LLC. TZ Insurance Solutions LLC and TruBridge, Inc. represent Medicare Advantage Organizations and Prescription Drug Plans having Medicare contracts; enrollment in any plan depends upon contract renewal.

Plan availability varies by region and state. For a complete list of available plans, please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.

Medicare has neither reviewed nor endorsed this information.