Does Medicare Cover Knee Braces?
Medicare Part B may cover your knee brace if it is considered medically necessary. Read on to learn more.
If you have Medicare Part B and are suffering from knee pain, Medicare Part B may cover your knee brace.
In this article, we'll look at the coverage for medical equipment under Part B and the costs you may have to pay out of pocket.
Medicare Knee Brace Coverage
Medicare Part B covers a broad set of durable medical equipment (DME), including braces for the arms, legs, back and neck. However, the brace must be considered medically necessary by a doctor to be covered by Medicare.
Medicare.gov allows you to search for a DME supplier from their website. Simply enter your zip code to find a DME supplier in your area.
Competitive Bidding Program
The Medicare Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program changes the amount Medicare pays for certain DMEPOS items.
If you live in an a competitive bidding area for Medicare supplies, suppliers will submit bids to Medicare regarding how much they will charge. Qualified, accredited suppliers with winning bids are chosen as Medicare contract suppliers.
Paying for Your Brace
Even if Medicare Part B covers your knee brace, you must share in a portion of the costs. Some of the out-of-pocket costs you may be responsible for include:
- Part B deductible
Your Part B deductible must be paid before Medicare will pay its share. In 2023, the standard Part B deductible is $226 per year.
- Part B coinsurance
Once your deductible is met, Medicare will pay 80 percent of Medicare-approved services. You are responsible for the remaining 20 percent.
Learn more about common procedures that medicare covers.