Does Medicare Cover Knee Braces?

Medicare Part B may cover knee braces if deemed medically necessary. Medicare Advantage plans may also cover knee braces, and some Medicare Advantage plans may offer additional benefits not covered by Original Medicare.

Medicare Part B may cover your knee brace or other durable medical equipment if it is considered medically necessary by a doctor.

Medicare Advantage (Part C) plans may also cover knee braces that are deemed medically necessary.

Some Medicare Advantage plans also cover things like bathroom grab bars and other home mobility modifications.

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Does Medicare pay for knee support?

Medicare Part B covers a wide range of durable medical equipment (DME), including braces for the arms, legs, back and neck.

DME consists of items which:

  • Are ordered or prescribed by a physician
  • Are primarily used to serve a medical purpose
  • Are reusable
  • Are appropriate for use in the home
  • Are not useful to a person in the absence of illness or injury

How much do knee braces cost with Medicare?

Even if your knee brace is covered by Medicare, you may face some out-of-pocket costs, including:

  • Medicare Part B deductible
    $185 per year in 2019

  • Medicare Part B coinsurance
    You typically pay 20 percent of the Medicare-approved amount for most doctor’s services after you meet your Part B deductible

Medicare Advantage plans can cover braces

Medicare Advantage plans must provide the same hospital and medical benefits as Original Medicare (Medicare Part A and Part B).

This means that if your knee brace would be covered by Original Medicare, it will also be covered by a Medicare Advantage plan.

Medicare Advantage plans are sold by private insurance companies as an alternative to your Part A and Part B benefits.

In addition to the standard hospital and medical benefits provided by Original Medicare, most Medicare Advantage plans cover prescription drugs, and many offer additional benefits such as:

Find Medicare Advantage plans available near you

A licensed insurance agent can help you find Medicare Advantage plans in your area that may cover your medically necessary knee braces.

 

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